How does injury compensation affect health and disability in patients with complaints of whiplash? A qualitative study among rehabilitation experts-professionals.

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van der Meer, Suzan; Pieterse, Marcel; Reneman, Michiel; Verhoeven, Jan; van der Palen, Job

2016-01-01

To explore rehabilitation professionals' opinions about the influence and the pathways of injury compensation (IC) on health and disability in patients with whiplash associated disorder (WAD). Semi-structured interviews were performed among a purposeful selected sample of Dutch expert-professionals in the field of rehabilitation of patients with WAD. Inclusion continued until saturation was reached. Inductive and deductive thematic analyses were performed. Ten rehabilitation expert-professionals (five females), working as physician, psychologist or physiotherapist, were interviewed. All expert-professionals acknowledged that IC can influence rehabilitation, health and disability. The expert-professionals provided three causal pathways; a pathway through prolonged distress, a behavioral pathway, and patient characteristics that may either attenuate or worsen their response. They assess the influence of IC mainly with interview techniques. Most professionals discuss the potential influence of IC with their patients, because they want to give clear information to the patient. Some emphasize that their role is neutral in relation with the IC. Others mention that financial consequences can accompany functional improvement. Rehabilitation expert-professionals believe that IC may affect rehabilitation, health and disability in patients with WAD. Three pathways are mentioned by the experts-professionals. According to rehabilitation expert-professionals, an injury compensation (IC) can lead to distress, by creating a (conscious or unconscious) conflict of interests within a patient between striving for compensation on one hand, and recovery on the other hand. Patient characteristics can either attenuate or worsen IC-related distress. Reliable and valid tools need to be developed to assess the influence of IC on health, disability and rehabilitation, and to limit the negative effects. Rehabilitation professionals can discuss the possible unintended effects of IC with their

Health-Improving Rehabilitation Program of Pysical Education at Higher School

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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. 

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

Congruence or Discrepancy? Comparing Patients' Health Valuations and Physicians' Treatment Goals for Rehabilitation for Patients with Chronic Conditions

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Nagl, Michaela; Farin, Erik

2012-01-01

The aim of this study was to test the congruence of patients' health valuations and physicians' treatment goals for the rehabilitation of chronically ill patients. In addition, patient characteristics associated with greater or less congruence were to be determined. In a questionnaire study, patients' health valuations and physicians' goals were…

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

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Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

Cardiac Rehabilitation: MedlinePlus Health Topic

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... in Spanish Electrocardiogram (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cardiac Rehabilitation updates ... How to take your pulse Pulse Related Health Topics Heart Attack Heart Diseases How to Prevent Heart ...

Gait characteristics after gait-oriented rehabilitation in chronic stroke.

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Peurala, Sinikka H; Titianova, Ekaterina B; Mateev, Plamen; Pitkänen, Kauko; Sivenius, Juhani; Tarkka, Ina M

2005-01-01

To assess the effects of rehabilitation in thirty-seven ambulatory patients with chronic stroke during three weeks in-patient rehabilitation period. In the intervention group, each patient received 75 min physiotherapy daily every workday including 20 minutes in the electromechanical gait trainer with body-weight support (BWS). In the control group, each patient participated in 45 min conventional physiotherapy daily. Motor ability was assessed with the first five items of the Modified Motor Assessment Scale (MMAS1-5) and ten meters walking speed. Spatio-temporal gait characteristics were recorded with an electrical walkway. The MMAS1-5 (pgait characteristics improved only in the intervention group, as seen in increased Functional Ambulation Profile score (p=0.023), velocity (p=0.023), the step lengths (affected side, p=0.011, non-affected side p=0.040), the stride lengths (p=0.018, p=0.006) and decreased step-time differential (p=0.043). Furthermore, all gait characteristics and other motor abilities remained in the discharge level at the six months in the intervention group. It appears that BWS training gives a long-lasting benefit in gait qualities even in chronic stroke patients.

Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences.

Science.gov (United States)

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization's 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance). The development of recommendations based on situation analysis and best-available data is crucial. In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT)) were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders). The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

[Networking as a subject of research and quality characteristic of rehabilitation].

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Mau, W

2010-12-01

Rehabilitation has to meet numerous challenges in the sectorized health service and social security system. Rehabilitation science has analysed these problems at the interfaces between different actors and domains of care in a number of studies. In research projects and quality assurance, the solution-oriented and networking aspects of rehabilitation particularly of persons with chronic illnesses and disabilities are of interest. Therefore, exemplary studies concerning interface analyses leading to solutions and networking activities are discussed in this article. Different problems and fields of action regarding access to rehabilitation are presented: the role of physicians in practice concerning the patients' applications for rehabilitation, post-acute rehabilitation since introduction of the Diagnosis Related Groups in the acute hospital setting, and the involvement of companies and different funding agencies. With regard to networking in rehabilitation, issues dealt with are work-related interventions as well as challenges for the rehabilitation team concerning joint presentation of concepts in the face of an increasing differentiation of competences and a new distribution of roles and tasks. In this context, quality management within the rehabilitation facilities as well as internal and external patient-orientation including shared decision-making are highly significant during the rehabilitation process. The planning of activities to be realized after discharge from the rehabilitation facility is dealt with in greater detail in view of recommendations for and implementation of physical activities and stepwise return-to-work measures. Rehabilitation has an important course-setting function by supporting rehabilitants on their way toward self-management. Networking within, including and by means of rehabilitation requires considerable effort, which needs to be followed along by research and quality assurance. Due to its multifaceted competences and experiences

Obesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach.

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Gianluca eCastelnuovo

2014-06-01

Full Text Available Obesity is currently an important public health problem of epidemic proportions (globesity. Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach by enhancing the steps specified by psychological and medical treatment protocols. These outcomes may be augmented further by the mHealth approach, through creating new treatment delivery methods to increase compliance and engagement. mHealth (m-health, mobile health can be defined as the practice of medicine and public health, supported by mobile communication devices for health services and information. mHealth applications which can be implemented in weight loss protocols and obesity rehabilitation are discussed, taking into account future research directions in this promising area.

Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

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Margrit Löbner

Full Text Available OBJECTIVE: To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient and setting-specific rehabilitation outcomes. METHODS: 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. RESULTS: 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. CONCLUSION: 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

Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences

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Christoph Gutenbrunner

2017-06-01

Full Text Available Objective: Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization’s 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance. The development of recommendations based on situation analysis and best-available data is crucial. Methods: In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. Results: The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders. Conclusion: The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

Rehabilitation Research at the National Institutes of Health:

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Bean, Jonathan F.; Damiano, Diane; Ehrlich-Jones, Linda; Fried-Oken, Melanie; Jette, Alan; Jung, Ranu; Lieber, Rick L.; Malec, James F.; Mueller, Michael J.; Ottenbacher, Kenneth J.; Tansey, Keith E.; Thompson, Aiko

2017-01-01

Abstract Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the American With Disabilities Act, the NIH established the National Center for Medical Rehabilitation Research with the goal of developing and implementing a rehabilitation research agenda. Currently, a total of 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Dr Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference under the title “Rehabilitation Research at NIH: Moving the Field Forward.” This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future. This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: Frontera WR, Bean JF, Damiano D, et al. Am J Phys Med Rehabil. 2017;97(4):393–403. PMID:28499004

Rehabilitation time before disability pension.

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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.

Rehabilitation time before disability pension

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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.

The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review.

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Frier, Amanda; Barnett, Fiona; Devine, Sue

2017-05-01

This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation. A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered. Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible. Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation. Implications for Rehabilitation Social determinants of health are important to consider in the rehabilitation of neurological conditions. Understanding the interplay between the social determinants of health and neurological rehabilitation may enhance the possible outcomes for those requiring rehabilitation. Increased awareness and capacity of health care professionals involved in neurological rehabilitation may hasten momentum towards decreased health

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

Objective To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. Methods 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. Results 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). Conclusion 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

Rehabilitation in Madagascar: Challenges in implementing the World Health Organization Disability Action Plan.

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Khan, Fary; Amatya, Bhasker; Mannan, Hasheem; Burkle, Frederick M; Galea, Mary P

2015-09-01

To provide an update on rehabilitation in Madagascar by using local knowledge to outline the potential barriers and facilitators for implementation of the World Health Organization (WHO) Disability Action Plan (DAP). A 14-day extensive workshop programme (September-October 2014) was held at the University Hospital Antananarivo and Antsirabe, with the Department of Health Madagascar, by rehabilitation staff from Royal Melbourne Hospital, Australia. Attendees were rehabilitation professionals (n=29) from 3 main rehabilitation facilities in Madagascar, who identified various challenges faced in service provision, education and attitudes/approaches to people with disabilities. Their responses and suggested barriers/facilitators were recorded following consensus agreement, using objectives listed in the DAP. The barriers and facilitators outlined by participants in implementing the DAP objectives include: engagement of health professionals and institutions using a multi-sectoral approach, new partnerships, strategic collaboration, provision of technical assistance, future policy directions, and research and development. Other challenges for many basic policies included: access to rehabilitation services, geographical coverage, shortage of skilled work-force, limited info-technology systems; lack of care-models and facility/staff accreditation standards; limited health services infrastructure and "disconnect" between acute and community-based rehabilitation. The DAP summary actions were useful planning tools to improve access, strengthen rehabilitation services and community-based rehabilitation, and collate data for outcome research.

Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy.

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Prodinger, Birgit; Cieza, Alarcos; Oberhauser, Cornelia; Bickenbach, Jerome; Üstün, Tevfik Bedirhan; Chatterji, Somnath; Stucki, Gerold

2016-06-01

To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions. Secondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations. Along the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings. Persons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264. Not applicable. For regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively. Thirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF. The identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across

Rehabilitation and everyday life in people with stress-related ill health

OpenAIRE

Eriksson, Therese

2012-01-01

The overall aim was to explore and describe knowledge of the perceived occupational repertoire in people with stress-related ill health and their experiences from the rehabilitation process, with a specific focus on rehabilitation in a therapeutic garden and how the rehabilitation experiences are connecting with everyday life. Study I was a cross-sectional study that aimed to describe and compare how occupational gaps were reported in everyday occupations in a rehabilitation group of pe...

[Psychosocial rehabilitation: perceptions of the mental health staff].

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Jorge, Maria Salete Bessa; Randemark, Norma Faustino Rocha; Queiroz, Maria Veraci Oliveira; Ruiz, Erasmo Miessa

2006-01-01

This study is inserted in assumptions of research's analysis qualitative which objective was to interpretate the Mental Health professional's perspectives about psychosocial rehabilitation of mental disorder's porter to know as them proceed it in their professional practice. Data collection came up by the application of semi-structured interviews to 8 Mental Health professionals that work in the Center of Psychosocial Attention. After the readings, notes of pieces of talk, subcategories and categories were composed after the interpretation based on the literature. The results pointed that psychosocial rehabilitation is a process which implementation and still needs effective overcome of traditional paradigma of health mental disease, that form conception and therapeutic practices and requires trust of professionals about the users' capacity of live as citizen in the most variable segments of social life.

Responding to the World Health Organization Gobal Disability Action Plan in Ukraine: Developing a National Disability, Health and Rehabilitation Plan

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Christoph Gutenbrunner

2017-11-01

Full Text Available In order to support the development of a National Disability, Health and Rehabilitation Plan (NDHRP for Ukraine, a technical consultation was carried out by a Rehabilitation Advisory Team (RAT of the International Society of Physical and Rehabilitation Medicine (ISPRM in 2015. The consultation was based on assessment of the situation of persons with disabilities and the rehabilitation system in Ukraine. Recommendations for activities and projects to improve rehabilitation services within the healthcare system were developed and proposed. In order to reach consensus on the recommendations, dialogues were held with different stakeholders, including the Ministry of Public Health. The recommendations included: coordination of disability and rehabilitation policies within the Ministry of Public Health and among other involved ministries; translation and adaptation of international definitions of functioning, disability, and assessment tools into Ukrainian; data collection on the epidemiology of disability and the need for rehabilitation; implementation of health-related rehabilitation services; and implementation of international definitions and curricula of rehabilitation professions. The mission was regarded as successful and one year later a few changes had been adopted by the Ukrainian government. Further action based on this research is necessary. It will be important to track the changes and evaluate the results after an appropriate period of time.

Parents' mental health and psychiatric expertise in child welfare family rehabilitation.

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Riihimäki, Kirsi

2015-02-01

Parents' mental health disorders are not well known within child welfare services. First, to assess the mental health disorders and treatment needs of parents participating in the child welfare-centred family rehabilitation; Second, to evaluate the work of psychiatric nurses and the effectiveness of consultations by psychiatrists in such cases. During 2010, a total of 141 parents participated in child welfare-centred family rehabilitation. The primary psychiatric disorders of parents not currently receiving psychiatric care were assessed, as was the appropriate treatment for them. The majority of parents in child welfare-centred family rehabilitation suffered from severe mental health disorders, often unrecognized and untreated. As much as 93% of parents were referred to mental health or substance abuse treatment, almost half of them to secondary care. The work of psychiatric nurses and consultations by psychiatrists were found to be useful. Most parents suffered from severe unrecognized and untreated mental health disorders. There is a high demand for adult-psychiatric expertise in child welfare.

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

Science.gov (United States)

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

2016-04-01

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

Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

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Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

2015-02-01

Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait.

Science.gov (United States)

Omu, Onutobor; Reynolds, Frances

2012-01-01

The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere.

[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.

Lumbar spinal fusion patients' demands to the primary health sector: evaluation of three rehabilitation protocols

DEFF Research Database (Denmark)

Soegaard, Rikke; Christensen, Finn B; Lauerberg, Ida

2006-01-01

Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patie...... service utilization in the primary health care sector as compared to the usual regimen and a training exercise regimen. The results stress the importance of a cognitive element of coping in a rehabilitation program.......Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patient......-articulated demands to the primary health care sector following lumbar spinal fusion and three different in-hospital rehabilitation regimens in a prospective, randomized study with a 2-year follow-up. Ninety patients were randomized 3 months post lumbar spinal fusion to either a 'video' group (one-time oral...

Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

Science.gov (United States)

Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

2017-10-02

Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the

Bleeding frequency and characteristics among hematologic malignancy inpatient rehabilitation patients with severe thrombocytopenia.

Science.gov (United States)

Fu, Jack B; Tennison, Jegy M; Rutzen-Lopez, Isabel M; Silver, Julie K; Morishita, Shinichiro; Dibaj, Seyedeh S; Bruera, Eduardo

2018-03-28

To identify the frequency and characteristics of bleeding complications during acute inpatient rehabilitation of hematologic malignancy patients with severe thrombocytopenia. Retrospective descriptive analysis. Comprehensive cancer center acute inpatient rehabilitation unit. Consecutive hematologic malignancy patients with a platelet count of less than or equal to 20,000/microliter (μL) on the day of acute inpatient rehabilitation admission from 1/1/2005 through 8/31/2016. Medical records were retrospectively analyzed for demographic, laboratory, and medical data. Patients were rehabilitated using the institutional exercise guidelines for thrombocytopenic patients. Bleeding events noted in the medical record. Out of 135 acute inpatient rehabilitation admissions, 133 unique patients were analyzed with a total of 851 inpatient rehabilitation days. The mean platelet count was 14,000/μL on the day of admission and 22,000/μL over the course of the rehabilitation admission. There were 252 days of inpatient rehabilitation where patients had less than 10,000/μL platelets. A total of 97 bleeding events were documented in 77/135 (57%) admissions. Of the 97 bleeding events, 72 (74%), 14 (14%), and 11 (11%) were considered to be of low, medium, and high severity, respectively. There were 4/97 (4%) bleeding events that were highly likely attributable to physical activity but only 1/4 was considered high severity. Bleeding rates were .09, .08, .17, and .37 for > 20,000, 15-20,000, 10-15,000, and rehabilitation in severely thrombocytopenic hematologic cancer patients. Bleeding rates increased with lower platelet counts. However, using the exercise guidelines for severely thrombocytopenic patients, the risk of severe exercise-related bleeding events was low.

Oral health-related quality of life after prosthetic rehabilitation in patients with oral cancer: A longitudinal study with the Liverpool Oral Rehabilitation Questionnaire version 3 and Oral Health Impact Profile-14 questionnaire.

Science.gov (United States)

Dholam, K P; Chouksey, G C; Dugad, J

2016-01-01

Prosthodontic rehabilitation helps to improve the oral health-related quality of life (OHRQOL). The Liverpool Oral Rehabilitation Questionnaire (LORQ) and Oral Health Impact Profile (OHIP) are specific tools that measure OHRQOL. The primary objective of this study was to assess the impact of oral rehabilitation on patients' OHRQOL following treatment for cancer of oral cavity using LORQ version 3 (LORQv3) and OHIP-14 questionnaire. Secondary objectives were to identify issues specific to oral rehabilitation, patients compliance to prosthetic rehabilitation, the effect of radiation treatment on prosthetic rehabilitation, to achieve meaningful differences over a time before & after prosthetic intervention, to carryout and document specific patient-deprived problem. Seventy-five oral cancer patients were studied. Patients were asked to rate their experience of dental problems before fabrication of prosthesis and after 1 year using LORQv3 and OHIP-14. The responses were compared on Likert scale. Patients reported with extreme problems before rehabilitation. After 1 year of prosthetic rehabilitation, there was improvement noticed in all the domain of LORQv3 and OHIP-14. Complete compliance to the use of prosthetic appliances for 1 year study period was noted. In response to the question no. 40 (LORQv3), only 15 patients who belonged to the obturator group, brought to notice the problems which were not addressed in the LORQv3 questionnaire. The study showed that the oral cancer patients coped well and adapted to near normal oral status after prosthetic rehabilitation. This contributed to the improved overall health-related quality of life.

Social support and subjective health complaints among patients participating in an occupational rehabilitation program

OpenAIRE

Øyeflaten, Irene; Gabriele, Jeanne M.; Fisher, Edwin B.; Eriksen, Hege R.

2010-01-01

Objectives: To examine differences in rehabilitation patients' social support received from rehabilitation staff and from support providers outside rehabilitation, and to examine the relationships between social support and the patients' reports of subjective health complaints (SHC). Methods: 131 patients (68 % females, mean age 45 years) participating in a 4-week, inpatient, occupational rehabilitation program were included. All patients completed questionnaires on demographic variables, SHC...

Developing post-disaster physical rehabilitation: role of the World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine.

Science.gov (United States)

Gosney, James; Reinhardt, Jan Dietrich; Haig, Andrew J; Li, Jianan

2011-11-01

This special report presents the role of the World Health Organization (WHO) Liaison Sub-Committee on Rehabilitation Disaster Relief (CRDR) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in developing an enhanced physical rehabilitation relief response to large-scale natural disasters. The CRDR has stated that disaster rehabilitation is an emerging subspecialty within physical and rehabilitation medicine (PRM). In reviewing the existing literature it was found that large natural disasters result in many survivors with disabling impairments, that these survivors may have better clinical outcomes when they are treated by PRM physicians and teams of rehabilitation professionals, that the delivery of these rehabilitation services to disaster sites is complicated, and that their absence can result in significant negative consequences for individuals, communities and society. To advance its agenda, the CRDR sponsored an inaugural Symposium on Rehabilitation Disaster Relief as a concurrent scientific session at the 2011 ISPRM 6th World Congress in San Juan, Puerto Rico. The symposium included oral and poster presentations on a range of relevant topics and concluded with an international non-governmental organization panel discussion that addressed the critical question "How can rehabilitation actors coordinate better in disaster?" Building upon the symposium, the CRDR is developing a disaster rehabilitation evidence-base, which will inform and educate the global professional rehabilitation community about needs and best practices in disaster rehabilitation. The Journal of Rehabilitation Medicine (JRM) has commissioned this special report to announce a series of papers on disaster rehabilitation from the symposium's scientific programme. Authors are invited to submit papers on the topic for inclusion in this special series. JRM also encourages expert commentary in the form of Letters to the Editor.

Sex differences in health status and rehabilitation outcomes in patients with atrial fibrillation treated with ablation

DEFF Research Database (Denmark)

Wagner, Mette Kirstine; Zwisler, Ann-Dorthe Olsen; Risom, Signe Stelling

2018-01-01

(EHRA) score I-II had a positive effect of rehabilitation. CONCLUSION: The results suggest that sex differences exist in self-reported health after rehabilitation in patients ablated for AF. Patients with an I-II EHRA score seem more likely to gain from the rehabilitation programme compared with those......BACKGROUND: Increased physical capacity after comprehensive rehabilitation in patients with atrial fibrillation (AF) undergoing ablation has been found in the CopenHeartRFA trial. The purpose of this study was to investigate: (a) sex differences in health status, psychological distress and quality...... of life, (b) sex differences in rehabilitation outcomes and (c) predictors of effect of rehabilitation. METHODS: We conducted an exploratory analysis of data from the randomized CopenHeartRFA trial, where patients treated with ablation were randomized with 1:1 to comprehensive rehabilitation consisting...

Rehabilitation of patients with chlamydial spondyloarthritis at the health resortv

Directory of Open Access Journals (Sweden)

V.M. Sokrut

2017-02-01

Full Text Available Background. Rehabilitation of patients with chlamy­dial spondyloarthritis (CSA under the conditions of the health resort remains undeveloped, there are not enough data to elucidate the mechanism of natural and preformed physical factors in such category of patients, the criteria for the effectiveness of rehabilitation measures not yet defined. The objective of the study: to evaluate the results of treatment in patients with CSA in a Slaviansk balneological health resort. Materials and methods. The research included 117 patients, who were treated at the rheumatological clinic, and then underwent rehabilitation in health resort, which has continental sulfide lake muds and brines with highly minerali­zed chloride-sodium composition. Among the patients under the study, there were 61 % of males and 39 % of females with an average age of 35 years. Both genders did not differ in the duration of illness (median of 7 years and the degree of activity of the pathological process. Seropositivity for rheumatoid factor is detected in 2 % of patients, and by the presence of antibodies to cyclic citrulline peptide — in 70 %. During the resort stage, in 91 % of cases of СSA, Chlamydia trachomatis was found in prostatic secretions, scrapings from the urethra, cervix, vaginal walls, 83 % reported positive serological tests for chlamydial infection. Results. Analysis of the results showed that in 3 % of cases the effect was absent, in 14 % there was a slight improvement, in 50 % — an improvement and in 33 % — a significant improvement. The effectiveness of sanatorium stage of rehabilitation for women was higher, and due to increasing degree of disease activity, the positive results were getting worse. A significant adverse effect on the efficiency of sanatorium and health resort treatment activity has the presence of sacroiliitis and cardiac pathology in patients. Differences in the effectiveness of rehabilitation of patients depends on the types of the

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

Clinical Characteristics and Low Vision Rehabilitation Methods for Partially Sighted School-Age Children.

Science.gov (United States)

Özen Tunay, Zuhal; Çalışkan, Deniz; İdil, Aysun; Öztuna, Derya

2016-04-01

To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of diagnosis, accompanying ocular findings, visual acuity of the children both for near and distance with and without low vision devices, and the methods of low vision rehabilitation (for distance and for near) were determined. The demographic characteristics of the children and the parental consanguinity were recorded. The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7%) of them were male and 62 (41.3%) of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36%) followed by cortical visual impairment (18%). The most frequently used rehabilitation methods were: telescopic lenses (91.3%) for distance vision; magnifiers (38.7%) and telemicroscopic systems (26.0%) for near vision. A significant improvement in visual acuity both for distance and near vision were determined with low vision aids. A significant improvement in visual acuity can be achieved both for distance and near vision with low vision rehabilitation in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation.

Research supporting the congruence between rehabilitation principles and home health nursing practice.

Science.gov (United States)

Neal, L J

1999-01-01

A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

Science.gov (United States)

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

Bio-energetic rehabilitation of human health with use of therapeutic fasting

International Nuclear Information System (INIS)

Kechutkina, E.M.; Inyushin, V.M.; Asanov, D.R.

2000-01-01

The work devoted to study of mothers' and children's coming from ecologically unfavorable regions rehabilitation measures effectiveness and health improvement in condition of sanatorium-resort conditions. Comprehensive approach was developed in this direction. The approach includes of bio-energetic, psychologic, clearing measures in combination with weight-out faltering and observation of health status with help of electro-physiological methods. In result of conducted study and following analysis positive influence of hunger (in complex with resonance photoactivation bio-energetic excesses, psycho-training) process of bio-energetic rehabilitation of human health. It is concluded that most powerful energizing of reserve opportunities of body takes place at complete refusal from food and transition on internal nourishment (endogenous) that was confirm at 7-day festering by indexes of homeostasis shift

Rehabilitation and Care of the Handicapped.

Science.gov (United States)

Engberg, Eugenie; And Others

An overview of services to help the handicapped is given in light of the characteristics of social conditions and social development in Denmark, and the history of rehabilitative care is examined. Information is given on the following areas: legislative, organization and financing; the national health service; the general education of handicapped…

Health-related quality of life in rehabilitants with different cancer entities.

Science.gov (United States)

Lamprecht, J; Thyrolf, A; Mau, W

2017-09-01

The focus of the study is the analysis of changes in health-related quality of life in various cancer entities during and after an inpatient rehabilitation programme. In a multicentre longitudinal study, a total of 211 cancer patients (breast cancer: N = 84; prostate cancer: N = 90; colon cancer: N = 37) were asked about their quality of life (EORTC QLQ-C30; HADS) at the beginning, the end and 3 months after the end of the rehabilitation programme. In different domains of quality of life significant and mostly clinically relevant improvements were found during rehabilitation. The breast and prostate cancer patients improved most in emotional functioning, colon cancer patients in global quality of life. With regard to the severity of symptoms, the fatigue burden improved in breast and colon cancer patients, nausea in the prostate cancer patients. However, they are increases 3 months after rehabilitation. Functional burdens improved 3 months after the end of rehabilitation in the physical domain for all cancer patients. For breast cancer patients, emotional functioning decreased significantly 3 months after rehabilitation. An inpatient oncological rehabilitation programme can lead to an improvement in quality of life. © 2016 John Wiley & Sons Ltd.

Characteristics of successful and unsuccessful completers of 3 postacute brain injury rehabilitation pathways.

Science.gov (United States)

Malec, James F; Degiorgio, Lisa

2002-12-01

To determine whether successful participants along different postacute brain injury rehabilitation pathways differ on demographic, injury-related, disability, and outcome variables. Secondary analysis of pre- and posttreatment, and 1-year follow-up data obtained in a previous study of specialized vocational services (SVS) for persons with brain injury. Outpatient brain injury rehabilitation clinic. One hundred fourteen persons with acquired brain injury. Participants in 3 distinct rehabilitation pathways were studied: SVS only; SVS and a 3-h/wk community reintegration outpatient group; and SVS and 6-h/d comprehensive day treatment (CDT). Mayo-Portland Adaptability Inventory (MPAI); Vocational Independence Scale; and "success," as defined by community-based employment (CBE) at 1-year follow-up. The percentage (77%-85%) of participants in CBE at 1-year follow-up did not differ among the 3 pathways. CDT participants had more limited educational backgrounds, were less recently injured, and showed greater disability and more impaired self-awareness than those receiving limited intervention (ie, SVS or community reintegration outpatient group). MPAI scores for limited-intervention participants who were unsuccessful were similar in level to successful participants in CDT. Logistic regression models were developed to predict the probability of success with limited intervention and CDT. Different rehabilitation pathways result in CBE for a large percentage of persons with brain injury if the intensity of service is appropriately matched to the severity of the disability, the time since injury, and other participant characteristics. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan

Directory of Open Access Journals (Sweden)

Christoph Gutenbrunner

2018-01-01

Full Text Available Objective: A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. Methods: The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. Results and discussion: The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

Communication Framework for Tele-rehabilitation Systems with QoS Guarantee

Directory of Open Access Journals (Sweden)

Dandanov Nikolay

2017-01-01

Full Text Available Nowadays, there is great interest in developing telemedicine technologies. These technologies will provide health care from distance swiftly and lightly, as well as reduce the expenses for activities, such as rehabilitation. Telemedicine applications are possible due to the advances in information technologies and the ever-expanding communication network infrastructure. The network characteristics bandwidth, packet loss, latency, jitter and policies are crucial for the performance of tele-rehabilitation systems. Because in tele-rehabilitation human lives are at stake, guaranteeing the Quality of Service (QoS is important. In this paper, an approach for assuring the QoS for information transmission in tele-rehabilitation systems is proposed.

[The development of the system of medical rehabilitation based at the Russian health resort facilities: investment prospects].

Science.gov (United States)

Povazhnaya, E L; Gusakova, E V; Moiseenko, S V

2018-05-21

The present work is devoted to the prospects for attracting investments for the maintenance and development of the medical rehabilitation practices based at the Russian health resort facilities. The article describes the prerequisites for the enhancement of the investment attractiveness of the development of the system of medical rehabilitation in the said institutions including the formulation and strengthening of the legal and regulatory framework, the capacity for the organization of the second and third stages of medical rehabilitation in the existing spa and health resort facilities, the attraction of the funds of compulsory medical insurance as an additional source of the financial support. The main legal documents regulating the organization and provision of medical rehabilitation based at the spa and health resort facilities are presented. The results of the implementation of the investment concept of the development of medical rehabilitation in the framework of the system of health resort treatment as exemplified by the experience of JSC «The group of companies «Medsi» are discussed. It is shown that the development of medical rehabilitation based at the spa and health resort facilities greatly contributes to the significant expansion of the potential customer base and promotes the further growth of business scale.

Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study.

Science.gov (United States)

Bolger, Ashlee; Collins, Andrew; Michels, Michelle; Pruitt, David

2018-03-14

Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known. To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms. Retrospective study. Inpatient rehabilitation unit within a large children's hospital. All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period. Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics. 30 admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P conversion disorder and leads to sustained functional improvement and return to school after discharge. ?? Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study.

Science.gov (United States)

Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

2017-08-11

Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards

Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation

NARCIS (Netherlands)

Iancu, S.C.; Zweekhorst, M.B.M.; Veltman, D.J.; van Balkom, A.J.L.M.; Bunders-Aelen, J.G.F.

2015-01-01

Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were

Impact of cardiac rehabilitation on health related quality of life.

LENUS (Irish Health Repository)

Riaz, A

2012-02-01

Cardiac rehabilitation (CR) programs are recognized as integral part of the comprehensive care of patients with cardiovascular disease and are recommended as useful and effective (Class I) by the American Heart Association (AHA). In this study we used serial administration of the short form 36 (SF36) to evaluate patient\\'s response to CR in terms of improvement in Health related Quality of Life. A total of 49 patients were included in the analysis. There was a significant improvement observed after CR in the Physical Capacity Score (42.3 vs 49.9 p = 0.0005). There was no significant improvement in the Mental Capacity Score (54.8 vs 54.9 p = 0.96). We conclude that Cardiac Rehabilitation Program causes a significant improvement in the health related quality of life of patients by improving their physical health and well being but does not improve the mental capacity which is already at a healthy level before CR.

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.

Uganda--rehabilitation, or redefinition of health services?

Science.gov (United States)

Dodge, C P

1986-01-01

Uganda had one of the best health care delivery systems in Africa. The decade of misrule by Amin saw a collapse of the country and an exodus of doctors and other professions. The 1979 liberation war and subsequent political instability and insecurity further aggravated the poor health services then available. When political stability was temporarily restored in December 1980 the cash crop export sector took priority over social services and the health budget declined to only 3.5% compared to a former level of 7.5% of government budget. Emergencies in West Nile, Karamoja and the Luwero triangle continued to plague rehabilitation efforts upto 1985. Alternate strategies for improving health are proposed including female education, increased budget allocations, food and nutrition policy and health information. Uganda's prospect for rebuilding the health services has begun with immunization, control of diarrhoeal diseases, nutrition surveillance in Karamoja and an essential drugs programme, but the success of these is dependent upon political stability and improvement in overall security.

Characteristics of a Danish population of adults with acquired deafblindness receiving rehabilitation services

DEFF Research Database (Denmark)

Dammeyer, Jesper Herup

2013-01-01

The aim of this study is to report on the characteristics of a population of 916 individuals with acquired deafblindness receiving national Danish counselling and rehabilitation services. Age, gender, prevalence, social status, and communication mode are some of the data included in this study....... Results show that 70% of the population was older than 79 years, 15% was between 65 and 79 years, and 15% of the population was younger than 65 years. Oral speech was used by 86%, sign language by 10%, and tactile sign language by 4%. Among individuals younger than 65 years, less than 50% was employed...... or in education. Results are discussed with respect to the organization of the Danish counselling and rehabilitation service system....

[Clinical anamnestic characteristics in neurological work-related medical rehabilitation : Necessity for a qualitative identification of severe restrictions of work ability].

Science.gov (United States)

Heßling, A; Brandes, I; Dierks, M-L; Leniger, T

2018-02-01

Severe restrictions of work ability (SRWA) as a condition for participation in neurological work-related medical rehabilitation (WMR) have not been adequately described up to now. Similarly, the applicability of the screening instrument SIMBO-C for evaluating SRWA in neurological rehabilitation has not yet been answered conclusively. Determination of clinical and anamnestic characteristics of neurological SRWA and assessment of the applicability of the screening instrument SIMBO-C in neurological WMR. For the identification of SRWA clinical and anamnestic characteristics of 344 rehabilitants were routinely collected. The clinically and anamnestically determined SRWA was described quantitatively and content-analytically and correlated with SIMBO-C. Of the rehabilitants 66% exhibited SRWA. Apart from the established characteristics of SRWA further person and disease-specific factors were found. The SIMBO-C score was significantly higher in the group with SRWA compared to the group without SRWA (45.6 ± 18.9 vs. 31.5 ± 12.5, p characteristics in the group with SRWA was homogeneous, regardless of the SIMBO-C score. The characteristics of neurological SRWA are mainly qualitatively shaped and may only partly be identified by SIMBO-C. A combined quantitative and qualitative approach is necessary in neurological WMR.

The International Classification of Functioning, Disability and Health (ICF): a unifying model for the conceptual description of the rehabilitation strategy.

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Stucki, Gerold; Cieza, Alarcos; Melvin, John

2007-05-01

An important basis for the successful development of rehabilitation practice and research is a conceptually sound description of rehabilitation understood as a health strategy based on a universally accepted conceptual model and taxonomy of human functioning. With the approval of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in 2001 and the reference to the ICF in the World Health Assembly's resolution on "Disability, including prevention, management and rehabilitation" in 2005, we can now rely on a universally accepted conceptual model. It is thus time to initiate the process of evolving an ICF-based conceptual description that can serve as a basis for similar conceptual descriptions and according definitions of the professions applying the rehabilitation strategy and of distinct scientific fields of human functioning and rehabilitation research. In co-operation with the Physical and Rehabilitation Medicine (PRM) section of the European Union of Medical Specialists (UEMS) and its professional practice committee, we present a first tentative version of an ICF-based conceptual description in this paper. A brief definition describes rehabilitation as the health strategy applied by PRM and professionals in the health sector and across other sectors that aims to enable people with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment. Readers of the Journal of Rehabilitation Medicine are invited to contribute towards achieving an internationally accepted ICF-based conceptual description of rehabilitation by submitting commentaries to the Editor of this journal.

Stroke rehabilitation in ontario: an opportunity for health care transformation.

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Meyer, Matthew J; Meyer, John P; Foley, Norine; Salter, Katherine; McClure, J Andrew; Teasell, Robert

2011-11-01

In this article, Ontario's stroke rehabilitation system is used to exemplify the challenges faced by rehabilitation and healthcare systems across Canada who are attempting to provide quality care to patients in the face of increasing demands. Currently, Ontario's rehabilitation system struggles in its efforts to provide accessible and comprehensive care to patients recovering from stroke. We begin our exploration by identifying both the primary stakeholders and the underlying factors that have contributed to the current challenges. The framework put forward in the Canadian Medical Association's recommendations for transformation is then used to suggest a vision for a more patient-focused system incorporating three key principles: a broader perspective, a patient-first approach, and greater unity. The use of health information technology, proper incentives, and greater accountability are discussed as mechanisms to improve the quality and efficiency of care.

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

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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.

Responding to the health and rehabilitation needs of people with disabilities post-Haiyan

Directory of Open Access Journals (Sweden)

Mylene Rose Benigno

2015-11-01

Full Text Available Introduction: It is estimated that 15% of the world’s population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. Method: A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Results: Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Discussion: Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters.

Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England.

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Killaspy, Helen; Marston, Louise; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; Arbuthnott, Maurice; Koeser, Leonardo; McCrone, Paul; Omar, Rumana Z; King, Michael

2016-04-07

Mental health rehabilitation services in England focus on people with complex psychosis. This group tend to have lengthy hospital admissions due to the severity of their problems and, despite representing only 10-20 % of all those with psychosis, they absorb 25-50 % of the total mental health budget. Few studies have investigated the effectiveness of these services and there is little evidence available to guide clinicians working in this area. As part of a programme of research into inpatient mental health rehabilitation services, we carried out a prospective study to investigate longitudinal outcomes and costs for patients of these services and the predictors of better outcome. Inpatient mental health rehabilitation services across England that scored above average (median) on a standardised quality assessment tool used in a previous national survey were eligible for the study. Unit quality was reassessed and costs of care and patient characteristics rated using standardised tools at recruitment. Multivariable regression modelling was used to investigate the relationship between service quality, patient characteristics and the following clinical outcomes at 12 month follow-up: social function; length of admission in the rehabiliation unit; successful community discharge (without readmission or community placement breakdown) and costs of care. Across England, 50 units participated and 329 patients were followed over 12 months (94 % of those recruited). Service quality was not associated with patients' social function or length of admission (median 16 months) at 12 months but most patients were successfully discharged (56 %) or ready for discharge (14 %), with associated reductions in the costs of care. Factors associated with successful discharge were the recovery orientation of the service (OR 1.04, 95 % CI 1.00-1.08), and patients' activity (OR 1.03, 95 % CI 1.01-1.05) and social skills (OR 1.13, 95 % CI 1.04-1.24) at recruitment. Inpatient mental health

Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling.

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Vadstrup, Eva S; Frølich, Anne; Perrild, Hans; Borg, Eva; Røder, Michael

2011-12-07

Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R). In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12) within the rehabilitation group and 5.6 points (p = 0.03) points among individual counselling participants.In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04). No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01) and 0.34 points within the individual counselling group (p group cardiovascular distress decreased 0.25 points (p = 0.01). A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling programme

Health-related quality of life and self-related health in patients with type 2 diabetes: Effects of group-based rehabilitation versus individual counselling

Directory of Open Access Journals (Sweden)

Vadstrup Eva S

2011-12-01

Full Text Available Abstract Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36 and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R. Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12 within the rehabilitation group and 5.6 points (p = 0.03 points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04. No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01 and 0.34 points within the individual counselling group (p p = 0.01. Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling

Rehabilitation interventions in multiple sclerosis: an overview.

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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

An Approach for a National eHealth Implementation – the Case of Modular Interactive Tiles for Rehabilitation

DEFF Research Database (Denmark)

Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf

2015-01-01

By the development of a mHealth tablet app together with modular interactive tiles for rehabilitation, we intend to facilitate the co-design, adaptation, demonstration and validation of modular ICT solutions for rehabilitation in deep rural sub-Saharan Africa. This results in highly mobile, modular...... community-based rehabilitation. Thereby, we investigate the adaptation, contextualisation and implementation in different rehabilitation methods and centres, including hospitals both in a city centres and in a rural area, NGO’s performing community based rehabilitation, and rehabilitation centres. Together...

Mental health rehabilitation in a care farm context: A descriptive review of Norwegian intervention studies.

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Pedersen, Ingeborg; Patil, Grete; Berget, Bente; Ihlebæk, Camilla; Gonzalez, Marianne Thorsen

2015-01-01

C are farming is a service developed at farms for promoting mental and physical health and is increasingly used in mental health rehabilitation in Norway. This article aims to present a descriptive review of Norwegian intervention research on care farms that provide rehabilitation for people with mental health disorders. This literature review applied a non-systematic search strategy: all articles in the field known to the authors were selected for inclusion. The selected studies were intervention studies that were conducted on farms in Norway, that used adult participants with mental health problems/disorders, and that reported outcome measures related to mental health. The studies and articles presented quantitative and/or qualitative data. The findings from the published articles report improvements to mental health problems, such as depression, anxiety, perceived stress, positive affect, rumination, and self-efficacy. Qualitative data describe a variety of positive experiences, such as improved coping ability, increased social support, and appreciation of the care farm activity. Participating in interventions on care farms positively influences mental health. Care farming may therefore be used as a supplementary approach in mental health rehabilitation, as it offers meaningful and engaging occupations and social inclusion.

Optimized balance rehabilitation training strategy for the elderly through an evaluation of balance characteristics in response to dynamic motions

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Jung, HoHyun; Chun, Keyoung Jin; Hong, Jaesoo; Lim, Dohyung

2015-01-01

Balance is important in daily activities and essential for maintaining an independent lifestyle in the elderly. Recent studies have shown that balance rehabilitation training can improve the balance ability of the elderly, and diverse balance rehabilitation training equipment has been developed. However, there has been little research into optimized strategies for balance rehabilitation training. To provide an optimized strategy, we analyzed the balance characteristics of participants in response to the rotation of a base plate on multiple axes. Seven male adults with no musculoskeletal or nervous system-related diseases (age: 25.5±1.7 years; height: 173.9±6.4 cm; body mass: 71.3±6.5 kg; body mass index: 23.6±2.4 kg/m2) were selected to investigate the balance rehabilitation training using customized rehabilitation equipment. Rotation of the base plate of the equipment was controlled to induce dynamic rotation of participants in the anterior–posterior, right-diagonal, medial–lateral, and left-diagonal directions. We used a three-dimensional motion capture system employing infrared cameras and the Pedar Flexible Insoles System to characterize the major lower-extremity joint angles, center of body mass, and center of pressure. We found statistically significant differences between the changes in joint angles in the lower extremities in response to dynamic rotation of the participants (P0.05). These results indicate that optimizing rotation control of the base plate of balance rehabilitation training equipment to induce anterior–posterior and medial–lateral dynamic rotation preferentially can lead to effective balance training. Additional tests with varied speeds and ranges of angles of base plate rotation are expected to be useful as well as an analysis of the balance characteristics considering a balance index that reflects the muscle activity and cooperative characteristics. PMID:26508847

Rehabilitation Research at the National Institutes of Health: Moving the Field Forward (Executive Summary).

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Frontera, Walter R; Bean, Jonathan F; Damiano, Diane; Ehrlich-Jones, Linda; Fried-Oken, Melanie; Jette, Alan; Jung, Ranu; Lieber, Rick L; Malec, James F; Mueller, Michael J; Ottenbacher, Kenneth J; Tansey, Keith E; Thompson, Aiko

Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the Americans With Disabilities Act, NIH established the National Center for Medical Rehabilitation Research, with the goal of developing and implementing a rehabilitation research agenda. Currently, 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference, "Rehabilitation Research at NIH: Moving the Field Forward." This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future. Copyright © 2017 by The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

HALOTHERAPY FOR PREVENTION AND MEDICAL REHABILITATION IN PEDIATRIC HEALTH CARE

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Alina V. Chervinskaya

2017-01-01

Full Text Available The primary focus of medical rehabilitation is the approach of model simulation of natural environment. Halotherapy is one of the nonpharmacological methods widely used in Russian public health care delivery including prophylaxis and rehabilitation in children. This method is based on the recreation of the air environment of a natural underground salt mine. The article presents an innovative method using a next generation of equipment for halotherapy: a guided halocomplex where the control on dosage regiments and aerodisperse medium parameters is implemented. The mechanisms of the effect of halotherapy are considered, the data of the clinical effectiveness for various paediatric diseases are outlined. 

Advances in outcomes measurement in rehabilitation medicine: current initiatives from the National Institutes of Health and the National Institute on Disability and Rehabilitation Research.

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Tulsky, David S; Carlozzi, Noelle E; Cella, David

2011-10-01

The articles in this supplement present recent advances in the measurement of patient-reported health-related quality-of-life (HRQOL) outcomes. Specifically, these articles highlight the combined efforts of the National Institutes of Health, National Institute for Neurological Disorders and Stroke, National Center on Medical Rehabilitation Research, National Institute on Disability and Rehabilitation Research, and Department of Veterans Affairs Rehabilitation Research and Development Service to improve HRQOL measurement. In addition, this supplement is intended to provide rehabilitation professionals with information about these efforts and the implications that these advances in outcomes measurement have for rehabilitation medicine and clinical practice. These new measurement scales use state-of-the-art method techniques, including item response theory and computerized adaptive testing. In addition, scale development involves both qualitative and quantitative methods, as well as the administration of items to hundreds or even thousands of research participants. The scales deliberately have been built with overlap of items between scales so that linkages and equivalency scores can be computed. Ultimately, these scales should facilitate direct comparison of outcomes instruments across studies and will serve as standard data elements across research trials without compromising the specificity of disease- or condition-targeted measures. This supplement includes the initial publications for many of these new measurement initiatives, each of which provides researchers and clinicians with better tools for evaluation of the efficacy of their interventions. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

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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.

Rehabilitation research at the National Institutes of Health moving the field forward (executive summary).

Science.gov (United States)

Frontera, Walter R; Bean, Jonathan F; Damiano, Diane; Ehrlich-Jones, Linda; Fried-Oken, Melanie; Jette, Alan; Jung, Ranu; Lieber, Rick L; Malec, James F; Mueller, Michael J; Ottenbacher, Kenneth J; Tansey, Keith E; Thompson, Aiko

2017-08-01

Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the Americans With Disabilities Act, NIH established the National Center for Medical Rehabilitation Research, with the goal of developing and implementing a rehabilitation research agenda. Currently, 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference, "Rehabilitation Research at NIH: Moving the Field Forward." This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rehabilitation Research at the National Institutes of Health: Moving the Field Forward (Executive Summary)

Science.gov (United States)

Frontera, Walter R.; Bean, Jonathan F.; Damiano, Diane; Ehrlich-Jones, Linda; Fried-Oken, Melanie; Jette, Alan; Jung, Ranu; Lieber, Rick L.; Malec, James F.; Mueller, Michael J.; Ottenbacher, Kenneth J.; Tansey, Keith E.; Thompson, Aiko

2017-01-01

Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the Americans With Disabilities Act, NIH established the National Center for Medical Rehabilitation Research, with the goal of developing and implementing a rehabilitation research agenda. Currently, 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference, “Rehabilitation Research at NIH: Moving the Field Forward.” This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future. PMID:28422639

Health and wellness characteristics of persons with traumatic brain injury.

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Braden, Cynthia A; Cuthbert, Jeffrey P; Brenner, Lisa; Hawley, Lenore; Morey, Clare; Newman, Jody; Staniszewski, Kristi; Harrison-Felix, Cynthia

2012-01-01

To describe health and wellness characteristics of persons with TBI living in the community, compare to other disability populations and evaluate the associations between health-related constructs. Observational. Outpatient rehabilitation hospital and a Veterans Affairs Medical Centre. Seventy-four community-dwelling adults with moderate-to-severe TBI. None. Health Promoting Lifestyle Profile II (HPLP-II), Self Rated Abilities Health Practices Scale (SRAHP), Barriers to Health Promoting Activities for Disabled Scale (BHPAD), Medical Outcomes Study 12-Item Health Status Survey Short Form (SF-12), Personal Resource Questionnaire-adapted (PRQ-a), Perceived Wellness Survey (PWS), Diener Satisfaction with Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O). Health-promoting behaviours, self-efficacy and barriers to health were comparable to other disability populations. Perceived health status, participation and life satisfaction were decreased. Measures of health promotion and self-efficacy were positively associated with perceived mental health status, life satisfaction and participation. Barriers to healthy activities were negatively associated with health promotion, self-efficacy and perceived mental health status. Health and wellness status was below desired levels for the study cohort, and comparable to other disability populations. Better understanding of associations among health-related constructs is needed. Continued research on conceptually-based health and wellness interventions for persons with TBI is recommended.

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.

Glenohumeral osteoarthritis: overview, therapy, and rehabilitation.

Science.gov (United States)

Macías-Hernández, Salvador Israel; Morones-Alba, Juan Daniel; Miranda-Duarte, Antonio; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania; Cruz-Medina, Eva; Olascoaga-Gómez, Andrea; Tallabs-Almazan, Laura Verónica; Palencia, Chanell

2017-08-01

Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.

Changes in socio-economic and health condition of rehabilitated slum dwellers in Kolkata, West Bengal

Directory of Open Access Journals (Sweden)

M.H. Askari

2016-04-01

Full Text Available The cancerous spread of slum has been a rampant problem in urban areas worldwide. The acute shortage of housing facilities compels the poor to live in slums. Proper rehabilitation is considered as a very essential remedial measure to provide better living environment to slum peoples. This study is an essential attempt to gauge the effectiveness of a rehabilitation program, which studies the changes in socio-economic and health condition of rehabilitated slum dwellers since they got rehabilitated. In order to do so, a household survey was carried comprising 240 households in two rehabilitated sites in the city of Kolkata (ward no. 107 and 114 during the month of July, 2014. The results conforms a strand of a belief that in-situ rehabilitation or rehabilitation within short distance is more effective. A rehabilitation too far away area disrupts the existing social, economic and political ties of neighborhoods. Measures have also been proposed to overcome such problems and to make the slum dwellers an integral part of urban society.

Impact of oral rehabilitation on patients with head and neck cancer: A study using the Liverpool Oral Rehabilitation Questionnaire and the Oral Health Impact Profile-14.

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Dholam, Kanchan P; Dugad, Jinesh A; Sadashiva, Karthik M

2017-04-01

The treatment of oral cancers affects oral functions and quality of life (QOL). Dental rehabilitation is a major step toward enhancing quality of life after controlling the disease. The effects of the disease, treatment, and rehabilitation need to be evaluated to assess oral health-related QOL. The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) and Oral Health Impact Profile-14 (OHIP-14) are specific assessment questionnaires of oral rehabilitation. The purpose of this study was to assess the impact of oral rehabilitation on patients with head and neck cancer by using the LORQv3 and OHIP-14 questionnaires and to discover and document specific patient-derived problems related to the issues of oral rehabilitation. The LORQv3 and OHIP-14 questionnaires were administered to 60 participants with oral cancer, who were in need of oral rehabilitation. They were asked to rate their dental problems on a Likert scale before fabrication of their prostheses (baseline) and at the 3-month follow-up visit after prosthetic rehabilitation. Paired comparison was done using the Wilcoxon signed rank test according to the distribution, and Cronbach alpha was used to assess internal consistency. Subscale scores were determined by mean value (α=.05). For the LORQv3 questionnaire, a 10% to 27% improvement was found in the domain of oral function, and a 20% improvement in orofacial appearance, with improvement in patient satisfaction with the prosthesis. Using the OHIP-14 questionnaire, a 45% to 67% improvement was generally seen in all domains. After assessment using the LORQv3 and OHIP-14 questionnaires, prosthetic rehabilitation was seen to contribute to the betterment of patients with head and neck cancer. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

[Recommendations for the Stepwise Occupational Reintegration: Can the Characteristic of the Patients Explain the Differences Between the Rehabilitation Centers?].

Science.gov (United States)

Schmid, L; Jankowiak, S; Kaluscha, R; Krischak, G

2016-06-01

The first step to initiate a stepwise occupational reintegration (SOR) is the recommendation of the rehabilitation centers. Therefore rehabilitation centers have a significant impact on the use of SOR. There is evidence that the recommendation rate between the rehabilitation centers differs clearly. The present survey therefore analyses in detail the differences of the recommendation rate and examines which patient-related factors could explain the differences. This study is based on analysis of routine data provided by the German pension insurance in Baden-Württemberg (Rehabilitationsstatistikdatenbasis 2013; RSD). In the analyses rehabilitation measures were included if they were conducted by employed patients (18-64 years) with a muscular-skeletal system disease or a disorder of the connective tissue. Logistic regression models were performed to explain the differences in the recommendation rate of the rehabilitation centers. The data of 134 853 rehabilitation measures out of 32 rehabilitation centers were available. The recommendation rate differed between the rehabilitation centers from 1.36-18.53%. The logistic regression analysis showed that the period of working incapacity 12 month before the rehabilitation and the working capacity on the current job were the most important predictors for the recommendation of a SOR by the rehabilitation centers. Also the rehabilitation centers themselves have an important influence. The results of this survey indicate that the characteristic of the patients is an important factor for the recommendation of SOR. Additionally the rehabilitation centers themselves have an influence on the recommendation of SOR. The results point to the fact that the rehabilitation centers use different criteria by making a recommendation. © Georg Thieme Verlag KG Stuttgart · New York.

Patients undergoing subacute rehabilitation have accurate expectations of their health-related quality of life at discharge

Directory of Open Access Journals (Sweden)

McPhail Steven

2012-08-01

Full Text Available Abstract Background Expectations held by patients and health professionals may affect treatment choices and participation (by both patients and health professionals in therapeutic interventions in contemporary patient-centered healthcare environments. If patients in rehabilitation settings overestimate their discharge health-related quality of life, they may become despondent as their progress falls short of their expectations. On the other hand, underestimating their discharge health-related quality of life may lead to a lack of motivation to participate in therapies if they do not perceive likely benefit. There is a scarcity of empirical evidence evaluating whether patients’ expectations of future health states are accurate. The purpose of this study is to evaluate the accuracy with which older patients admitted for subacute in-hospital rehabilitation can anticipate their discharge health-related quality of life. Methods A prospective longitudinal cohort investigation of agreement between patients’ anticipated discharge health-related quality of life (as reported on the EQ-5D instrument at admission to a rehabilitation unit and their actual self-reported health-related quality of life at the time of discharge from this unit was undertaken. The mini-mental state examination was used as an indicator of patients’ cognitive ability. Results Overall, 232(85% patients had all assessment data completed and were included in analysis. Kappa scores ranged from 0.42-0.68 across the five EQ-5D domains and two patient cognition groups. The percentage of exact correct matches within each domain ranged from 69% to 85% across domains and cognition groups. Overall 40% of participants in each cognition group correctly anticipated all of their self-reported discharge EQ-5D domain responses. Conclusions Patients admitted for subacute in-hospital rehabilitation were able to anticipate their discharge health-related quality of life on the EQ-5D instrument

Attitudes, beliefs, and perceptions of caregivers and rehabilitation providers about disabled children's sleep health: a qualitative study.

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Chen, Xiaoli; Gelaye, Bizu; Velez, Juan Carlos; Pepper, Micah; Gorman, Sara; Barbosa, Clarita; Zafonte, Ross D; Redline, Susan; Williams, Michelle A

2014-10-01

Children with disabilities are more likely to have sleep disturbances than children without disabilities. Identifying attitudes, beliefs, knowledge, and perceptions of caregivers and health professionals is essential in developing effective intervention programs to improve disabled children's sleep health. However, no such qualitative data about adults who have key roles in the life and daytime activities of children with disabilities are available. This qualitative study aimed to understand attitudes, beliefs, knowledge, and perceptions about disabled children's sleep hygiene among caregivers and rehabilitation providers of children with disabilities. Twenty seven adults, including nine primary caregivers and eighteen rehabilitation providers, participated in five focus group discussions between September and December 2012 at the Rehabilitation Center in Punta Arenas, Chile. A trained facilitator guided focus group discussions using a semi-structured script. Audiotapes and transcripts of focus group discussions were reviewed and analyzed for recurrent themes. Participants identified seven themes related to children's sleep hygiene: lifestyle behaviors, family factors, children's disabilities and/or comorbidities, environmental factors, adults' responsibilities for children's sleep, perception of good sleep, and parental distress about children's sleep problems. While both caregivers and rehabilitation providers recognized the importance of sleep for children's health and functioning, they differed in their understanding of how sleep hygiene practices influence sleep. Rehabilitation providers recognized the negative influence of electronics on sleep and the positive influence of sleep routines. In contrast, caregivers reported use of television/movie watching and stimulants as coping strategies for managing children's sleep problems. Caregivers may benefit from better understanding the influence of electronics and stimulant use on child sleep health. Rehabilitation

Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study.

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Muschalla, Beate; Jöbges, Michael

2018-01-01

To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Cross-sectional observation study. Neurology, orthopedic, and cardiology rehabilitation clinics. Patients (N=1610; age, 18-65y) with work anxieties. Not applicable. Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non-work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Characteristics of Patients With Satisfactory Functional Gain Following Total Joint Arthroplasty in a Postacute Rehabilitation Setting.

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Hershkovitz, Avital; Vesilkov, Marina; Beloosesky, Yichayaou; Brill, Shai

2017-01-10

Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA. This was a retrospective study of 180 patients with TJA admitted during 2010-2013. The main outcome measures were the Functional Independence Measure (FIM), the Montebello Rehabilitation Factor Score (MRFS) on the motor FIM, and the Timed Get Up and Go Test. Satisfactory functional gain was defined as an mFIM MRFS score above median score. Comparisons of clinical and demographic characteristics between patients who achieved a satisfactory functional gain versus those who did not were performed by the Mann-Whitney U test and the χ test. The proportion of patients who achieved a satisfactory functional gain was similar in the total knee arthroplasty and total hip arthroplasty (THA) groups. The most significant characteristic of patients who achieved a satisfactory functional gain was their admission functional ability. Age negatively impacted the ability to achieve a satisfactory functional gain in patients with THA. Functional level on admission is the best predictive factor for a better rehabilitation outcome for patients with TJA. Age negatively affects functional gain in patients with THA.

Living Labs: overview of ecological approaches for health promotion and rehabilitation.

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Korman, M; Weiss, P L; Kizony, R

2016-01-01

The term "Living Lab" was coined to reflect the use of sensors to monitor human behavior in real life environments. Until recently such measurements had been feasible only within experimental laboratory settings. The objective of this paper is to highlight research on health care sensing and monitoring devices that enable direct, objective and accurate capture of real-world functioning. Selected articles exemplifying the key technologies that allow monitoring of the motor-cognitive activity of persons with disabilities during naturally occurring daily experiences in real-life settings are discussed in terms of (1) the ways in which the Living Lab approach has been used to date, (2) limitations related to clinical assessment in rehabilitation settings and (3) three categories of the instruments most commonly used for this purpose: personal technologies, ambient technologies and external assistive systems. Technology's most important influences on clinical practice and rehabilitation are in a shift from laboratory-based to field-centered research and a transition between in-clinic performance to daily life activities. Numerous applications show its potential for real-time clinical assessment. Current technological solutions that may provide clinicians with objective, unobtrusive measurements of health and function, as well as tools that support rehabilitation on an individual basis in natural environments provide an important asset to standard clinical measures. Until recently objective clinical assessment could not be readily performed in a client's daily functional environment. Novel technologies enable health care sensing and monitoring devices that enable direct, objective and accurate capture of real-world functioning. Such technologies are referred to as a "Living Lab" approach since they enable the capture of objective and non-obtrusive data that clinicians can use to assess performance. Research and development in this field help clinicians support maintain

[The education influence on effects of rehabilitation in patients after stroke].

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Dudka, Sabina; Winczewski, Piotr; Janczewska, Katarzyna; Kubsik, Anna; Woldańska-Okońska, Marta

2016-11-25

Patients after stroke face a new situation where some educational and pedagogical actions should be reinitiated. Stroke often causes a break away from the previous lifestyle. It the acute phase it excludes the possibility of employment or performance of household duties that were carried out before or indulging in previously preferred ways of spending free time. Patients often abandon the habits that they developed before stroke, inclusive of hygienic habits. Therefore, it is an important objective of rehabilitation to reinstate in stroke patients behaviours characteristic of their peers, which would mark the beginning of their own care for health. The pedagogic and educational activities should lead to a transformation in the patient. This could be one of the factors in facilitating the patient's return to previous forms of activity. The aim of this study was to analyze progress in patient's rehabilitation and satisfaction, to assess impact of health education on higher satisfaction and better knowledge in stroke patients as well as on their recovery. Another aim was to assess the factors that maximize the patients' chances of returning to the labor market. The study involved 30 patients after stroke, 8 women and 22 men, over 40 years of age, who underwent either early or late rehabilitation, the type of which affected the time of treatment. The minimal duration of the patient's stay was 21 days, in which time an individually tailored way of education, rehabilitation, treatment and care was implemented. The study used a questionnaire and the Bartel and the Rankin scales. The subject of the analysis consisted of 22 questions that were based on hypotheses. They assessed the facts, the sources of information, knowledge and subjective feelings of the patients concerning the education carried out by the rehabilitation team and its impact on the patients' rehabilitation. A highly significant (p<0,01) improvement to patients' health and an increase in their knowledge

Olle Höök Lectureship 2015: The World Health Organization's paradigm shift and implementation of the International Classification of Functioning, Disability and Health in rehabilitation.

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Stucki, Gerold

2016-06-13

The World Health Organization's (WHO) paradigm shift, implied by the launch of the International Classification of Functioning, Disability and Health (ICF), is inextricably entwined with the emergence of rehabilitation as a key health strategy of the 21st century. To enable health systems to scale up rehabilitation we must spearhead the implementation of the ICF in rehabilitation towards its system-wide implementation in the healthcare system at large. In this essay, based on the Olle Höök lecture 20151, it is argued that the launch of the ICF in 2001 represents a paradigm shift, as it has enabled the WHO to more comprehensively act on its mandate and has guided WHO policies to shape the health system in response to population functioning needs. It is shown that this paradigm shift has important implications for rehabilitation, including its conceptualization and scientific methods. A prerequisite for the system-wide implementation of the ICF in clinical practice, policy, and research, is the availability of practical tools that allow for the universal and standardized description of functioning. Finally, some reflections are presented on how we may foster the system-wide implementation of the ICF by applying approaches from the implementation sciences.

[Rehabilitation in geriatric patients after ischemic stroke--a comparison of 2 organisational systems in Germany using claims data of a statutory health insurance fund].

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Abbas, S; Ihle, P; Hein, R; Schubert, I

2013-12-01

Due to historical aspects in some federal states in Germany rehabilitation of geriatric patients is organized in geriatric departments in hospitals (§ 109 SGB V). In other states rehabilitation of these patients is mainly realized in geriatric rehabilitation facilities outside hospital care after approval by the health insurance (§ 111 SGB V). Thus, it is of interest to compare both types of health care with respect to differences in population characteristics, resource utilization and outcome parameters (i.e., excess costs, rehospitalization, fracture risk and mortality) using a common geriatric indication, the ischemic stroke, as an example. Claims data of the AOK (Local Health Care Fund) from seven federal states in Germany were used. Insured persons with a documented hospital stay with discharge diagnosis cerebral infarction/stroke (ICD-10 I63, I64, below denoted by "ischemic stroke") in 2007 (N=39,887) were included and allocated to the respective form of rehabilitative health care via the OPS (German procedure classification for inpatient procedures) procedure 8-550 (§ 109, N=1,272) or via admission to a geriatric rehabilitation unit within 1 month after hospital discharge (§ 111, N=2,200). All direct costs were ascertained and presented with and without costs of long-term care. Excess costs were calculated as the difference of costs between the first year after insult and the costs in the previous year. Excess costs in the 2 types of care were compared using multivariate quantile regression analysis. Risk of hospitalization (due to ischemic stroke or fracture) and risk of death in a 1-year follow-up was analysed using multivariate cox regression. Insured members treated according to health care type § 109 were somewhat older (mean: 81 vs. 80 years of age), more frequently female (72 vs. 67%), more often receiving long-term care (27 vs. 19%) and had more often documented sequelae after insult (>=4 diseases 39 vs. 28%). No significant differences in

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

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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.

Person-Generated Health Data in Simulated Rehabilitation Using Kinect for Stroke: Literature Review.

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Dimaguila, Gerardo Luis; Gray, Kathleen; Merolli, Mark

2018-05-08

Person- or patient-generated health data (PGHD) are health, wellness, and clinical data that people generate, record, and analyze for themselves. There is potential for PGHD to improve the efficiency and effectiveness of simulated rehabilitation technologies for stroke. Simulated rehabilitation is a type of telerehabilitation that uses computer technologies and interfaces to allow the real-time simulation of rehabilitation activities or a rehabilitation environment. A leading technology for simulated rehabilitation is Microsoft's Kinect, a video-based technology that uses infrared to track a user's body movements. This review attempts to understand to what extent Kinect-based stroke rehabilitation systems (K-SRS) have used PGHD and to what benefit. The review is conducted in two parts. In part 1, aspects of relevance for PGHD were searched for in existing systematic reviews on K-SRS. The following databases were searched: IEEE Xplore, Association of Computing Machinery Digital Library, PubMed, Biomed Central, Cochrane Library, and Campbell Collaboration. In part 2, original research papers that presented or used K-SRS were reviewed in terms of (1) types of PGHD, (2) patient access to PGHD, (3) PGHD use, and (4) effects of PGHD use. The search was conducted in the same databases as part 1 except Cochrane and Campbell Collaboration. Reference lists on K-SRS of the reviews found in part 1 were also included in the search for part 2. There was no date restriction. The search was closed in June 2017. The quality of the papers was not assessed, as it was not deemed critical to understanding PGHD access and use in studies that used K-SRS. In part 1, 192 papers were identified, and after assessment only 3 papers were included. Part 1 showed that previous reviews focused on technical effectiveness of K-SRS with some attention on clinical effectiveness. None of those reviews reported on home-based implementation or PGHD use. In part 2, 163 papers were identified and after

Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction.

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Breeze, J; Rennie, A; Morrison, A; Dawson, D; Tipper, J; Rehman, K; Grew, N; Snee, D; Pigadas, N

2016-10-01

Health-related quality of life (QoL) reported by patients has the potential to improve care after ablative surgery of the midface, as existing treatment algorithms still generally revolve around outcomes assessed traditionally only by clinicians. Decisions in particular relate to reconstruction with a flap compared with rehabilitation with an obturator, the need for adjuvant treatment, and morbidity related to the size of the defect. We prospectively collected health-related QoL assessments for 39 consecutive patients treated by maxillectomy between 01 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire, and who had a mean (SD) duration of follow-up of 14 (4). We made sub-group analyses using paired t tests and analysis of variance (ANOVA) to compare reconstruction with a flap with rehabilitation with obturators, size of the vertical defect, and whether adjuvant treatment with radiotherapy or chemoradiotherapy adversely affected it. Overall there was a significant decrease in health-related QoL after treatment compared with before (p<0.001), but there was no significant difference in the effects of any of the paired reconstructive and rehabilitation treatments on it. Obturators remain an important option for rehabilitation in selected patients in addition to reconstruction with a flap. We found that neither increasing the size of the vertical defect (in an attempt to ensure clear margins) nor the use of postoperative radiotherapy seemed to have any adverse effect on QoL. More patients are required before we can conclude that the potential survival benefits of such measures may outweigh any adverse effects. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Changes in Health-Related Quality of Life During Rehabilitation in Patients With Operable Lung Cancer

DEFF Research Database (Denmark)

Sommer, Maja S.; Trier, Karen; Vibe-Petersen, Jette

2017-01-01

. RESULTS: Forty patients were included, 73% of whom completed rehabilitation. Results on emotional well-being (P mental health component score (P = .0004) showed an overall statistically significant improvement during the study. CONCLUSION: This feasibility...... study demonstrated that global quality of life, mental health, and emotional well-being improved significantly during the study, from time of diagnosis until 1 year after resection, in patients with NSCLC participating in rehabilitation.......INTRODUCTION: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. OBJECTIVES: The objective is to present health-related quality of life (HRQoL) changes over time before and 1...

Post-stroke rehabilitation in Italy: inconsistencies across regional strategies.

Science.gov (United States)

Guidetti, D; Spallazzi, M; Baldereschi, M; Di Carlo, A; Ferro, S; Rota E Morelli, N; Immovilli, P; Toni, D; Polizzi, B M; Inzitari, D

2014-06-01

Remarkable differences among European countries have been found in stroke rehabilitation models, owing to the fact that stroke rehabilitation services are embedded in health care systems. Comprehensive data on service utilization by stroke survivors in Italy are lacking, but would be instrumental in improving efficiency and effectiveness of post-acute stroke care, and consequently, in containing costs and improving outcomes. The purpose of the present study was to survey the Italian regional legislations in order to examine the provision of rehabilitation services for stroke survivors in Italy. This is a cross-sectional, observational study. Post-stroke intra- and extra-hospital rehabilitation. All decrees and resolutions as to post-acute stroke rehabilitation were collected from each Italian region. All decrees and resolutions were examined by the means of a check list including quantitative and qualitative characteristics, selected in accordance with national official recommendations. Each completed check list was then sent to each regional reference person, who filled in the section on the implementation of the indications and compliance. The study was carried out from November 2009 to September 2010. The documents were collected from 19 out of the 20 Italian regions. The results of the study indicate that there are many, remarkable regional variations in health policies concerning post-stroke care. Instruments for evaluation and criteria for allocating stroke patients to proper rehabilitation setting vary across regions, but data on the potential impact of these variations on clinical outcomes are still lacking. The study highlights the issue that, in Italy, delivery of post-stroke rehabilitation services is not uniform nation-wide and varies substantially across regions. The lack of a comprehensive post-acute stroke strategy is a major obstacle to service availability. The study results advocate the need for a consistent and comprehensive strategic planning of

Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review.

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Côté, Daniel

2013-01-01

The purpose of this comprehensive literature review it to explore cross-cultural issues in occupational rehabilitation and work disability prevention. A literature review on cross-cultural issues was performed in medicine, health sciences, and social sciences databases (PubMed, Ingenta, Canadian Centre for Occupational Health and Safety, Ergonomics Abstract, Google Scholar, OSH Update and the Quebec Workers' Compensation Board data base). A total of 27 documents published until 2010 in English or French were selected and analyzed. Cross-cultural issues in occupational rehabilitation show that representations of pain, communication and therapist-patient relationship and intercultural competence could be presented as the major topics covered in the selected literature. As for the general topic of immigrant workers and OSH, barriers were identified revealing personal, relational, contextual and structural levels that put immigrant and minority workers in situation of vulnerability (ex. linguistic and cultural barriers, lack of knowledge of the system, precarious work or exposition to higher risk hazards, etc.). Cultural issues in occupational rehabilitation put less attention to work-related contextual factors but emphasized on attitude and pain behaviours, perceptions of illness and appropriate treatment, therapist-patient relationship and cultural competences among OT professionals. The growth of immigration in countries such as Canada poses a real challenge to the delivery of health care and rehabilitation services. Despite growing concerns in providing culturally appropriate heath cares, intervention models, tools and training tools are still lacking in occupational rehabilitation and disability management. Nevertheless, cultural competence seems to be a promising concept to be implemented in work rehabilitation and disability management.

Coping, problem solving, depression, and health-related quality of life in patients receiving outpatient stroke rehabilitation.

Science.gov (United States)

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

2015-08-01

To investigate whether patients with high and low depression scores after stroke use different coping strategies and problem-solving skills and whether these variables are related to psychosocial health-related quality of life (HRQOL) independent of depression. Cross-sectional study. Two rehabilitation centers. Patients participating in outpatient stroke rehabilitation (N=166; mean age, 53.06±10.19y; 53% men; median time poststroke, 7.29mo). Not applicable. Coping strategy was measured using the Coping Inventory for Stressful Situations; problem-solving skills were measured using the Social Problem Solving Inventory-Revised: Short Form; depression was assessed using the Center for Epidemiologic Studies Depression Scale; and HRQOL was measured using the five-level EuroQol five-dimensional questionnaire and the Stroke-Specific Quality of Life Scale. Independent samples t tests and multivariable regression analyses, adjusted for patient characteristics, were performed. Compared with patients with low depression scores, patients with high depression scores used less positive problem orientation (P=.002) and emotion-oriented coping (Pproblem orientation (Pproblem orientation was independently related to psychosocial HRQOL (β=.086; P=.018) and total HRQOL (β=.058; P=.031). Patients with high depression scores use different coping strategies and problem-solving skills than do patients with low depression scores. Independent of depression, positive problem-solving skills appear to be most significantly related to better HRQOL. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke

DEFF Research Database (Denmark)

Tistad, Malin; Tham, Kerstin; von Koch, Lena

2012-01-01

a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds......BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation...... or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using...

INFORMATIZATION OF HEALTH CARE. TNE ANALYSIS FEATURES OF INFORMATION ARE IN REHABILITATION PROCESS

Directory of Open Access Journals (Sweden)

O. P. Mintser

2013-11-01

Given that rehabilitation programs are individually designed for each patient, taking into account the general condition, the characteristics of the disease, the initial level of physical condition, the patient’s personality, age, gender, occupation, etc., they can be viewed as a project or pre-plan the system of measures.

Characteristics of Inpatient Care and Rehabilitation for Acute First-Ever Stroke Patients

Science.gov (United States)

Chang, Won Hyuk; Shin, Yong-Il; Lee, Sam-Gyu; Oh, Gyung-Jae; Lim, Young Shil

2015-01-01

Purpose The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients. Materials and Methods This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge. Results A total of 2159 patients were reviewed. The mean age was 61.5±14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management. Conclusion Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke. PMID:25510773

Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

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Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

2017-03-01

Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

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.

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.

Association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation.

Science.gov (United States)

Dossa, Almas; Glickman, Mark E; Berlowitz, Dan

2011-11-15

Limited evidence exists regarding the association of pre-existing mental health conditions in patients with stroke and stroke outcomes such as rehospitalization, mortality, and function. We examined the association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation. Our observational study used the 2001 VA Integrated Stroke Outcomes database of 2162 patients with stroke who underwent rehabilitation at a Veterans Affairs Medical Center. Separate models were fit to our outcome measures that included 6-month rehospitalization or death, 6-month mortality post-discharge, and functional outcomes post inpatient rehabilitation as a function of number and type of mental health conditions. The models controlled for patient socio-demographics, length of stay, functional status, and rehabilitation setting. Patients had an average age of 68 years. Patients with stroke and two or more mental health conditions were more likely to be readmitted or die compared to patients with no conditions (OR: 1.44, p = 0.04). Depression and anxiety were associated with a greater likelihood of rehospitalization or death (OR: 1.33, p = 0.04; OR:1.47, p = 0.03). Patients with anxiety were more likely to die at six months (OR: 2.49, p = 0.001). Patients with stroke with pre-existing mental health conditions may need additional psychotherapy interventions, which may potentially improve stroke outcomes post-hospitalization.

Problematising risk in stroke rehabilitation.

Science.gov (United States)

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

2016-11-01

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

Minimum data set to measure rehabilitation needs and health outcome after major trauma: application of an international framework.

Science.gov (United States)

Hoffman, Karen P; Playford, Diane E; Grill, Eva; Soberg, Helene L; Brohi, Karim

2016-06-01

Measurement of long term health outcome after trauma remains non-standardized and ambiguous which limits national and international comparison of burden of injuries. The World Health Organization (WHO) has recommended the application of the International Classification of Function, Disability and Health (ICF) to measure rehabilitation and health outcome worldwide. No previous poly-trauma studies have applied the ICF comprehensively to evaluate outcome after injury. To apply the ICF categorization in patients with traumatic injuries to identify a minimum data set of important rehabilitation and health outcomes to enable national and international comparison of outcome data. A mixed methods design of patient interviews and an on-line survey. An ethnically diverse urban major trauma center in London. Adult patients with major traumatic injuries (poly-trauma) and international health care professionals (HCPs) working in acute and post-acute major trauma settings. Mixed methods investigated patients and health care professionals (HCPs) perspectives of important rehabilitation and health outcomes. Qualitative patient data and quantitative HCP data were linked to ICF categories. Combined data were refined to identify a minimum data set of important rehabilitation and health outcome categories. Transcribed patient interview data (N.=32) were linked to 234 (64%) second level ICF categories. Two hundred and fourteen HCPs identified 121 from a possible 140 second level ICF categories (86%) as relevant and important. Patients and HCPs strongly agreed on ICF body structures and body functions categories which include temperament, energy and drive, memory, emotions, pain and repair function of the skin. Conversely, patients prioritised domestic tasks, recreation and work compared to HCP priorities of self-care and mobility. Twenty six environmental factors were identified. Patient and HCP data were refined to recommend a 109 possible ICF categories for a minimum data set. The

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....

Insurance Coverage for Rehabilitation Therapies and Association with Social Participation Outcomes among Low-Income Children.

Science.gov (United States)

Mirza, Mansha; Kim, Yoonsang

2016-01-01

(1) To profile children's health insurance coverage rates for specific rehabilitation therapies; (2) to determine whether coverage for rehabilitation therapies is associated with social participation outcomes after adjusting for child and household characteristics; (3) to assess whether rehabilitation insurance differentially affects social participation of children with and without disabilities. We conducted a cross-sectional analysis of secondary survey data on 756 children (ages 3-17) from 370 households living in low-income neighborhoods in a Midwestern U.S. city. Multivariate mixed effects logistic regression models were estimated. Significantly higher proportions of children with disabilities had coverage for physical therapy, occupational therapy, and speech and language pathology, yet gaps in coverage were noted. Multivariate analysis indicated that rehabilitation insurance coverage was significantly associated with social participation (OR = 1.67, 95% CI: 1.013-2.75). This trend was sustained in subgroup analysis. Findings support the need for comprehensive coverage of all essential services under children's health insurance programs.

The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study.

Directory of Open Access Journals (Sweden)

Chien-Min Chen

Full Text Available Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce.This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan.Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0.Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P < 0.001 were the most important predictor of whether a patient with hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy comprised the majority (71.2% of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were <0.1% of the total annual medical costs.Musculoskeletal or nervous system-related surgical procedures and increased use of clotting factor VIII concentrate affect the rehabilitation utilization of patients with hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A.

Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants.

Science.gov (United States)

Saltychev, Mikhail; Laimi, Katri; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2014-06-01

To investigate the changes in rehabilitants' perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics. Prospective cohort study based on register and repeated survey data. Public sector employees in ten towns and five hospital districts. A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009. Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland. Differences in perceived work ability level before and after rehabilitation. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation. Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval -0.98 to -0.67) in the short-term and by 1.26 (95% confidence interval -1.45 to -1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants' baseline characteristics. Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation. © The Author(s) 2014.

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...

Experience in rehabilitation works of the team of Ukraine Ministry of Public Health at the Chernobyl' NPP

International Nuclear Information System (INIS)

Tabachnikov, S.I.; Snizhenko, Yu.P.; Kazakov, V.N.; Macheret, E.I.; Mel'nik, V.V.; Roslyakov, V.S.; Cherepkov, V.N.

1992-01-01

The task of the medical team of the Ukraine Ministry of Public Health included: realization of the rehabilitation and sanitation measures for the Chernobyl' NPP operative personnel and their family numbers in November 1986 - March 1987 during interduty period on the basis of the Kiev balneological mud nursing-home; functional rehabilitation of the operative and control personnel and other persons engaged at the Chernobyl' NPP at working places directly, in NPP dispensaries. Analysis of the rehabilitation and sanitation measure efficiencies showed the advisability of their further realization

Characteristics of Hospitals Associated with Complete and Partial Implementation of Electronic Health Records.

Science.gov (United States)

Bhounsule, Prajakta; Peterson, Andrew M

2016-01-01

(1) To determine the proportion of hospitals with and without implementation of electronic health records (EHRs). (2) To examine characteristics of hospitals that report implementation of EHRs partially or completely versus those that report no implementation. (3) To identify hospital characteristics associated with nonimplementation to help devise future policy initiatives. This was a retrospective cross-sectional study using the 2012 American Hospital Association Annual Survey Database. The outcome variable was the implementation of EHRs completely or partially. Independent variables were hospital characteristics, such as staffing, organization structure, accreditations, ownership, and services and facilities provided at the hospitals. Descriptive frequencies were determined, and multinomial logistic regression was used to determine variables independently associated with complete or partial implementation of EHRs. In this study, 12.6 percent of hospitals reported no implementation of EHRs, while 43.9 percent of hospitals implemented EHRs partially and 43.5 percent implemented EHRs completely. Overall characteristics of hospitals with complete and partial implementation were similar. The multinomial regression model revealed a positive association between the number of licensed beds and complete implementation of EHRs. A positive association was found between children's general medical, surgical, and heart hospitals and complete implementation of EHRs. Conversely, psychiatric and rehabilitation hospitals, limited service hospitals, hospitals participating in a network, service hospitals, government nonfederal hospitals, and nongovernment not-for-profit hospitals showed less likelihood of complete implementation of EHRs. Study findings suggest a disparity of EHR implementation between larger, for-profit hospitals and smaller, not-for-profit hospitals. Low rates of implementation were observed with psychiatric and rehabilitation hospitals. EHR policy initiatives

Developing a Rehabilitation Model of Breast Cancer Patients Through Literature Review and Hospital Rehabilitation Programs

Directory of Open Access Journals (Sweden)

Bok-Yae Chung, PhD, RN, APN

2008-03-01

Conclusion: Rehabilitation of breast cancer patients deserves special attention to achieve optimal quality of life. Health care professionals need to be educated about rehabilitation as an effective intervention.

Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners

Science.gov (United States)

Wright, Courtney J.; Zeeman, Heidi; Biezaitis, Valda

2016-01-01

Given that the literature suggests there are various (and often contradictory) interpretations of holistic practice in brain injury rehabilitation and multiple complexities in its implementation (including complex setting, discipline, and client-base factors), this study aimed to examine the experiences of practitioners in their conceptualization and delivery of holistic practice in their respective settings. Nineteen health practitioners purposively sampled from an extensive Brain Injury Network in Queensland, Australia participated in individual interviews. A systematic text analysis process using Leximancer qualitative analysis program was undertaken, followed by manual thematic analysis to develop overarching themes. The findings from this study have identified several items for future inter-professional development that will not only benefit the practitioners working in brain injury rehabilitation settings, but the patients and their families as well. PMID:27270604

Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners.

Science.gov (United States)

Wright, Courtney J; Zeeman, Heidi; Biezaitis, Valda

2016-01-01

Given that the literature suggests there are various (and often contradictory) interpretations of holistic practice in brain injury rehabilitation and multiple complexities in its implementation (including complex setting, discipline, and client-base factors), this study aimed to examine the experiences of practitioners in their conceptualization and delivery of holistic practice in their respective settings. Nineteen health practitioners purposively sampled from an extensive Brain Injury Network in Queensland, Australia participated in individual interviews. A systematic text analysis process using Leximancer qualitative analysis program was undertaken, followed by manual thematic analysis to develop overarching themes. The findings from this study have identified several items for future inter-professional development that will not only benefit the practitioners working in brain injury rehabilitation settings, but the patients and their families as well.

Erosional stability of rehabilitated uranium mine structures incorporating natural landform characteristics, northern tropical Australia

International Nuclear Information System (INIS)

East, T.J.; Uren, C.J.; Noller, B.N.; Cull, R.F.; Curley, P.M.; Unger, C.J.

1994-01-01

Australian Government guidelines specify that tailings containment structures at rehabilitated uranium mines in the Alligator Rivers Region of tropical northern Australia should have an engineered structural life of 1000 years. As part of the containment structure design process, erosion plots incorporating both regional geomorphological characteristics (concave hillslope profiles and a weathering-resistant rock cover of schist) and more conventional engineering design parameters (straight slopes and mine waste rock) were constructed at the Ranger Uranium Mine. The plots were monitored for storm runoff, and concentrations of solutes, suspended solids and selected ions over successive wet seasons. The concave slopes (the hillslope analogues) had lower peak discharges and lower concentrations of suspended solids than the straight slopes. However, solute concentrations in runoff from the schist covered (hillslope) slopes were higher than from the waste rock covered plots. Solute (mainly magnesium sulfate) concentrations for both rock types decreased by about an order of magnitude over the wet season. High sulfate concentrations are also likely to decrease substantially after several wet seasons, due to settlement of the waste rock and a reduction in rates of weathering. Development of a vegetation cover on the rehabilitated landforms will reduce the high suspended sediment concentrations. These initial results suggest that rehabilitated uranium mine structures which utilise selected features of stable natural landforms in their design may have greater erosional stability than more conventionally engineered structures. (orig.)

Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness.

Science.gov (United States)

Sahlin, Eva; Ahlborg, Gunnar; Tenenbaum, Artur; Grahn, Patrik

2015-02-09

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

User involvement in mental health rehabilitation

DEFF Research Database (Denmark)

Petersen, Kirsten; Hounsgaard, Lise; Borg, Tove

2012-01-01

reading, structural analysis, and critical interpretation. Findings: The study showed that user involvement in rehabilitation was experienced by the users as a struggle for self-determination and recognition. Being able to decide and to have influence on daily activities and everyday life, together...... with having goals to reach during rehabilitation, were viewed as valuable. Situations without influence or involving coercion were reported especially during periods of illness or hospitalization. Conclusions: The results of this study contribute to knowledge about user involvement from service users...

[Application of the International Classification of Functioning, Disability and Health (ICF) in Psychosomatic Rehabilitation and Addiction Rehabilitation in Germany - The Current State].

Science.gov (United States)

Spies, M; Brütt, A L; Freitag, M; Buchholz, A

2015-10-01

The aim of this study was to gather information on the current state of the implementation of the International Classification of Functioning, Disability and Health (ICF) in psychosomatic and addiction rehabilitation. In the summer of 2013, rehabilitation clinics in Germany were surveyed online on their ICF utilization. The questionnaire covered scope and purpose of ICF use, application of ICF core sets and assessments as well as barriers to the use of ICF. Of 359 clinics invited, 104 (30%) participated in the survey. Of those surveyed, 60 (61.9%) claimed to have taken measures to implement the ICF in their clinic; only 37 (38.5%), however, reported using the ICF in their daily work. The main barriers identified were complexity of the ICF, time management issues and training deficits. Approaches to ICF use are not uniform. There is a need for training programs, and guidance from health care insurance providers could help towards uniform implementation of the ICF. © Georg Thieme Verlag KG Stuttgart · New York.

Persons with physical disabilities’ experiences of rehabilitation services at Community Health Centres in Cape Town.

Directory of Open Access Journals (Sweden)

C.K. Kahonde

2010-02-01

Full Text Available Background: Rehabilitation is of fundamental importance for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it  is  important  to  seek  clients’  perspectives  of  the  rehabilitation  services and  to  incorporate  these  perspectives  into  the  planning  and  delivery  of rehabilitation  services.  The  aim  of  this  study  was  to  explore  the  persons with  physical  disabilities’  experiences  of  the  rehabilitation  services  they received at Community Health Centres (CHCs. Methods: In-depth  qualitative  interviews  were  used  to  collect  data.  Ten  persons  with  physical  disabilities,  who  had  received  rehabilitation  services at CHCs participated in the in-depth interviews. The interviews were tape-recorded and transcribed verbatim.  Thematic analysis was used to analyse the data.  Results: The  clients  experienced  problems  with  accessing  transport  and  obtaining  information  from  the  service providers. Experiences regarding clients’ involvement in the rehabilitation were varied. All the clients reported positive experiences regarding their interaction with service providers and family involvement. Conclusion: The experiences of the participants who accessed CHCs for rehabilitation were positive and negative. The service providers should therefore address the aspects of rehabilitation that were negatively experienced.

[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.

77 FR 37022 - Disability and Rehabilitation Research Projects and Centers Program; Rehabilitation Engineering...

Science.gov (United States)

2012-06-20

... training to facilitate the advancement of knowledge and understanding of the unique needs of traditionally... opportunities for early-career rehabilitation engineers. RERCs seek to solve rehabilitation problems and remove... sector of the economy, productivity, competition, jobs, the environment, public health or safety, or...

Nursing home reimbursement and the allocation of rehabilitation therapy resources.

Science.gov (United States)

Murtaugh, C M; Cooney, L M; DerSimonian, R R; Smits, H L; Fetter, R B

1988-10-01

Most public funding methods for long-term care do not adequately match payment rates with patient need for services. Case-mix payment systems are designed to encourage a more efficient and equitable allocation of limited health care resources. Even nursing home case-mix payment systems, however, do not currently provide the proper incentives to match rehabilitation therapy resources to a patient's needs. We were able to determine by a review of over 8,500 patients in 65 nursing homes that certain diagnoses, partial dependence in activities of daily living (ADLs), clear mental status, and improving medical status are associated with the provision of rehabilitation services to nursing home residents. These patient characteristics are clinically reasonable predictors of the need for therapy and should be considered for use in nursing home case-mix reimbursement systems. Primary payment source also was associated with the provision of rehabilitation services even after taking into account significant patient characteristics. It is unclear how much of the variation in service use across payers is due to differences in patient need as opposed to differences in the financial incentives associated with current payment methods.

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.

Relationship of psychology inpatient rehabilitation services and patient characteristics to outcomes following spinal cord injury: the SCIRehab project.

Science.gov (United States)

Heinemann, Allen W; Wilson, Catherine S; Huston, Toby; Koval, Jill; Gordon, Samuel; Gassaway, Julie; Kreider, Scott E D; Whiteneck, Gale

2012-11-01

To evaluate the effects of psychological interventions on rehabilitation outcomes, including residence and functional status at discharge, and residence, school attendance, or employment, and physical, social, occupational, and mobility aspects of participation 1 year after spinal cord injury (SCI). Prospective observational cohort study. Six inpatient rehabilitation facilities in the United States. Inpatients with SCI 12 years of age and older. Usual rehabilitation care. Functional Independence Measure at rehabilitation discharge and 1-year injury anniversary; discharge destination and residence at 1-year anniversary; Craig Handicap Assessment and Reporting Technique, Diener Satisfaction with Life Scale, Patient Health Questionnaire, employment or school attendance, rehospitalization, and occurrence of a pressure ulcer at 1-year anniversary. More time in psycho-educational interventions was associated with better function, discharge to home, home residence at 1 year, and the absence of pressure ulcers at 1 year. More psychotherapeutic sessions focusing on processing emotions and/or locus of control were associated with poorer function at discharge and 1 year, less physical independence and community mobility, lower satisfaction with life, and the presence of pressure sores at 1 year. Psychological services are an important component of comprehensive medical rehabilitation and tailored to patient needs and readiness to benefit from rehabilitation. Services focused on remediating deficits tend to be associated with negative outcomes, while services intended to foster adjustment and growth tend to be associated with favorable outcomes. Further research is needed to determine the optimal type and timing of psychological services during inpatient rehabilitation based on individuals' strengths and vulnerabilities. Note: This is the sixth in this third series of SCIRehab articles.

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 ...

Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

DEFF Research Database (Denmark)

Sibilitz, Kirstine L.; Berg, Selina K.; Rasmussen, Trine B.

2016-01-01

Objective: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart......-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. Results: 76% were men, mean age 62 years......, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0...

Health monitoring and rehabilitation of a concrete structure using intelligent materials

Science.gov (United States)

Song, G.; Mo, Y. L.; Otero, K.; Gu, H.

2006-04-01

This paper presents the concept of an intelligent reinforced concrete structure (IRCS) and its application in structural health monitoring and rehabilitation. The IRCS has multiple functions which include self-rehabilitation, self-vibration damping, and self-structural health monitoring. These functions are enabled by two types of intelligent (smart) materials: shape memory alloys (SMAs) and piezoceramics. In this research, Nitinol type SMA and PZT (lead zirconate titanate) type piezoceramics are used. The proposed concrete structure is reinforced by martensite Nitinol cables using the method of post-tensioning. The martensite SMA significantly increases the concrete's damping property and its ability to handle large impact. In the presence of cracks due to explosions or earthquakes, by electrically heating the SMA cables, the SMA cables contract and close up the cracks. In this research, PZT patches are embedded in the concrete structure to detect possible cracks inside the concrete structure. The wavelet packet analysis method is then applied as a signal-processing tool to analyze the sensor signals. A damage index is defined to describe the damage severity for health monitoring purposes. In addition, by monitoring the electric resistance change of the SMA cables, the crack width can be estimated. To demonstrate this concept, a concrete beam specimen with reinforced SMA cables and with embedded PZT patches is fabricated. Experiments demonstrate that the IRC has the ability of self-sensing and self-rehabilitation. Three-point bending tests were conducted. During the loading process, a crack opens up to 0.47 inches. Upon removal of the load and heating the SMA cables, the crack closes up. The damage index formed by wavelet packet analysis of the PZT sensor data predicts and confirms the onset and severity of the crack during the loading. Also during the loading, the electrical resistance value of the SMA cable changes by up to 27% and this phenomenon is used to

Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists.

Science.gov (United States)

Kristensen, Hanne Kaae; Ytterberg, Charlotte; Jones, Dorrie Lee; Lund, Hans

2016-12-01

Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision-making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research-based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework. A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists' documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury. The study included 131 patients. The therapists' praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented. Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent. Implications for Rehabilitation In order to individualize the rehabilitation offered, more attention and focus on involving and giving words to patients' expectations, perceptions, experiences, and perspectives is needed. With the intention of enabling meaningful participation the health professionals need to pay more attention to the importance of environmental factors. Both guidelines and clinical practice should consider all components of the International Classification of Functioning, Disability and

Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

Directory of Open Access Journals (Sweden)

Eva Sahlin

2015-02-01

Full Text Available After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR. Region Västra Götaland (VGR started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57 and an occupational health service (OHS model (n = 45. Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

Psychosocial rehabilitation and mental health (24th European Congress of Psychiatry materials review

Directory of Open Access Journals (Sweden)

Iryna Frankova

2016-09-01

Full Text Available Background: Mental illness - is a heavy burden of modern society and may be underestimated. There are several reasons: the high prevalence of this category of disorders, high level of stigmatization, treatment gap between those who are mentally ill and those will be treated. The economic crisis and the lack of resources, make psychosocial rehabilitation of mental disorders even more complicated. Methods: This review is based on materials of the 24th Congress of the European Psychiatric Association (April 2016, Madrid, the participants of the "Eastern European Academy of the World Psychiatric Association and "Servier" company specifically for psychiatric journals of WPA Zone 10 (East European Educational WPA-Servier Academy - «EEE WPA-Servier Academy». The review will present materials from several symposiums: "Psychosocial rehabilitation and mental health", "Overcoming the stigma of mental disorders: recent advances and initiatives," "Fight stigma: a global challenge", and state-of-the-art report, "Psychosocial interventions in schizophrenia ». Results: As result, we anticipate that this review will distribute and promote knowledge about high quality standards and evidence-based research and treatment methods among the modern community of mental health experts. Conclusion: Current approach in psychosocial rehabilitation of severe mental disorders has changed significantly due to the data of evidence-based medicine, the use of effective, superior methods suggests a good outcome for a larger number of patients.

Learning via participation - a user perspective on user involvement in mental health rehabilitation

DEFF Research Database (Denmark)

Petersen, Kirsten Schultz; Borg, Tove; Hounsgaard, Lise

2012-01-01

The aim of the study is to gain insight into the user’s perspective on user involvement in mental health rehabilitation. The study was designed as a field study lasting 15 months in two supported housing schemes. An ethnographic approach by James Spradley was employed, involving participant...

Generating Expectations: What Pediatric Rehabilitation Can Learn From Mental Health Literature.

Science.gov (United States)

Smart, Eric; Nalder, Emily; Rigby, Patty; King, Gillian

2018-04-03

Family-Centered Care (FCC) represents the ideal service delivery approach in pediatric rehabilitation. Nonetheless, implementing FCC as intended in clinical settings continues to be hindered by knowledge gaps. One overlooked gap is our understanding of clients' therapy expectations. This perspective article synthesizes knowledge from the mental health services literature on strategies recommended to service providers for generating transparent and congruent therapy expectations with clients, and applies this knowledge to the pediatric rehabilitation literature, where this topic has been researched significantly less, for the purpose of improving FCC implementation. Dimensions of the Measure of Processes of Care, an assessment tool that measures clients' perceptions of the extent a service is family-centered, inform the organization of therapy expectation-generating strategies: (1) Providing Respectful and Supportive Care (assessing and validating clients' expectations); (2) General and Specific Information (foreshadowing therapy journeys, explaining treatment rationale, and conveying service provider qualifications); (3) Coordinated and Comprehensive Care (socializing clients to roles and reflecting on past socialization); and (4) Enabling and Partnership (applying a negotiation framework and fostering spaces safe to critique). Strategies can help pediatric rehabilitation service providers work with families to reframe unrealistic expectations, establish congruent beliefs supporting effective partnerships, and prevent possible disillusionment with therapy over time.

CHARACTERISTICS OF RESEARCH METHODOLOGY DEVELOPMENT IN SPECIAL EDUCATION AND REHABILITATION

Directory of Open Access Journals (Sweden)

Natasha ANGELOSKA-GALEVSKA

2004-12-01

Full Text Available The aim of the text is to point out the developmental tendencies in the research methodology of special education and rehabilitation worldwide and in our country and to emphasize the importance of methodological training of students in special education and rehabilitation at the Faculty of Philosophy in Skopje.The achieved scientific knowledge through research is the fundamental pre-condition for development of special education and rehabilitation theory and practice. The results of the scientific work sometimes cause small, insignificant changes, but, at times, they make radical changes. Thank to the scientific researches and knowledge, certain prejudices were rejected. For example, in the sixth decade of the last century there was a strong prejudice that mentally retarded children should be segregated from the society as aggressive and unfriendly ones or the deaf children should not learn sign language because they would not be motivated to learn lip-reading and would hardly adapt. Piaget and his colleagues from Geneva institute were the pioneers in researching this field and they imposed their belief that handicapped children were not handicapped in each field and they had potentials that could be developed and improved by systematic and organized work. It is important to initiate further researches in the field of special education and rehabilitation, as well as a critical analysis of realized researches. Further development of the scientific research in special education and rehabilitation should be a base for education policy on people with disabilities and development of institutional and non-institutional treatment of this population.

Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

Directory of Open Access Journals (Sweden)

Sundh J

2017-06-01

Full Text Available Josefin Sundh,1 Helena Lindgren,2 Mikael Hasselgren,2 Scott Montgomery,3–5 Christer Janson,6 Björn Ställberg,7 Karin Lisspers7 1Department of Respiratory Medicine, School of Medical Sciences, 2Medical Programme, School of Medical Sciences, 3Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, 4Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; 5Department of Epidemiology and Public Health, University College, London, UK; 6Department of Medical Sciences, Respiratory, Allergy and Sleep Research, 7Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden Introduction: Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Materials and methods: Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. Results: In primary care, nurse-based asthma/COPD clinics were common (87%, with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%. In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%, occupational therapists (3% vs 10%, nutritionists (5% vs 13%, and counselors (1% vs 4%. A higher COPD Assessment Test score

Communication Framework for Tele-rehabilitation Systems with QoS Guarantee

OpenAIRE

Dandanov Nikolay; Semov Plamen; Ivanov Antoni; Christoff Nicole; Poulkov Vladimir

2017-01-01

Nowadays, there is great interest in developing telemedicine technologies. These technologies will provide health care from distance swiftly and lightly, as well as reduce the expenses for activities, such as rehabilitation. Telemedicine applications are possible due to the advances in information technologies and the ever-expanding communication network infrastructure. The network characteristics bandwidth, packet loss, latency, jitter and policies are crucial for the performance of tele-reh...

Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program.

Science.gov (United States)

Müller, Carsten; Krauth, Konstantin A; Gerß, Joachim; Rosenbaum, Dieter

2016-09-01

Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models. Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p cancer patients.

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.

Depression screening among older adults attending low-vision rehabilitation and eye-care services: Characteristics of those who screen positive and client acceptability of screening.

Science.gov (United States)

Holloway, Edith E; Sturrock, Bonnie A; Lamoureux, Ecosse L; Keeffe, Jill E; Rees, Gwyneth

2015-12-01

To investigate characteristics associated with screening positive for depressive symptoms among older adults accessing low-vision rehabilitation and eye-care services and to determine client acceptability of depression screening using the Patient Health Questionnaire-2 (PHQ-2) in these settings. One-hundred and twenty-four older adults (mean = 77.02 years, SD = 9.12) attending low-vision rehabilitation and eye-care services across Australia were screened for depression and invited to complete a telephone-administered questionnaire to determine characteristics associated with depressive symptoms and client acceptability of screening in these settings. Thirty-seven per cent (n = 46/124) of participants screened positive for depressive symptoms, and the majority considered the new depression screening method to be a 'good idea' in vision services (85%). Severe vision loss (<6/60 in the better eye) was associated with an increased odds of screening positive for depressive symptoms (odds ratio 2.37; 95% confidence interval 1.08-6.70) even after adjusting for potential confounders. Participants who screened positive had a preference for 'talking' therapy or a combination of medication and 'talking therapy' delivered within their own home (73%) or via telephone (67%). The PHQ-2 appears to be an acceptable method for depression screening in eye-care settings among older adults. Targeted interventions that incorporate home-based or telephone delivered therapy sessions may improve outcomes for depression in this group. © 2014 ACOTA.

Review: Health Management in Disasters with Focusing on Rehabilitation

Directory of Open Access Journals (Sweden)

Hamid Reza Khankeh

2008-07-01

Full Text Available Disasters should never be considered as routine. Disasters of any kind—natural or manmade—clearly disrupt the normal functioning of any community and frequently overwhelm both personal and community resources. In the post-disaster context, following the initial shock of the disaster, returning lives and livelihoods to normalcy becomes a primary concern of the affected communities and nations. Traditionally, this has been known as the recovery and rehabilitation phase, where "normalcy" refers to the return of the community to the state it was in prior to the disaster event. Rehabilitation is this process of returning the community to “normal” that may extend for many years and involves the physical, social and economic components of the community. Disasters can take on a life of their own, therefore being prepared is the single most effective way to improve outcomes. Proper pre-event planning and providing mechanisms for resource coordination are critical which will be resulted a successful response. It should focus on increasing the participation of civil authorities in order to reestablish local authorities. In order to develop safer communities with fewer deaths, physical injuries, and psycho-social trauma following disasters, health systems must be capable of providing a coordinated response during disasters and of delivering effective mitigation and preparedness programs before disaster impact. The health sector has a vested interest and a key role in this process. In addition, prior to the occurrence of disasters, national, provincial, and local planning should be blueprinted by managers. The public must be educated regarding the importance of individual and family preparation for disaster

Spinal Cord Injury Rehabilitation in Nepal

Directory of Open Access Journals (Sweden)

Nabina Shah

2013-06-01

Full Text Available Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life. Keywords: rehabilitation; spinal injury.

SCIRehab uses practice-based evidence methodology to associate patient and treatment characteristics with outcomes.

Science.gov (United States)

Whiteneck, Gale G; Gassaway, Julie

2013-04-01

To describe the application of practice-based evidence (PBE) methodology to spinal cord injury (SCI) rehabilitation in the SCIRehab study, and to summarize associations of patient characteristics and treatment interventions to outcomes. Prospective observational study. Six SCI rehabilitation centers. Patients with traumatic SCI (N=1376) admitted for first rehabilitation. Not applicable. FIM and residence at discharge, and FIM, residence, Craig Handicap Assessment and Reporting Technique, work/school status, Patient Health Questionnaire-9, Diener Satisfaction with Life Scale, rehospitalization, and presence of pressure ulcers at 1 year postinjury. Patient demographic and injury characteristics explained significant variation in rehabilitation outcomes, particularly functional outcomes. Regression modeling also identified a large number of significant associations with outcomes when total time in each discipline was modeled and when models were developed for each discipline, examining time spent in the many specific interventions provided by each discipline. The application of PBE methodology in the SCIRehab study provided extensive information about the process of inpatient SCI rehabilitation. While patient demographic and injury characteristics explain substantial variation in rehabilitation outcomes, particularly functional outcomes, significant relations also were found between the type and quantity of treatment interventions delivered by each rehabilitation discipline and a broad range of outcomes. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

Science.gov (United States)

Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

2013-06-01

To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, Pservice quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

Aiming for a healthier life: a qualitative content analysis of rehabilitation goals in patients with rheumatic diseases.

Science.gov (United States)

Berdal, Gunnhild; Sand-Svartrud, Anne-Lene; Bø, Ingvild; Dager, Turid N; Dingsør, Anne; Eppeland, Siv G; Hagfors, Jon; Hamnes, Bente; Nielsen, Merete; Slungaard, Bente; Wigers, Sigrid H; Hagen, Kåre Birger; Dagfinrud, Hanne S; Kjeken, Ingvild

2018-04-01

To explore and describe rehabilitation goals of patients with rheumatic diseases during rehabilitation stays, and examine whether goal content changed from admission to discharge. Fifty-two participants were recruited from six rehabilitation centers in Norway. Goals were formulated by the participants during semi-structured goal-setting conversations with health professionals trained in motivational interviewing. An inductive qualitative content analysis was conducted to classify and quantify the expressed goals. Changes in goal content from admission to discharge were calculated as percentage differences. Goal content was explored across demographic and contextual characteristics. A total of 779 rehabilitation goals were classified into 35 categories, within nine overarching dimensions. These goals varied and covered a wide range of topics. Most common at admission were goals concerning healthy lifestyle, followed by goals concerning symptoms, managing everyday life, adaptation, disease management, social life, and knowledge. At discharge, goals about knowledge and symptoms decreased considerably, and goals about healthy lifestyle and adaptation increased. The health profession involved and patient gender influenced goal content. The rehabilitation goals of the patients with rheumatic diseases were found to be wide-ranging, with healthy lifestyle as the most prominent focus. Goal content changed between admission to, and discharge from, rehabilitation stays. Implications for rehabilitation Rehabilitation goals set by patients with rheumatic diseases most frequently concern healthy lifestyle changes, yet span a wide range of topics. Patient goals vary by gender and are influenced by the profession of the health care worker involved in the goal-setting process. To meet the diversity of patient needs, health professionals need to be aware of their potential influence on the actual goal-setting task, which may limit the range of topics patients present when they are

The Importance of Patient Involvement in Stroke Rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Tistad, Malin; Koch, Lena von

2016-01-01

OBJECTIVE: To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. METHOD: Data...... was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess....... CONCLUSIONS: The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health services needs....

Effect of Cardiac Rehabilitation in Patients with ICD

DEFF Research Database (Denmark)

Christensen, Anne Vinggaard; Zwisler, Ann-Dorthe; Svendsen, Jesper Hastrup

2015-01-01

(rehabilitation: 47.7 points [SD 10.1] vs 54.8 points [7.1] and usual care: 48.1 points [SD 10.9] vs 51.9 points [SD 9.6], P = 0.05). CONCLUSIONS: After ICD implantation, significant gender differences were found in physical health, mental health, and QoL. Effects of rehabilitation were found among men only...... in physical component scale, mental component scale, social functioning, physical functioning, bodily pain, vitality, mental health, and QoL with men having higher scores. Among men only, significant differences were found in VO2 (rehabilitation: 20.9 mL/min/kg [standard deviation (SD) 8.1] vs 23.4 m...... and gender predicted effect of rehabilitation on the mental component scale....

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.

Stroke Care 2: Stroke rehabilitation

NARCIS (Netherlands)

Langhorne, P.; Bernhardt, J.; Kwakkel, G.

2011-01-01

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

Health Benefits for Vocational Rehabilitation Consumers: Comparison of Access Rates with Workers in the General Population

Science.gov (United States)

Lustig, Daniel C.; Strauser, David R.

2010-01-01

Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…

K-means cluster analysis of rehabilitation service users in the Home Health Care System of Ontario: examining the heterogeneity of a complex geriatric population.

Science.gov (United States)

Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2012-12-01

To examine the heterogeneity of home care clients who use rehabilitation services by using the K-means algorithm to identify previously unknown patterns of clinical characteristics. Observational study of secondary data. Home care system. Assessment information was collected on 150,253 home care clients using the provincially mandated Resident Assessment Instrument-Home Care (RAI-HC) data system. Not applicable. Assessment information from every long-stay (>60 d) home care client that entered the home care system between 2005 and 2008 and used rehabilitation services within 3 months of their initial assessment was analyzed. The K-means clustering algorithm was applied using 37 variables from the RAI-HC assessment. The K-means cluster analysis resulted in the identification of 7 relatively homogeneous subgroups that differed on characteristics such as age, sex, cognition, and functional impairment. Client profiles were created to illustrate the diversity of this geriatric population. The K-means algorithm provided a useful way to segment a heterogeneous rehabilitation client population into more homogeneous subgroups. This analysis provides an enhanced understanding of client characteristics and needs, and could enable more appropriate targeting of rehabilitation services for home care clients. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

Mapping the rehabilitation interventions of a community stroke team to the extended International Classification of Functioning, Disability and Health Core Set for Stroke.

Science.gov (United States)

Evans, Melissa; Hocking, Clare; Kersten, Paula

2017-12-01

This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand. Interventions were retrospectively extracted from 18 medical records and linked to the International Classification of Functioning, Disability and Health and the Extended International Classification of Functioning, Disability and Health Core Set for Stroke. The frequencies of linked interventions and the health discipline providing the intervention were calculated. Analysis revealed that 98.8% of interventions provided by the rehabilitation team could be linked to the Extended International Classification of Functioning, Disability and Health Core Set for Stroke, with more interventions for body function and structure than for activities and participation; no interventions for emotional concerns; and limited interventions for community, social and civic life. Results support previous recommendations for additions to the EICSS. The results support the use of the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in New Zealand and demonstrates its use as a quality assurance tool that can evaluate the scope and practice of a rehabilitation service. Implications for Rehabilitation The Extended International Classification of Functioning Disability and Health Core Set for Stroke appears to represent the stroke interventions of a community stroke rehabilitation team in New Zealand. As a result, researchers and clinicians may have

Measuring acute rehabilitation needs in trauma: preliminary evaluation of the Rehabilitation Complexity Scale.

Science.gov (United States)

Hoffman, Karen; West, Anita; Nott, Philippa; Cole, Elaine; Playford, Diane; Liu, Clarence; Brohi, Karim

2013-01-01

Injury severity, disability and care dependency are frequently used as surrogate measures for rehabilitation requirements following trauma. The true rehabilitation needs of patients may be different but there are no validated tools for the measurement of rehabilitation complexity in acute trauma care. The aim of the study was to evaluate the potential utility of the Rehabilitation Complexity Scale (RCS) version 2 in measuring acute rehabilitation needs in trauma patients. A prospective observation study of 103 patients with traumatic injuries in a Major Trauma Centre. Rehabilitation complexity was measured using the RCS and disability was measured using the Barthel Index. Demographic information and injury characteristics were obtained from the trauma database. The RCS was closely correlated with injury severity (r=0.69, p<0.001) and the Barthel Index (r=0.91, p<0.001). However the Barthel was poor at discriminating between patients rehabilitation needs, especially for patients with higher injury severities. Of 58 patients classified as 'very dependent' by the Barthel, 21 (36%) had low or moderate rehabilitation complexity. The RCS correlated with acute hospital length of stay (r=0.64, p=<0.001) and patients with a low RCS were more likely to be discharged home. The Barthel which had a flooring effect (56% of patients classified as very dependent were discharged home) and lacked discrimination despite close statistical correlation. The RCS outperformed the ISS and the Barthel in its ability to identify rehabilitation requirements in relation to injury severity, rehabilitation complexity, length of stay and discharge destination. The RCS is potentially a feasible and useful tool for the assessment of rehabilitation complexity in acute trauma care by providing specific measurement of patients' rehabilitation requirements. A larger longitudinal study is needed to evaluate the RCS in the assessment of patient need, service provision and trauma system performance

The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

Science.gov (United States)

Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

2014-01-01

Objective To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Design and setting Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Participants Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Interventions Not applicable. Main outcome measure(s) Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales’ classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. Results A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. PMID:24849795

Use of a mobile device in mental health rehabilitation: A clinical and comprehensive analysis of 11 cases.

Science.gov (United States)

Briand, Catherine; Sablier, Juliette; Therrien, Julie-Anne; Charbonneau, Karine; Pelletier, Jean-François; Weiss-Lambrou, Rhoda

2018-07-01

This study aimed to test the feasibility of using a mobile device (Apple technology: iPodTouch®, iPhone® or iPad®) among people with severe mental illness (SMI) in a rehabilitation and recovery process and to document the parameters to be taken into account and the issues involved in implementing this technology in living environments and mental health care settings. A qualitative multiple case study design and multiple data sources were used to understand each case in depth. A clinical and comprehensive analysis of 11 cases was conducted with exploratory and descriptive aims (and the beginnings of explanation building). The multiple-case analysis brought out four typical profiles to illustrate the extent of integration of a personal digital assistant (PDA) as a tool to support mental health rehabilitation and recovery. Each profile highlights four categories of variables identified as determining factors in this process: (1) state of health and related difficulties (cognitive or functional); (2) relationship between comfort level with technology, motivation and personal effort deployed; (3) relationship between support required and support received; and (4) the living environment and follow-up context. This study allowed us to consider the contexts and conditions to be put in place for the successful integration of mobile technology in a mental health rehabilitation and recovery process.

The Perspectives of Health Care Professionals on the Value of Peer Mentoring during Rehabilitation

Science.gov (United States)

Townsend, Rob

2013-01-01

There is growing acknowledgement that individuals who experience peer support following a major health event adapt more effectively to physical and psycho-social challenges. Research indicates that patients who experience peer mentoring support during the immediate rehabilitation period appear to adapt better and perceive themselves as better…

Achieving a holistic perspective in stroke rehabilitation

DEFF Research Database (Denmark)

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

2015-01-01

Background/Aims: Holistic, multidisciplinary rehabilitation is often the most appropriate for stroke patients. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a comprehensive conceptual framework and systematic terminology used...... to a holistic approach in stroke rehabilitation, including an understanding of functioning and the ability to participate in everyday life. Using this approach to rehabilitation, disability is not only perceived as a consequence of stroke but also in the context of the individual person, where interactions...... the holistic approach....

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

[Dance projects as an integral part of CI rehabilitation and their impact on mental health: a pilot study].

Science.gov (United States)

Klink, B; Praetorius, M; Roder, S; Hintermair, M

2014-07-01

Alongside improvements in hearing and communication skills, the rehabilitation of children, adolescents and adults with a cochlear implant (CI) in recent years has increasingly taken into account mental health and quality of life issues. In the context of the programs offered, this study assesses the significance of dance for the mental health of adult clients with a CI. Eleven adult CI users participated in a dance project, which took place as a cooperation between the ENT University Hospital Heidelberg and the Baden State Theatre Karlsruhe. Participants were questioned at two different time points for assessment with the mental health scales (SPG). These scales measure seven different aspects of psychosocial well-being (including autonomy, willpower, affirmation of life and meaningfulness). Significant positive changes in the domains of affirmation of life, self-reflection and social integration were revealed by before and after comparisons; tendencies toward positive change were observed (p ≤ 0.10) in the domains of willpower, naturalness and meaningfulness. No changes were observed in the autonomy domain. The results indicate that the mental health of adult clients with a CI can be strengthened by dance as a complementary rehabilitation module. Concepts of CI rehabilitation should increasingly find anchor in the consideration of such arrangements for its range of offers.

42 CFR 483.45 - Specialized rehabilitative services.

Science.gov (United States)

2010-10-01

.... If specialized rehabilitative services such as but not limited to physical therapy, speech-language pathology, occupational therapy, and mental health rehabilitative services for mental illness and mental...

Mental health nurses' experiences of schizophrenia rehabilitation in China and India: a preliminary study.

Science.gov (United States)

Higgins, Louise; Dey-Ghatak, Priya; Davey, Gareth

2007-02-01

Nursing methods based on Western models may not be culturally relevant to patients from ethnic minority groups or other countries. In order to meet the needs of all patients, more research is needed to understand the cultural and social factors that influence nursing approaches. This paper reports preliminary open-ended discussions with mental health nurses in China and India in order to gain insights into the cultural and social issues that surround social rehabilitation of patients with schizophrenia. Rehabilitation methods included cognitive behavioural therapy, psychosocial methods, and employment/vocational training. Several cultural and social issues drive the rehabilitation process in both countries, including the use of traditional medicine and healers, emphasis on family involvement, stigma, gender inequality, and lack of resources. Participants in both countries were working hard to tackle some of these issues, but also expressed need for improved resources. The study provides an insight into the cultural and social factors that shape schizophrenia rehabilitation in China and India, and serves as a baseline for further research about nursing across cultures. The study also highlights the marked differences in attitudes, values, and behaviours across cultural groups that need to be considered by nursing professionals to ensure that services are culturally competent.

Rehabilitation Traumatology: A Narrative Review.

Science.gov (United States)

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

2017-09-01

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

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 ...

Can Older Adults Accurately Report their Use of Physical Rehabilitation Services?

Science.gov (United States)

Freedman, Vicki A; Kasper, Judith D; Jette, Alan

2018-04-10

To explore accuracy of rehabilitation service use reports by older adults and variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). We calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of survey-based measures from an observational panel study, the National Health and Aging Trends Study (NHATS), relative to measures developed from linked Medicare claims. Community-dwelling sample of Medicare fee-for-service beneficiaries in 2015 NHATS who were enrolled in Medicare Parts A and B for 12 months prior to their interview (N=4,228). Respondents were asked whether they received rehabilitation services in the last year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the last year. Self-reported measures had high sensitivity (77%) and PPV (80%) and even higher specificity and NPV (approaching 95%). However, in adjusted models sensitivity was lower for Black enrollees, the very old, and those with lower education levels. Survey-based measures of rehabilitation accurately captured use over the past year but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans. Copyright © 2018. Published by Elsevier Inc.

Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial

Science.gov (United States)

2013-01-01

Background It is becoming increasingly necessary for community health centers to make rehabilitation services available to patients with osteoarthritis of the knee. However, for a number of reasons, including a lack of expertise, the small size of community health centers and the availability of only simple medical equipment, conventional rehabilitation therapy has not been widely used in China. Consequently, most patients with knee osteoarthritis seek treatment in high-grade hospitals. However, many patients cannot manage the techniques that they were taught in the hospital. Methods such as acupuncture, tuina, Chinese medical herb fumigation-washing and t’ai chi are easy to do and have been reported to have curative effects in those with knee osteoarthritis. To date, there have been no randomized controlled trials validating comprehensive traditional Chinese medicine for the rehabilitation of knee osteoarthritis in a community health center. Furthermore, there is no standard rehabilitation protocol using traditional Chinese medicine for knee osteoarthritis. The aim of the current study is to develop a comprehensive rehabilitation protocol using traditional Chinese medicine for the management of knee osteoarthritis in a community health center. Method/design This will be a randomized controlled clinical trial with blinded assessment. There will be a 4-week intervention utilizing rehabilitation protocols from traditional Chinese medicine and conventional therapy. Follow-up will be conducted for a period of 12 weeks. A total of 722 participants with knee osteoarthritis will be recruited. Participants will be randomly divided into two groups: experimental and control. Primary outcomes will include range of motion, girth measurement, the visual analogue scale, and results from the manual muscle, six-minute walking and stair-climbing tests. Secondary outcomes will include average daily consumption of pain medication, ability to perform daily tasks and health

Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling

DEFF Research Database (Denmark)

Vadstrup, Eva S; Frølich, Anne; Perrild, Hans

2011-01-01

Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness ...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

European initiative for the application of the International Classification of Functioning, Disability and Health: development of Clinical Assessment Schedules for specified rehabilitation services.

Science.gov (United States)

Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold

2017-04-01

Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for

Welcome to the Maiden Issue of International Journal of Health and Rehabilitation Sciences

Directory of Open Access Journals (Sweden)

Manjula Shantaram

2012-07-01

Full Text Available Today marks the publication date of the inaugural issue of the International Journal of Health and Rehabilitation Sciences (IJHRS. IJHRS is a publication of Global Network of Health Educators (GNHE, a not-for-profit initiative of Health educators worldwide in a mission to promote the health related awareness across the globe. We would like to take this opportunity to place on record my hearty thanks to all the members of GNHE and editorial board of IJHRS for their invaluable personal and scientific resources for guiding the journal from initial planning to the first steps it is taking now. Our aim is that IJHRS will be the paramount archive of knowledge in the areas of Health and Rehabilitation sciences. IJHRS is in open access format, in our view the only relevant such model in these times where information must be freely available to all. The traditional subscription-based model inherently denies free access to knowledge and seems contrary to the attribute of scientific thought. Our goal is to have a rapid peer review process, and we will make every effort to make an initial decision at the earliest. The peer review process will match scholarly reviewers with submitted manuscripts to produce high quality articles of interest and scientific caliber. The process is confidential so that criticisms and revisions are made in the fairest manner possible. The final decision on publication will be made by the editorial board. We will look for submissions of interesting and important scientific information that hopefully will have clinical application. High quality research of all types will be fostered and published with pride in the journal. IJHRS will be shortly indexed in Index Copernicus and other indexing authorities. We have the opportunity to improve the quality of life of so many people in developing countries and otherwise disadvantaged situations. The talent and determination of our readers is a resource with unlimited potential and we have

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...

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.

Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation

Directory of Open Access Journals (Sweden)

Tina Pretnar

2014-08-01

Full Text Available Background: Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL, but the presence of systemic diseases can also affect the well-being of an individual.The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP.Methods: 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8 were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images.Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %, followed by a headache (N = 15, 11.5 %, allergies and asthma (n = 13, 10 %, and a rheumatic disease (N = 11, 8.5 %. Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024. The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP, and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104.Conclusions: The total number of remaining teeth in the oral cavity (p = 0.031, the presence of osteoporosis (p = 0.024, and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104. Other systemic diseases (cardiovascular disease, headache, allergies and

White Book on Physical and Rehabilitation Medicine in Europe. Chapter 2. Why rehabilitation is needed by individual and society.

Science.gov (United States)

2018-04-01

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence. The chapter describes the increasing burden of disability due to conditions seen in PRM practice rather than on all those diseases contributing to physical disablement and does not include mental illness, learning disabilities, etc. Ten percent of Western Europe's population have a disability and are surviving longer, resulting in higher costs for health and social care and a greater impact of co-morbidities. The chapter also describes the impact and increased costs in the absence of rehabilitation. Not only is money spent on rehabilitation recovered with five to nine-fold savings (e.g. in return to work), but rehabilitation is effective in all phases of health conditions. Specialized rehabilitation (as delivered by PRM services) is highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients. Disability discrimination has been outlawed and the text describes the legal context and status of a person living in Europe with a disability. The second part highlights the United Nations Conventions on human rights, confirmed in the World Report on Disability, but also on the principles of ethical practice among PRM physicians. The third part addresses the variability of access to and funding of rehabilitation services across countries. The

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

[The psychological security in the framework of the system of factors responsible for the effectiveness of spa and health resort-based rehabilitation].

Science.gov (United States)

Krasnyanskaya, T M; Tylets, V G

The present work was designed to address the problem of ensuring the psychological security in the framework of organization of the rehabilitative treatment based at the spa and health resort facilities. We undertook the questionnaire study for which 650 subjects were recruited among those attending spa and health resort facilities of the cities of Essentuki and Kislovodsk. The participants were asked to estimate the level of their personal security and the quality of the provided means for the rehabilitative treatment and general health improvement. It was found that as many as 43% of the respondents reported the moderate level of psychological security whereas about 30% of them estimated the level of their psychological security as low. Overall, the attitude toward the available means for health improvement and rehabilitation proved extremely variable. The factorial analysis has demonstrated the highly subjective opinions of the responders as regards the provided services categorized in terms of therapeutic (mineral water, preformed physical factors, peloid and dietary therapy), health improvement (herbal medicine, therapeutic physical training, therapy, bioclimatic therapy), and recreational (animation, excursion and touristic activities) factors. The value of these factors was perceived differently by the vacationers with different feelings of psychological security. Those reporting the high level of psychological security demonstrated the positive attitude toward all factors and circumstances available for the general improvement of the health status whereas the holidaymakers reporting the moderate level of personal psychological security exhibited the non-equivalent attitude toward the provided services; namely, they highly estimated the available therapeutic factors but either underestimated the value of the constituent components of the health improving and recreational factors or demonstrated the very selective attitude toward their assessment. Generally

Are there meaningful longitudinal changes in health related quality of life--SF36, in cardiac rehabilitation patients?

LENUS (Irish Health Repository)

McKee, Gabrielle

2012-02-01

BACKGROUND: This study aimed to observe changes in quality of life and minimal clinical important differences of quality of life over time in cardiac rehabilitation patients and to compare these with published normal data. METHODS: In this non-randomised study, SF36 questionnaires were completed by 187 patients recruited to a Phase III cardiac rehabilitation multidisciplinary outpatient programme. Data was collected at beginning, end and six months after Phase III cardiac rehabilitation programme. RESULTS: There were significant improvements in physical functioning, role limitation due to physical function, pain and general health perception scales, over the above time frame, from both a statistically and a mean clinical important difference point of view. These improvements occurred mainly during the cardiac rehabilitation programme phase. CONCLUSIONS: These improvements meant that patients six months post-cardiac rehabilitation were only 5% below the quality of life for an aged matched normal group. However patients still had significant deficits in physical role and emotional role limitations. Suitable measurement of quality of life on an individual basis, supported by normal values is needed. This would facilitate the identification of shortfalls in patient quality of life and the subsequent tailoring of care to address these individualised patient needs.

Factors associated with discharge to home versus discharge to institutional care after inpatient stroke rehabilitation.

Science.gov (United States)

Nguyen, Vu Q C; PrvuBettger, Janet; Guerrier, Tami; Hirsch, Mark A; Thomas, J George; Pugh, Terrence M; Rhoads, Charles F

2015-07-01

To examine sociodemographic and clinical characteristics independently associated with discharge home compared with discharge to a skilled nursing facility (SNF) after acute inpatient rehabilitation. Retrospective cohort study. Three tertiary accredited acute care rehabilitation facilities. Adult patients with stroke (N=2085). Not applicable. Not applicable. Of 2085 patients with stroke treated at 3 centers over a 4-year period, 78.2% (n=1631) were discharged home and 21.8% (n=454) discharged to an SNF. Findings from a multivariable logistic regression analysis indicated that patients were less likely to be discharged home if they were older (odds ratio [OR], .98; 95% confidence interval [CI], .96-.99), separated or divorced (compared with married; OR, .61; 95% CI, .48-.79), or with Medicare health insurance (compared with private insurance; OR, .69; 95% CI, .55-.88), or had dysphagia (OR, .83; 95% CI, .71-.98) or cognitive deficits (OR, .79; 95% CI, .77-.81). The odds of being discharged home were higher for those admitted with a higher motor FIM score (OR, 1.10; 95% CI, 1.09-1.11). The following were not associated with discharge disposition: sex, race, prestroke vocational status, availability of secondary health insurance, number of days from stroke onset to rehabilitation facility admission, stroke type, impairment group, cognitive FIM on admission, other stroke deficits (aphasia, ataxia, neglect, or speech disturbance), stroke complications of hyponatremia or urinary tract infection, or comorbid conditions. One in 5 patients with stroke were discharged to an SNF after inpatient rehabilitation. On admission, several sociodemographic and clinical characteristics were identified that could be considered as important factors in early discussions for discharge planning. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Virtual reality environments for psycho-neuro-physiological assessment and rehabilitation.

Science.gov (United States)

Riva, G; Bolzoni, M; Carella, F; Galimberti, C; Griffin, M J; Lewis, C H; Luongo, R; Mardegan, P; Melis, L; Molinari-Tosatti, L; Poerschmann, C; Rovetta, A; Rushton, S; Selis, C; Wann, J

1997-01-01

Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation-is an European Community funded project (Telematics for health-HC 1053 http:/(/)www.etho.be/ht_projects/vrepar/) whose aim is: to develop a PC based virtual reality system (PC-VRS) for the medical market that can be marketed at a price which is accessible to its possible end-users (hospitals, universities and research centres) and which would have the modular, connectability and interoperability characteristics that the existing systems lack; to develop three hardware/software modules for the application of the PC VRS in psychoneurophysiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia and obesity), movement disorders (Parkinson's disease and torsion dystonia) and stroke disorders (unilateral neglect and hemiparesis). This paper presents the rationale of the different approaches and the methodology used.

Pediatric burn rehabilitation: Philosophy and strategies

Directory of Open Access Journals (Sweden)

Shohei Ohgi

2013-09-01

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

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.

Vocational rehabilitation evaluation and the International Classification of Functioning, Disability, and Health (ICF).

Science.gov (United States)

Saltychev, Mikhail; Kinnunen, Aila; Laimi, Katri

2013-03-01

To identify the most frequent functional limitations according to the International Classification of Functioning, Disability, and Health (ICF) obtained by unstandardised clinical assessment of patients with chronic musculoskeletal disorders who underwent vocational rehabilitation evaluation; and to compare the obtained list with simplified versions of ICF. The descriptions of functional limitations were retrospectively identified for 32 patients. The original vocational rehabilitation evaluation was conducted by a multi-professional team in an out-patient clinic of a university hospital. The obtained descriptions were converted to ICF codes, the most frequent being compared with the ICF Checklist of the World Health Organization (WHO) and the ICF Comprehensive and Brief Core Sets suggested by the ICF Research Branch. In the study population (53 % women), 141 ICF codes were identified with a preciseness of three or more digits, the average being 21 codes/subject (median 20.0, range 9-40). When truncated to three digits, 84 ICF codes remained (average 18 codes/subject, range 9-25), 45 of which appeared in over 10 % of the study population, 24 also being found in the ICF Comprehensive, 5 in the ICF Brief Core Sets, and 33 in the WHO ICF Checklist. The list of most frequent ICF codes retrospectively obtained in this study from unstandardised records showed a similarity with ICF Comprehensive and Brief Core Sets by ICF Research Branch and the ICF Checklist by WHO, but with a bias towards the identification of body structures and functions. The results support the use of ICF in vocational rehabilitation evaluation to ensure comprehensiveness of evaluation. The ICF Comprehensive Core Set seems to be the most useful for the needs of multiprofessional team when assessing functioning of patients.

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

‘The Remembering Group’; facilitating a cognitive stimulation group in an inpatient health and rehabilitation setting.

OpenAIRE

Peacock-Brennan, Sinead; Jamal, S.; O’Sullivan, G.

2016-01-01

A trainee clinical psychologist and two occupational therapists reflect upon the\\ud experience of adapting a cognitive stimulation therapy group for an inpatient health\\ud and rehabilitation setting. The adaptations, benefits and challenges of implementing\\ud the group are discussed.

Automation model of sewerage rehabilitation planning.

Science.gov (United States)

Yang, M D; Su, T C

2006-01-01

The major steps of sewerage rehabilitation include inspection of sewerage, assessment of structural conditions, computation of structural condition grades, and determination of rehabilitation methods and materials. Conventionally, sewerage rehabilitation planning relies on experts with professional background that is tedious and time-consuming. This paper proposes an automation model of planning optimal sewerage rehabilitation strategies for the sewer system by integrating image process, clustering technology, optimization, and visualization display. Firstly, image processing techniques, such as wavelet transformation and co-occurrence features extraction, were employed to extract various characteristics of structural failures from CCTV inspection images. Secondly, a classification neural network was established to automatically interpret the structural conditions by comparing the extracted features with the typical failures in a databank. Then, to achieve optimal rehabilitation efficiency, a genetic algorithm was used to determine appropriate rehabilitation methods and substitution materials for the pipe sections with a risk of mal-function and even collapse. Finally, the result from the automation model can be visualized in a geographic information system in which essential information of the sewer system and sewerage rehabilitation plans are graphically displayed. For demonstration, the automation model of optimal sewerage rehabilitation planning was applied to a sewer system in east Taichung, Chinese Taiwan.

Patient and health professional views on rehabilitation practices and outcomes following total hip and knee arthroplasty for osteoarthritis:a focus group study

Directory of Open Access Journals (Sweden)

Backman Catherine L

2010-05-01

Full Text Available Abstract Background There is worldwide variation in rehabilitation practices after total hip arthroplasty (THA and total knee arthroplasty (TKA and no agreement on which interventions will lead to optimal short and long term patient outcomes. As a first step in the development of clinical practice guidelines for post-acute rehabilitation after THA and TKA, we explored experiences and attitudes about rehabilitation practices and outcomes in groups of individuals identified as key stakeholders. Methods Separate focus groups and interviews were conducted with patients (THA or TKA within past year and three health professional groups: allied health professionals (AHPs, orthopaedic surgeons, and other physicians, in Canada and the United States. Pairs of moderators led the focus groups using a standardized discussion guide. Discussions were audiotaped and transcribed verbatim. A content analysis within and across groups identified key themes. Results Eleven focus groups and eight interviews took place in six sites. Patients (n = 32 varied in age, stage of recovery, and surgical and rehabilitation experiences. Health professionals (n = 44 represented a range of disciplines, practice settings and years of experience. Six key themes emerged: 1 Let's talk (issues related to patient-health professional and inter-professional communication; 2 Expecting the unexpected (observations about unanticipated recovery experiences; 3 It's attitude that counts (the importance of the patient's positive attitude and participation in recovery; 4 It takes all kinds of support (along the continuum of care; 5 Barriers to recovery (at patient, provider and system levels, and 6 Back to normal (reflecting diversity of expected outcomes. Patients offered different, but overlapping views compared to health professionals regarding rehabilitation practices and outcomes following THA and TKA. Conclusion Results will inform subsequent phases of guideline development and ensure

MANUAL OF STANDARDS FOR REHABILITATION CENTERS AND FACILITIES.

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CANIFF, CHARLES E.; AND OTHERS

A 5-YEAR PROJECT TO SPECIFY STANDARDS OF REHABILITATION CENTERS AND FACILITIES RESULTED IN THREE PUBLICATIONS. THIS MANUAL INCLUDES THE CHARACTERISTICS AND GOALS OF REHABILITATION FACILITIES. THE STANDARDS FOR ORGANIZATION, SERVICES THAT SHOULD BE PROVIDED, PERSONNEL INCLUDED, RECORDS AND REPORTS, FISCAL MANAGEMENT, AND THE PHYSICAL PLANT ARE…

Medical Rehabilitation in Natural Disasters: A Review.

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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

Pulmonary rehabilitation in lymphangioleiomyomatosis: a controlled clinical trial.

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Araujo, Mariana S; Baldi, Bruno G; Freitas, Carolina S G; Albuquerque, André L P; Marques da Silva, Cibele C B; Kairalla, Ronaldo A; Carvalho, Celso R F; Carvalho, Carlos R R

2016-05-01

Lymphangioleiomyomatosis (LAM) is a cystic lung disease frequently associated with reduced exercise capacity. The aim of this study was to assess safety and efficacy of pulmonary rehabilitation in LAM.This controlled clinical trial included 40 patients with LAM and a low physical activity level. The pulmonary rehabilitation programme comprised 24 aerobic and muscle strength training sessions and education. The primary outcome was exercise capacity (endurance time during a constant work rate exercise test). Secondary outcomes included health-related quality of life (St George's Respiratory Questionnaire (SGRQ)), 6-min walking distance (6MWD), dyspnoea, peak oxygen consumption (V'O2 ), daily physical activity (pedometer), symptoms of anxiety and depression, lung function and peripheral muscle strength (one-repetition maximum).The baseline characteristics were well balanced between the groups. The pulmonary rehabilitation group exhibited improvements in the following outcomes versus controls: endurance time (median (interquartile range) 169 (2-303) s versus -33 (-129-39) s; p=0.001), SGRQ (median (interquartile range) -8 (-16-2) versus 2 (-4-5); p=0.002) and 6MWD (median (interquartile range) 59 (13-81) m versus 20 (-12-30) m; p=0.002). Dyspnoea, peak V'O2 , daily physical activity and muscle strength also improved significantly. No serious adverse events were observed.Pulmonary rehabilitation is a safe intervention and improves exercise capacity, dyspnoea, daily physical activity, quality of life and muscle strength in LAM. Copyright ©ERS 2016.

[Cardiac rehabilitation: current status and future challenges].

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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

International casemix and funding models: lessons for rehabilitation.

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Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert; Eagar, Kathy

2012-03-01

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'An understanding of the different international models for funding of health care services and casemix systems, as exemplified by those in the US, Australia and the UK.' Payment for treatment in healthcare systems around the world is increasingly based on fixed tariff models to drive up efficiency and contain costs. Casemix classifications, however, must account adequately for the resource implications of varying case complexity. Rehabilitation poses some particular challenges for casemix development. The objectives of this educational narrative review are (a) to provide an overview of the development of casemix in rehabilitation, (b) to describe key characteristics of some well-established casemix and payment models in operation around the world and (c) to explore opportunities for future development arising from the lessons learned. Diagnosis alone does not adequately describe cost variation in rehabilitation. Functional dependency is considered a better cost indicator, and casemix classifications for inpatient rehabilitation in the United States and Australia rely on the Functional Independence Measure (FIM). Fixed episode-based prospective payment systems are shown to contain costs, but at the expense of poorer functional outcomes. More sophisticated models incorporating a mixture of episode and weighted per diem rates may offer greater flexibility to optimize outcome, while still providing incentive for throughput. The development of casemix in rehabilitation poses similar challenges for healthcare systems all around the world. Well-established casemix systems in the United States and Australia have afforded valuable lessons for other countries to learn from, but have not provided all the answers. A range

Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool?

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Keshner Emily A

2004-12-01

Full Text Available Abstract Virtual reality (VR technology is rapidly becoming a popular application for physical rehabilitation and motor control research. But questions remain about whether this technology really extends our ability to influence the nervous system or whether moving within a virtual environment just motivates the individual to perform. I served as guest editor of this month's issue of the Journal of NeuroEngineering and Rehabilitation (JNER for a group of papers on augmented and virtual reality in rehabilitation. These papers demonstrate a variety of approaches taken for applying VR technology to physical rehabilitation. The papers by Kenyon et al. and Sparto et al. address critical questions about how this technology can be applied to physical rehabilitation and research. The papers by Sveistrup and Viau et al. explore whether action within a virtual environment is equivalent to motor performance within the physical environment. Finally, papers by Riva et al. and Weiss et al. discuss the important characteristics of a virtual environment that will be most effective for obtaining changes in the motor system.

A rehabilitation training partnership in Madagascar.

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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.

Innovation in Rehabilitation Services and Clinical Programs for Health Care

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Asghar Dadkhah

2014-06-01

Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.

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Skolasky, Richard L; Maggard, Anica M; Li, David; Riley, Lee H; Wegener, Stephen T

2015-07-01

To determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. Prospective clinical trial. Academic medical center. Consecutive lumbar spine surgery patients (N=122) defined in our companion article (Part I) were assigned to a control group (did not receive HBCC, n=59) or HBCC group (received HBCC, n=63). Brief motivational interviewing-based HBCC versus control (significance, Pgroup did not show improvement compared with the control group. Thematic analysis identified 3 common barriers to engagement: (1) low self-efficacy because of lack of knowledge and support (62%); (2) anxiety related to fear of movement (57%); and (3) concern about pain management (48%). The influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement. Addressing these barriers should lead to greater improvements in rehabilitation engagement. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Process of pulmonary rehabilitation and program organization.

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Wouters, E F M; Augustin, I M L

2011-09-01

Pulmonary rehabilitation programs are highly directed to return patients suffering from chronic lung diseases to a state of self-help. These programs are largely organized as temporary interventions in a highly fragmented delivery care system for patients with chronic respiratory conditions. In an optimal health care organizational structure, pulmonary rehabilitation needs to be considered as an essential part of an individualized, integrated care process, organized from the vantage point of the patient and the patients'health continuum. Pulmonary rehabilitation programs need to become organized as patient-centered care, respectful of and responsive to individual patient preferences, needs and values. Partnering and communication skills are considered as drivers for successful rehabilitation. Assessment is considered as the cornerstone to evaluate the individual needs and problems in order to develop an individualized intervention. Pulmonary rehabilitation programs need to move away from a supply-driven functional organizational structure towards integrated structures, including the full range of medical expertise, technical skills and specialized facilities needed to compete on added value in the management of patients with chronic respiratory diseases.

EVALUATING PATIENTS’ NEEDS AMONG REHABILITATION SETTING

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Mohammed M. J. Alqahtani

2015-09-01

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

A survey on the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai.

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Lu, Wenliang; Zhou, Ping; Zheng, Songbai; Xue, Di

2017-01-01

Although many studies have discussed burnout in clinical physicians, the evidence literature about physical rehabilitation professionals is still limited in China. To understand the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai. Twenty-four hospitals located in three districts of Shanghai were selected for this study. The questionnaire surveys of 24 hospitals and their 221 rehabilitation professionals and 235 other medical professionals were conducted. The percentages of the hospitals that had rehabilitation departments in three districts of Shanghai ranged from 25.0% to 88.9%, suggesting a great variation in distribution of rehabilitation resources. Only one tertiary general hospital had 12 beds for inpatient rehabilitation. The surveyed rehabilitation professionals who had graduate or undergraduate education accounted for 64.90% as a whole, but 49.32% in community health centers, 66.67% in secondary general hospitals, and 77.78% in tertiary general hospitals. The average scores for emotional exhaustion, cynicism and low professional efficacy were 11.66, 7.48, and 10.36 respectively. This study reveals that the resources in the field of rehabilitation in Shanghai need to be enhanced to meet its future demands. It is also recommended that the managers in secondary general hospitals and the local government pay more attention to the rehabilitation professionals in the secondary general hospitals because they are reporting higher emotional exhaustion. Finally, the value of rehabilitation services to help persons with disabilities need to be better conveyed to all interested parties.

Shift Work and Quality of Personal, Professional, and Family Life among Health Care Workers in a Rehabilitation Center in Greece.

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Skoufi, Georgia I; Lialios, Georgios A; Papakosta, Styliani; Constantinidis, Theodoros C; Galanis, Petros; Nena, Evangelia

2017-01-01

Adverse work schedules and conditions may affect the physical, mental, and social wellbeing of workers, impairing quality of life and causing conflict between family and work roles. To compare quality of life, professional quality of life (ProQOL), and work/family conflict (WFC) between shift workers and nonshift workers and explore possible associations with demographic characteristics. : A cross-sectional study was conducted in a rehabilitation center in Central Greece, recording demographic, occupational, and family characteristics. Participants answered the World Health Organization-5 Well-Being Index, the ProQOL questionnaire [compassion satisfaction (CS), and the burnout (BO) and secondary traumatic stress scales], and the WFC scale. IBM Statistical Package for the Social Sciences version 19.0 for Windows. Ninety-one employees (68.7% shift workers) participated, with mean age 33.5. Females reported higher compassion/satisfaction level ( P = 0.031). Nursing profession was associated with higher levels of BO ( P = 0.021), impact of work to family life ( P = 0.008), and impact of family to work (FtW), and WFC ( P = 0.008). Parenthood increased the impact of FtW ( P = 0.008) and predispose to WFC ( P = 0.023). In general, wellbeing was significantly correlated with CS ( r = 0.368, P health.

Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level.

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Bestehorn, Kurt; Jannowitz, Christina; Horack, Martin; Karmann, Barbara; Halle, Martin; Völler, Heinz

2011-01-01

After the acute hospital stay, most cardiac patients in Germany are transferred for a 3-4-week period of inpatient cardiac rehabilitation. We aim to describe patient characteristics and risk factor management of cardiac rehabilitation patients with a focus on drug treatment and control status, differentiated by education level (low level, elementary school; intermediate level, secondary modern school; high level, grammar school/university). Data covering a time period between 2003 and 2008 from 68,191 hospitalized patients in cardiac rehabilitation from a large-scale registry (Transparency Registry to Objectify Guideline- Oriented Risk Factor Management) were analyzed descriptively. Further, a multivariate model was applied to assess factors associated with good control of risk factors. In the total cohort, patients with a manifestation of coronary artery disease (mean age 63.7 years, males 71.7%) were referred to cardiac rehabilitation after having received percutaneous coronary intervention (51.6%) or coronary bypass surgery (39.5%). Statin therapy increased from 76.3% at entry to 88.9% at discharge, and low density lipoprotein cholesterol education. In contrast with patients having high education, those with low education had more diabetes, hypertension, and peripheral arterial disease, had lower exercise capacity, and received less treatment with statins and guideline-orientated therapy in general. In the multivariate model, good control was significantly more likely in men (odds ratio 1.38; 95% confidence interval 1.30-1.46), less likely in patients of higher age (0.99; 0.99-0.99), with diabetes (0.90; 0.85-0.95), or peripheral arterial disease (0.88; 0.82-0.95). Compared with a low level education, a mid level education was associated with poor control (0.94; 0.89-0.99), while high education did not have a significant effect (1.08; 0.99-1.17). Patients with different levels of education treated in cardiac rehabilitation did not differ relevantly in terms of

The Predictive Value of Cognitive Impairments Measured at the Start of Clinical Rehabilitation for Health Status 1 Year and 3 Years Poststroke

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Verhoeven, Clara L.; Schepers, Vera P.; Post, Marcel W.; van Heugten, Caroline M.

2011-01-01

The objective of this study was to investigate the value of screening for cognitive functions at the start of an inpatient rehabilitation programme to predict the health status 1 and 3 years poststroke. In this longitudinal cohort study of stroke patients in inpatient rehabilitation data of 134 participants were analysed. Cognitive and clinical…

Modern stroke rehabilitation through e-health-based entertainment

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Krukowski, Artur

2016-01-01

This book describes a new, “e-Health” approach to stroke rehabilitation.  The authors propose an alternative approach that combines state of the art ICT technologies ranging from Augmented and Virtual Reality gaming environments to latest advances in immersive user interfaces for delivering a mixed-reality training platform, along with advanced embedded micro sensing and computing devices exhibiting enhanced power autonomy by using the latest Bluetooth Smart communication interfaces and energy saving approaches. These technologies are integrated under the umbrella of an online Personal Health Record (PHR) services allowing for delivery of personalized, patient-centric medical services whether at home, in a clinic or on the move. Describes innovative ways for achieving mixed-reality gaming environments; Enhances immersive experience by combining virtual projections with user interfaces based on body motion analysis; Offers cost-effective body motion capture by hybridizing wearable sensor data; Utilizes e...

Home-based versus centre-based cardiac rehabilitation.

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Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

2010-01-20

The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) -0.11 (95% CI -0.35 to 0.13), as well as in modifiable risk factors (systolic blood pressure; diastolic blood pressure; total cholesterol

[Current provision of cardiac rehabilitation intervention in the Lombardy Region, Italy: a benchmark study].

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Ambrosetti, Marco; Porazzi, Emanuele; Diaco, Tommaso; Febo, Oreste; Tramarin, Roberto; Malinverni, Claudio; Zaniboni, Daniela; Passera, Martina; Marchetti, Paolo

2010-11-01

Benchmarking is a process of comparison between the performance characteristics of separate, often competing organizations, intended to enable each participant to improve its own performance in the marketplace. Benchmarking could be translated to the health system from the management field, in order to improve quality and health outcomes. This benchmarking study focused on structural and process aspects regarding the current delivery of cardiac rehabilitation (CR) interventions in the Lombardy Region. Data for analysis were derived from the ISYDE-2008 (Italian Survey on Cardiac Rehabilitation) project of the Italian Association for Cardiovascular Prevention, Rehabilitation, and Epidemiology. Thirty-eight CR units accepted to provide open information about types of supply of CR interventions, organization, location, number of active beds, personnel, duty services, expectancy days before admission, and complexity of patient populations. As a major finding, in-hospital programs actually represent the largest part of CR interventions delivered in the Lombardy Region, generally in well-defined cardiovascular departments, and patients are mostly referred in the short period after a major cardiovascular event. This model could help healthcare organizations to understand where they have strengths and weaknesses depending upon changes in supply, demand and market conditions.

42 CFR 440.130 - Diagnostic, screening, preventive, and rehabilitative services.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Diagnostic, screening, preventive, and rehabilitative services. 440.130 Section 440.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Definitions § 440.130 Diagnostic, screening, preventive, and rehabilitative services. (a) “Diagnostic services...

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

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

2012-10-01

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

The association between patient participation and functional gain following inpatient rehabilitation.

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Morghen, Sara; Morandi, Alessandro; Guccione, Andrew A; Bozzini, Michela; Guerini, Fabio; Gatti, Roberto; Del Santo, Francesco; Gentile, Simona; Trabucchi, Marco; Bellelli, Giuseppe

2017-08-01

To evaluate patients' participation during physical therapy sessions as assessed with the Pittsburgh rehabilitation participation scale (PRPS) as a possible predictor of functional gain after rehabilitation training. All patients aged 65 years or older consecutively admitted to a Department of Rehabilitation and Aged Care (DRAC) were evaluated on admission regarding their health, nutritional, functional and cognitive status. Functional status was assessed with the functional independence measure (FIM) on admission and at discharge. Participation during rehabilitation sessions was measured with the PRPS. Functional gain was evaluated using the Montebello rehabilitation factor score (MRFS efficacy), and patients stratified in two groups according to their level of functional gain and their sociodemographic, clinical and functional characteristics were compared. Predictors of poor functional gain were evaluated using a multivariable logistic regression model adjusted for confounding factors. A total of 556 subjects were included in this study. Patients with poor functional gain at discharge demonstrated lower participation during physical therapy sessions were significantly older, more cognitively and functionally impaired on admission, more depressed, more comorbid, and more frequently admitted for cardiac disease or immobility syndrome than their counterparts. There was a significant linear association between PRPS scores and MRFS efficacy. In a multivariable logistic regression model, participation was independently associated with functional gain at discharge (odds ratio 1.51, 95 % confidence interval 1.19-1.91). This study showed that participation during physical therapy affects the extent of functional gain at discharge in a large population of older patients with multiple diseases receiving in-hospital rehabilitation.

A pilot survey on the quality of life in respiratory rehabilitation carried out in COPD patients with severe respiratory failure: preliminary data of a novel Inpatient Respiratory Rehabilitation Questionnaire (IRRQ

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Pasqua Franco

2012-11-01

Full Text Available Abstract Background Measuring the state of health is a method for quantifying the impact of an illness on the day-to-day life, health and wellbeing of a patient, providing a quantitative measure of an individual’s quality of life (QoL. QoL expresses patient point of view by a subjective dimension and can express the results of medical intervention. Pulmonary rehabilitation is an essential component in the management of COPD patients, and measuring QoL has become a central focus in the study of this disease. Although nowadays several questionnaires for measuring the QoL in COPD patients are available, there are no questionnaires specifically developed for evaluating QoL in COPD patients undergoing respiratory rehabilitation. The aim of this study was to develop a novel questionnaire for the QoL quantification in COPD patients undergoing in-patient pulmonary rehabilitation program. Methods The questionnaire, administered to COPD patients undergoing long-term oxygen therapy into a respiratory rehabilitation ward, was developed by a simple and graphic layout to be administered to elderly patients. It included one form for admission and another for discharge. It included only tips related to the subjective components of QoL that would be relevant for patient, although likely not strictly related to the respiratory function. A descriptive analysis was performed for the socio-demographic characteristics and both the non-parametric Wilcoxon T-test and the Cronbach’s alpha index were calculated for evaluating the sensitivity of the questionnaire to the effects of respiratory rehabilitation and for identifying its consistency. Results The physical and psychological condition of the 34 COPD patients improved after the rehabilitative treatment and this finding was detected by the questionnaire (overall improvement: 14.2±2.5%, as confirmed by the non-parametric Wilcoxon test (p Conclusions This proposed questionnaire represents a substantial innovation

Research Productivity in Rehabilitation, Disability, and Allied Health Programs: A Focus Group Perspective on Minority-Serving Institutions

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Aref, Fariborz; Manyibe, Edward O.; Washington, Andre L.; Johnson, Jean; Davis, Dytisha; Eugene-Cross, Kenyotta; Moore, Cayla A.

2017-01-01

Purpose: The article outlines select individual and institutional factors that could contribute to rehabilitation, disability, and health research productivity among minority-serving institutions (MSIs; i.e., historically Black colleges/universities, Hispanic-serving institutions, and American Indian tribal colleges/universities). Method: We…

HealthSouth's inpatient rehabilitation facilities: how does their performance compare with other for-profit and nonprofit inpatient rehabilitation facilities?

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McCue, Michael J; Thompson, Jon M

2010-05-01

To assess the financial and operational differences in freestanding inpatient rehabilitation facilities (IRFs) that are operated by HealthSouth Corporation relative to other for-profit and nonprofit system-affiliated ownership groups. Since 2003, when it faced fraud charges and financial penalties, HealthSouth has experienced new management and refocused its business strategy. Because HealthSouth is the largest provider of freestanding IRF services, it is important to understand how their performance may differ relative to other ownership groups. We used the Mann-Whitney U test to assess differences in median values for financial and operational variables of HealthSouth-owned IRFs compared with other for-profit system IRFs and nonprofit system IRFs. System-affiliated freestanding IRFs in the United States. Sixty-four HealthSouth IRFs, 18 nonprofit system-affiliated IRFs, and 18 for-profit system-affiliated IRFs. Not applicable. Net patient revenue per adjusted discharge, operating expense per adjusted discharge, salary expense per full-time equivalent, and cash flow margin. HealthSouth IRFs had significantly lower net patient revenue per adjusted discharge and operating expense per adjusted discharge; however, its cash flow margin was significantly higher than other comparison groups. HealthSouth IRFs treated a higher case mix of patients relative to these comparison groups. The financial and operating performance of HealthSouth IRFs is stronger than other ownership groups. Strong cash flow will enable HealthSouth to pay down long-term debt.

Assessment of health-related quality of life of clients in vocational rehabilitation: association with depressive symptoms and type of services.

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Ferdiana, A; Post, M W; Finger, M; Bültmann, U; Escorpizo, R

2014-06-01

Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). To evaluate HRQOL in VR clients and identify factors associated with their HRQOL DESIGN, SETTING AND POPULATION: Cross-sectional study of 149 clients from 5 VR centers in Switzerland and Germany HRQOL was measured by 8 dimensions of the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and compared with sex-matched German population norms. Multiple regression analyses were conducted to identify whether VR-related variables (VR duration and type, sick leave duration) and depressive symptoms were associated with HRQOL dimensions independent of sociodemographics (age, sex, education) and clinical characteristics (type of disorders, number of comorbidities) HRQOL in VR clients was significantly lower in all dimensions measured by the SF-36 compared to the general population. Returning to the former workplace and being oriented to a new job were associated with less functional limitation due to physical problems, less pain and better mental health. Being oriented to a new job was also associated with better vitality. Presence of depressive symptoms was negatively related with all dimensions of HRQOL. Overall, the regression models explained 10%-25% variance of the physical HRQOL domain and 18%-27% variance of the mental HRQOL domain. Multiple dimensions of HRQOL were significantly decreased in VR clients. Depressive symptoms were prevalent and contributed significantly to poorer HRQOL, thus should be considered in the VR process. Further research is needed to ascertain the effect of different VR types to HRQOL and to elaborate the role of depressive symptoms in HRQOL over time. Rehabilitation professionals should be informed of the level of HRQOL in VR clients in order to tailor effective interventions to improve HRQOL by not only focusing on functional ability but also the

Influence of oral rehabilitation on the oral health-related quality of life of a child with ectodermal dysplasia.

Science.gov (United States)

de Alencar, Nashalie Andrade; Reis, Kátia Rodrigues; Antonio, Andréa Gonçalves; Maia, Lucianne Cople

2015-01-01

Ectodermal dysplasia (ED) is a rare congenital hereditary disorder among a group of syndromes characterized by abnormalities of ectodermic structures. The purpose of this report is to compare the oral health-related quality of life (OHRQoL) before and after complete oral rehabilitation of a five-year-old boy with ED. Delivery of upper and lower dentures resulted in immediate improvement of the child's OHRQoL. Although ED affects patients physically and emotionally, the early oral rehabilitation of young patients is crucial to improve their social interaction and restore their speech and masticatory function.

[The spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation].

Science.gov (United States)

Efimenko, N V; Kaĭsinova, A S

2014-01-01

To develop a new medical technology for the spa-and-health resort-based treatment of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation. A total of 100 patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation were available for the examination that included detailed investigations of the clinical picture, characteristics of the immune status, and psychological testing before and after a course of the spa-and-health resort-based treatment. The effectiveness of two therapeutic modalities was evaluated. One of them (control) prescribed to 50 patients consisted of standard antiulcer pharmacotherapy in combination with Essentuki Novaya drinking mineral water and carbon dioxide mineral baths, the other given to 50 patients included radon baths instead of carbon dioxide mineral baths. The combined application of drinking mineral waters, radon baths, and standard antiulcer pharmacotherapy produced the most conspicuous clinical effect in the framework of spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation as confirmed by positive dynamics of their psychoemotional status in 97.7% of the cases, regression of pain syndrome (91.5%), and improvement of humoral and cellular immunity (94%). An important result of the spa-and-health resort-based rehabilitation is the intensification of the reparative processes in gastroduodenal mucosa responsible for the healing of ulcers and erosions in 94.7% of the patients. The spa-and-health resort-based rehabilitation is a pathogenetically sound and efficacious approach to the management of the patients presenting with frequently recurring erosive and ulcerative lesions in the

Regenerative rehabilitation: a new future?

Science.gov (United States)

Perez-Terzic, Carmen; Childers, Martin K

2014-11-01

Modern rehabilitation medicine is propelled by newfound knowledge aimed at offering solutions for an increasingly aging population afflicted by chronic debilitating conditions. Considered a core component of future health care, the rollout of regenerative medicine underscores a paradigm shift in patient management targeted at restoring physiologic function and restituting normative impact. Nascent regenerative technologies offer unprecedented prospects in achieving repair of degenerated, diseased, or damaged tissues. In this context, principles of regenerative science are increasingly integrated in rehabilitation practices as illustrated in the present Supplement. Encompassing a growing multidisciplinary domain, the emergent era of "regenerative rehabilitation" brings radical innovations at the forefront of healthcare blueprints.

Patient-centred care: a review for rehabilitative audiologists.

Science.gov (United States)

Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

2014-02-01

This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

The perceptions of students in the allied health professions towards stroke rehabilitation teams and the SLP's role.

Science.gov (United States)

Insalaco, Deborah; Ozkurt, Elcin; Santiago, Digna

2007-01-01

The purpose of this study was to determine the perceptions and knowledge of final-year speech-language pathology (SLP), physical and occupational therapy (PT, OT) students toward stroke rehabilitation teams and the SLPs' roles on them. The investigators adapted a survey developed by (Felsher & Ross, 1994) and administered it to 35 PT, 35 OT, and 35 SLP final year students (n=105). We found that the students preferred the transdisciplinary team approach and agreed that the advantages of teamwork were the exchange of ideas, opportunities for participatory learning, and holistic treatment. Communication problems, time-consuming meetings, and role confusion were chosen as disadvantages. The students had clear perceptions of the SLP's role in aphasia, apraxia of speech, dysarthria, dysphagia, and auditory agnosia, but fewer recognized the SLP's role in alexia and memory. Some thought SLPs had a role in dressing apraxia and proprioceptive disorders. Suggestions to maximize the advantages and minimize possible disadvantages of teamwork are provided. Learners will: (1) identify the perceived advantages and disadvantages of stroke rehabilitation teamwork; (2) discover some allied health students' perceptions of the SLP's roles in stroke rehabilitation; (3) infer methods to create positive perceptions of stroke rehabilitation team members.

A Machine-to-Machine protocol benchmark for eHealth applications - Use case: Respiratory rehabilitation.

Science.gov (United States)

Talaminos-Barroso, Alejandro; Estudillo-Valderrama, Miguel A; Roa, Laura M; Reina-Tosina, Javier; Ortega-Ruiz, Francisco

2016-06-01

M2M (Machine-to-Machine) communications represent one of the main pillars of the new paradigm of the Internet of Things (IoT), and is making possible new opportunities for the eHealth business. Nevertheless, the large number of M2M protocols currently available hinders the election of a suitable solution that satisfies the requirements that can demand eHealth applications. In the first place, to develop a tool that provides a benchmarking analysis in order to objectively select among the most relevant M2M protocols for eHealth solutions. In the second place, to validate the tool with a particular use case: the respiratory rehabilitation. A software tool, called Distributed Computing Framework (DFC), has been designed and developed to execute the benchmarking tests and facilitate the deployment in environments with a large number of machines, with independence of the protocol and performance metrics selected. DDS, MQTT, CoAP, JMS, AMQP and XMPP protocols were evaluated considering different specific performance metrics, including CPU usage, memory usage, bandwidth consumption, latency and jitter. The results obtained allowed to validate a case of use: respiratory rehabilitation of chronic obstructive pulmonary disease (COPD) patients in two scenarios with different types of requirement: Home-Based and Ambulatory. The results of the benchmark comparison can guide eHealth developers in the choice of M2M technologies. In this regard, the framework presented is a simple and powerful tool for the deployment of benchmark tests under specific environments and conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy

Directory of Open Access Journals (Sweden)

Sherin H.M. Mehani

2013-03-01

Full Text Available Chronic heart failure (CHF is a complex syndrome characterized by progressive decline in left ventricular function, low exercise tolerance and raised mortality and morbidity. Left ventricular diastolic dysfunction plays a major role in CHF and progression of most cardiac diseases. The current recommended goals can theoretically be accomplished via exercise and pharmacological therapy so the aim of the present study was to evaluate the impact of cardiac rehabilitation program on diastolic dysfunction and health related quality of life and to determine the correlation between changes in left ventricular diastolic dysfunction and domains of health-related quality of life (HRQoL. Forty patients with chronic heart failure were diagnosed as having dilated cardiomyopathy (DCM with systolic and diastolic dysfunction. The patients were equally and randomly divided into training and control groups. Only 30 of them completed the study duration. The training group participated in rehabilitation program in the form of circuit-interval aerobic training adjusted according to 55–80% of heart rate reserve for a period of 7 months. Circuit training improved both diastolic and systolic dysfunction in the training group. On the other hand, only a significant correlation was found between improvement in diastolic dysfunction and health related quality of life measured by Kansas City Cardiomyopathy Questionnaire. It was concluded that improvement in diastolic dysfunction as a result of rehabilitation program is one of the important underlying mechanisms responsible for improvement in health-related quality of life in DCM patients.

[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.

Impact of Dental Rehabilitation on Oral Health-related Quality-of-life in Healthy Children and Those with Special Health Care Needs.

Science.gov (United States)

Farsi, Deema J; Farsi, Nada J; El-Housseiny, Azza A; Turkistani, Jihan M; Farsi, Najat M

2018-04-01

Aim: The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. Materials and methods: The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. Results: At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. Conclusion: The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. Clinical significance: The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Keywords: Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.

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

Zero Effort Technologies Considerations, Challenges, and Use in Health, Wellness, and Rehabilitation

CERN Document Server

Mihailidis, Alex; Hoey, Jesse

2011-01-01

This book introduces zero-effort technologies (ZETs), an emerging class of technology that requires little or no effort from the people who use it. ZETs use advanced techniques, such as computer vision, sensor fusion, decision-making and planning, and machine learning to autonomously operate through the collection, analysis, and application of data about the user and his/her context. This book gives an overview of ZETs, presents concepts in the development of pervasive intelligent technologies and environments for health and rehabilitation, along with an in-depth discussion of the design princ

Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data

Directory of Open Access Journals (Sweden)

Coralie English

2016-07-01

Full Text Available Questions: Among people receiving inpatient rehabilitation after stroke, does additional weekend physiotherapy and/or occupational therapy reduce the length of rehabilitation hospital stay compared to those who receive a weekday-only service, and does this change after controlling for individual factors? Does additional weekend therapy improve the ability to walk and perform activities of daily living, measured at discharge? Does additional weekend therapy improve health-related quality of life, measured 6 months after discharge from rehabilitation? Which individual, clinical and hospital characteristics are associated with shorter length of rehabilitation hospital stay? Design: This study pooled individual data from two randomised, controlled trials (n = 350 using an individual patient data meta-analysis and multivariate regression. Participants: People with stroke admitted to inpatient rehabilitation facilities. Intervention: Additional weekend therapy (physiotherapy and/or occupational therapy compared to usual care (5 days/week therapy. Outcome measures: Length of rehabilitation hospital stay, independence in activities of daily living measured with the Functional Independence Measure, walking speed and health-related quality of life. Results: Participants who received weekend therapy had a shorter length of rehabilitation hospital stay. In the un-adjusted analysis, this was not statistically significant (MD –5.7 days, 95% CI –13.0 to 1.5. Controlling for hospital site, age, walking speed and Functional Independence Measure score on admission, receiving weekend therapy was significantly associated with a shorter length of rehabilitation hospital stay (β = 7.5, 95% CI 1.7 to 13.4, p = 0.001. There were no significant between-group differences in Functional Independence Measure scores (MD 1.9 points, 95% CI –2.8 to 6.6, walking speed (MD 0.06 m/second, 95% CI –0.15 to 0.04 or health-related quality of life (SMD –0.04, 95% CI �

Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data.

Science.gov (United States)

English, Coralie; Shields, Nora; Brusco, Natasha K; Taylor, Nicholas F; Watts, Jennifer J; Peiris, Casey; Bernhardt, Julie; Crotty, Maria; Esterman, Adrian; Segal, Leonie; Hillier, Susan

2016-07-01

Among people receiving inpatient rehabilitation after stroke, does additional weekend physiotherapy and/or occupational therapy reduce the length of rehabilitation hospital stay compared to those who receive a weekday-only service, and does this change after controlling for individual factors? Does additional weekend therapy improve the ability to walk and perform activities of daily living, measured at discharge? Does additional weekend therapy improve health-related quality of life, measured 6 months after discharge from rehabilitation? Which individual, clinical and hospital characteristics are associated with shorter length of rehabilitation hospital stay? This study pooled individual data from two randomised, controlled trials (n=350) using an individual patient data meta-analysis and multivariate regression. People with stroke admitted to inpatient rehabilitation facilities. Additional weekend therapy (physiotherapy and/or occupational therapy) compared to usual care (5 days/week therapy). Length of rehabilitation hospital stay, independence in activities of daily living measured with the Functional Independence Measure, walking speed and health-related quality of life. Participants who received weekend therapy had a shorter length of rehabilitation hospital stay. In the un-adjusted analysis, this was not statistically significant (MD -5.7 days, 95% CI -13.0 to 1.5). Controlling for hospital site, age, walking speed and Functional Independence Measure score on admission, receiving weekend therapy was significantly associated with a shorter length of rehabilitation hospital stay (β=7.5, 95% CI 1.7 to 13.4, p=0.001). There were no significant between-group differences in Functional Independence Measure scores (MD 1.9 points, 95% CI -2.8 to 6.6), walking speed (MD 0.06 m/second, 95% CI -0.15 to 0.04) or health-related quality of life (SMD -0.04, 95% CI -0.26 to 0.19) at discharge. Modest evidence indicates that additional weekend therapy might reduce

Multidisciplinary team care in rehabilitation

DEFF Research Database (Denmark)

Momsen, A.-M.; Nielsen, C.V.; Rasmussen, J.O.

2012-01-01

Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...

[Effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life for patients with chronic lung disease].

Science.gov (United States)

Lee, Chang Kwan

2007-04-01

The purpose of this study was to examine the effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life in inpatients with chronic lung disease. This quasi experimental study was designed with a nonequivalent control group pre-post test time series. Twenty three patients were assigned to the experimental group and nineteen to the control group. The inpatient pulmonary rehabilitation program was composed of upper and lower extremity exercise, breathing retraining, inspiratory muscle training, education, relaxation and telephone contacts. This program consisted of 4 sessions with inpatients and 4 weeks at home after discharge. The control group was given a home based pulmonary rehabilitation program at the time of discharge. The outcomes were measured by the Borg score, 6MWD and the Chronic Respiratory Disease Questionnaire(CRQ). There was a statistically significant difference in dyspnea between the experimental group and control group, but not among time sequence, or interaction between groups and time sequence. Also significant improvements in exercise capacity and health related quality of life were found only in the experimental group. An Inpatient pulmonary rehabilitation program may be a useful intervention to reduce dyspnea, and increase exercise capacity and health related quality of life for chronic lung disease patients.

Geographic information systems (GIS): an emerging method to assess demand and provision for rehabilitation services.

Science.gov (United States)

Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl

2013-09-01

To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.

[Mobile geriatric rehabilitation in statutory health insurance: Conceptual strategy and results of a nationwide treatment documentation (Part 1)].

Science.gov (United States)

Meinck, Matthias; Pippel, K; Lübke, N

2017-04-01

Insurants have a statutory right to mobile rehabilitation in which a multidisciplinary team carries out treatment in the familiar home environment. Framework recommendations in geriatric medicine were presented by the statutory health insurance (SHI) and a standardized treatment documentation was implemented nationwide. This article presents the conceptual design and selected results from this treatment documentation and reports on the established practice. A total of 1879 anonymized cases of mobile geriatric rehabilitation carried out between 2011 and 2014 from 11 participating institutions were analyzed with respect to patient and process-related features. The patients were on average 81 years old and 61 % were female. The mobile rehabilitation was provided on average over 22 treatment days over a period of 8 weeks and in 84 % of cases following hospital treatment. Of the rehabilitation patients 27 % lived in a care home prior to treatment and 73 % were already allocated to a care level. The statistically significant gain in capacity for self-sufficiency was 18 points on the Barthel index at the end of the rehabilitation. The majority of treatment was provided by physiotherapists and occupational therapists followed by speech therapists and nursing personnel. Relevant differences were detected between the institutions regarding the indications, access route, therapy combinations, treatment frequency, scope and duration. At the same time individual requirements from the framework recommendations were sometimes not met. Even though the treatment documentation does not replace any external mobile rehabilitation quality assurance, it provides transparency in a still very limited range of services that are sometimes differently implemented at institutions. It therefore provides the basis for further development of mobile out-patient rehabilitation in SHI.

Access to rehabilitation: patient perceptions of inequalities in access to specialty pain rehabilitation from a gender and intersectional perspective

Directory of Open Access Journals (Sweden)

Maria Wiklund

2016-08-01

Full Text Available Background: Long-term musculoskeletal pain is common, particularly among women. Pain conditions are a concern in primary health care, and people with severe and complex pain are referred to specialty health care. There is gender bias in access, counselling, assessment, and treatment of long-term pain. Objective: This study explores patient accounts and perceptions about important (social factors for accessing specialised pain rehabilitation from gender and intersectional equality perspectives. We aimed to identify potential biases and inequalities in accessing rehabilitation resources at a specialised rehabilitation clinic. Design: Individual semi-structured interviews were conducted with 10 adults after an assessment or completion of a specialised rehabilitation programme in northern Sweden. Qualitative content analysis was used to explore patients’ perceptions of important factors for accessing rehabilitation. Results: One main theme was formulated as Access to rehab – not a given. Three categories of perceived inequality were demonstrated: power of gender, power of social status, and power of diagnosis. Participants perceived rehabilitation as a resource that is not equally available, but dependent on factors such as gender, socio-economic status, ability to work, ethnicity, or age, and more subtle aspects of social status and habitus (e.g. appearance, fitness, and weight. The character of diagnosis received (medical versus psychiatric or social was also noted. Conclusions: It is crucial that professionals are aware of how potential inequalities related to gender, social status, and diagnosis, and their intersections, can be created, perceived, and have influence on the processes of assessment and treatment. Reduction of social determinants of health and biases remain important within global, national, and local contexts.

Oral health and nutritional status in a group of geriatric rehabilitation patients.

Science.gov (United States)

Andersson, Pia; Westergren, Albert; Karlsson, Siv; Rahm Hallberg, Ingalill; Renvert, Stefan

2002-09-01

The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

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...

Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model.

Science.gov (United States)

Øyeflaten, Irene; Opsahl, Jon; Eriksen, Hege R; Braathen, Tore Norendal; Lie, Stein Atle; Brage, Søren; Ihlebæk, Camilla M; Breivik, Kyrre

2016-05-23

Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.

Physical rehabilitation following polytrauma. The Canadian Forces Physical Rehabilitation Program 2008-2011.

Science.gov (United States)

Besemann, Markus

2011-12-01

As a consequence of Canada's involvement in the war in Afghanistan, many members of the Canadian Forces have experienced debilitating injuries. Despite the Canadian Forces Health Services (CFHS) having outstanding relationships with many civilian care providers for the rehabilitation of injured soldiers, it became apparent early on that the high-level goals and aspirations of these returning soldiers were sometimes beyond the capability of these centres to facilitate. From this reality grew the need to develop a Physical Rehabilitation Program within the CFHS. This article describes the lessons learned since the creation of the program and outlines the future vision in terms of unique challenges and opportunities. The primary purpose of this article is to describe a hybrid model of civilian-military rehabilitation for injured soldiers and discuss the benefits and challenges of such a model of care.

Impact of environmental factors in home rehabilitation--a qualitative study from the perspective of older persons using the International Classification of Functioning, Disability and Health to describe facilitators and barriers.

Science.gov (United States)

Randström, Kerstin Björkman; Asplund, Kenneth; Svedlund, Marianne

2012-01-01

The aim of this study was to explore older people's experience of environmental factors that impact on their activity and participation in home rehabilitation. Older people aged between 68 and 93 years and receiving home rehabilitation were interviewed. A qualitative content analysis was performed on the interview text using the predetermined structure of the International Classification of Functioning, Disability and Health (ICF) environmental domain. The text was linked to the closest ICF category. The results identified environmental facilitators and barriers that influenced activity and participation among older people receiving home rehabilitation. Approaches that provided a facilitative environment were access to assistive products and technologies, alterations to the physical environment, social support and relationships, and adjusted health and social care services. A qualitative study using ICF-listed environmental factors contributed a holistic view of facilitators and barriers in home rehabilitation for older people. Awareness of the importance of the impact of the social environment on activities and participation could improve home rehabilitation services for older people. The study represents an important step towards a holistic approach using the ICF, which aims to enable all health care professionals to describe, plan and evaluate rehabilitation services together with older people across the health and social care sectors.

Facilities of Early Rehabilitation post Stroke in Poland 2010

DEFF Research Database (Denmark)

Opara, Jozef; Langhorne, Peter; Larsen, Torben

2012-01-01

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

Assessment methods for rehabilitation.

Science.gov (United States)

Biefang, S; Potthoff, P

1995-09-01

Diagnostics and evaluation in medical rehabilitation should be based on methods that are as objective as possible. In this context quantitative methods are an important precondition. We conducted for the German Pensions Insurance Institutions (which are in charge of the medical and vocational rehabilitation of workers and employees) a survey on assessment methods for rehabilitation which included an evaluation of American literature, with the aim to indicate procedures that can be considered for adaptation in Germany and to define further research requirements. The survey identified: (1) standardized procedures and instrumented tests for the assessment of musculoskeletal, cardiopulmonary and neurophysiological function; (2) personality, intelligence, achievement, neuropsychological and alcoholism screening tests for the assessment of mental or cognitive function; (3) rating scales and self-administered questionnaires for the assessment of Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL Scales); (4) generic profiles and indexes as well as disease-specific measures for the assessment of health-related quality of life and health status; and (5) rating scales for vocational assessment. German equivalents or German versions exist only for a part of the procedures identified. Translation and testing of Anglo-Saxon procedures should have priority over the development of new German methods. The following procedures will be taken into account: (a) instrumented tests for physical function, (b) IADL Scales, (c) generic indexes of health-related quality of life, (d) specific quality of life and health status measures for disorders of the circulatory system, metabolic system, digestive organs, respiratory tract and for cancer, and (e) vocational rating scales.

Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation.

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Tang, Lars H; Kikkenborg Berg, Selina; Christensen, Jan; Lawaetz, Jannik; Doherty, Patrick; Taylor, Rod S; Langberg, Henning; Zwisler, Ann-Dorthe

2017-04-01

To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between settings were compared using a time×setting interaction using a mixed effects regression model. Across the 158 included patients, an equivalent proportion preferred to undertake exercise rehabilitation in a centre-based setting (55%, 95% CI: 45% to 63%) compared to a home-based setting (45%, 95% CI: 37% to 53%, p=0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p=0.001) and higher exercise capacity (mean between group difference 15.9watts, 95% CI 3.7 to 28.1; p=0.011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed. Copyright © 2017. Published by Elsevier B.V.

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

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Jesus, Tiago Silva; Hoenig, Helen

2015-05-01

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

Community Based Nutrition Rehabilitation in Tanzania: Challenges and Lessons Learned

International Nuclear Information System (INIS)

Urio, Elisaphinate Moses; Jeje, Benedict; Ndossi, Godwin

2014-01-01

Full text: Malnutrition among children under the age of five continues to be a significant public health problem in Tanzania. Despite numerous nutritional interventions that have been implemented, the country still experiences high rates of malnutrition. According to Tanzania Demographic and Health Survey of 2010 the prevalence of underweight was estimated to be 16%, wasting 5% and stunting 42 %. Factors contributing to causes of malnutrition include immediate, underlying and basic causes. All these factors are interlinked and operate synergistically and not independently. Approaches for managing malnourished children in Tanzania evolved from facility based Nutrition Rehabilitation Units (NURU) in the late 1960s to Community Based Nutrition Rehabilitation (CBNR) in late 1980s. In the latter approach, malnourished children are rehabilitated in the same environment (village, home) that precipitated the condition, using resources and infrastructures available in the community. Mothers are taught about child feeding using family foods to make good food mixtures and of the importance of feeding frequency for the young child. Limitations for this approach include inadequate advocacy to leaders from districts down to the community level, few trained health providers and community health workers on knowledge and skills on community based nutrition rehabilitation, inadequate equipment and supplies for identification and categorization of malnutrition, low awareness of parents, care givers and community leaders on home rehabilitation of malnourished children. Nonetheless, Community Based Nutrition Rehabilitation approach has the potential to address malnutrition in children given political will and resources. (author)

Bearing Health Assessment Based on Chaotic Characteristics

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Chen Lu

2013-01-01

Full Text Available Vibration signals extracted from rotating parts of machinery carry a lot of useful information about the condition of operating machine. Due to the strong non-linear, complex and non-stationary characteristics of vibration signals from working bearings, an accurate and reliable health assessment method for bearing is necessary. This paper proposes to utilize the selected chaotic characteristics of vibration signal for health assessment of a bearing by using self-organizing map (SOM. Both Grassberger-Procaccia algorithm and Takens' theory are employed to calculate the characteristic vector which includes three chaotic characteristics, such as correlation dimension, largest Lyapunov exponent and Kolmogorov entropy. After that, SOM is used to map the three corresponding characteristics into a confidence value (CV which represents the health state of the bearing. Finally, a case study based on vibration datasets of a group of testing bearings was conducted to demonstrate that the proposed method can reliably assess the health state of bearing.

Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level

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Bestehorn K

2011-10-01

Full Text Available Kurt Bestehorn1, Christina Jannowitz2, Martin Horack3, Barbara Karmann2, Martin Halle4, Heinz Völler5 1Institute for Clinical Pharmacology, Technical University, Dresden; 2Medical Department, MSD Sharp and Dohme GmbH, Haar; 3Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen; 4Center for Prevention and Sports Medicine, Technical University, Munich; 5Klinik am See, Rehabilitation Center for Cardiovascular Diseases, Rüdersdorf, Germany Background: After the acute hospital stay, most cardiac patients in Germany are transferred for a 3–4-week period of inpatient cardiac rehabilitation. We aim to describe patient characteristics and risk factor management of cardiac rehabilitation patients with a focus on drug treatment and control status, differentiated by education level (low level, elementary school; intermediate level, secondary modern school; high level, grammar school/university. Methods: Data covering a time period between 2003 and 2008 from 68,191 hospitalized patients in cardiac rehabilitation from a large-scale registry (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management were analyzed descriptively. Further, a multivariate model was applied to assess factors associated with good control of risk factors. Results: In the total cohort, patients with a manifestation of coronary artery disease (mean age 63.7 years, males 71.7% were referred to cardiac rehabilitation after having received percutaneous coronary intervention (51.6% or coronary bypass surgery (39.5%. Statin therapy increased from 76.3% at entry to 88.9% at discharge, and low density lipoprotein cholesterol <100 mg/dL rates increased from 31.1% to 69.6%. Mean fasting blood glucose decreased from 108 mg/dL to 104 mg/dL, and mean exercise capacity increased from 78 W to 95 W. Age and gender did not differ by education. In contrast with patients having high education, those with low education had more diabetes

Computational Intelligence and Game Design for Effective At-Home Stroke Rehabilitation.

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Borghese, Nunzio Alberto; Pirovano, Michele; Lanzi, Pier Luca; Wüest, Seline; de Bruin, Eling D

2013-04-01

The aim of this article is to describe a game engine that has all the characteristics needed to support rehabilitation at home. The low-cost tracking devices recently introduced in the entertainment market allow measuring reliably at home, in real time, players' motion with a hands-free approach. Such systems have also become a source of inspiration for researchers working in rehabilitation. Computer games appear suited to guide rehabilitation because of their ability to engage the users. However, commercial videogames and game engines lack the peculiar functionalities required in rehabilitation: Games should be adapted to each patient's functional status, and monitoring the patient's motion is mandatory to avoid maladaptation. Feedback on performance and progression of the exercises should be provided. Lastly, several tracking devices should be considered, according to the patient's pathology and rehabilitation aims. We have analyzed the needs of the clinicians and of the patients associated in performing rehabilitation at home, identifying the characteristics that the game engine should have. The result of this analysis has led us to develop the Intelligent Game Engine for Rehabilitation (IGER) system, which combines the principles upon which commercial games are designed with the needs of rehabilitation. IGER is heavily based on computational intelligence: Adaptation of the difficulty level of the exercise is carried out through a Bayesian framework from the observation of the patient's success rate. Monitoring is implemented in fuzzy systems and based on rules defined for the exercises by clinicians. Several devices can be attached to IGER through an input abstraction layer, like the Nintendo ® (Kyoto, Japan) Wii™ Balance Board™, the Microsoft ® (Redmond, WA) Kinect, the Falcon from Novint Technologies (Albuquerque, NM), or the Tyromotion (Graz, Austria) Timo ® plate balance board. IGER is complemented with videogames embedded in a specific taxonomy

Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

Science.gov (United States)

Seel, Ronald T; Barrett, Ryan S; Beaulieu, Cynthia L; Ryser, David K; Hammond, Flora M; Cullen, Nora; Garmoe, William; Sommerfeld, Teri; Corrigan, John D; Horn, Susan D

2015-08-01

To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered. Secondary analysis of a prospective, multicenter, cohort database. TBI inpatient rehabilitation programs. Patients with complicated mild, moderate, or severe TBI (N=2130). Not applicable. Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment. A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided. This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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 ...

Efficacy of an mHealth intervention to stimulate physical activity in COPD patients after pulmonary rehabilitation.

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Vorrink, Sigrid N W; Kort, Helianthe S M; Troosters, Thierry; Zanen, Pieter; Lammers, Jan-Willem J

2016-10-01

Physical inactivity in patients with chronic obstructive pulmonary disease (COPD) is associated with poor health status and increased disease burden. The present study aims to test the efficacy of a previously developed mobile (m)Health intervention to improve or maintain physical activity in patients with COPD after pulmonary rehabilitation.A randomised controlled trial was performed in 32 physiotherapy practices in the Netherlands. COPD patients were randomised into intervention or usual care groups. The intervention consisted of a smartphone application for the patients and a monitoring website for the physiotherapists. Measurements were performed at 0, 3, 6 and 12 months. Physical activity, functional exercise capacity, lung function, health-related quality of life and body mass index were assessed.157 patients started the study and 121 completed it. There were no significant positive effects of the intervention on physical activity (at 0 months: intervention 5824±3418 steps per weekday, usual care 5717±2870 steps per weekday; at 12 months: intervention 4819±2526 steps per weekday, usual care 4950±2634 steps per weekday; p=0.811) or on the secondary end-points. There was a significant decrease over time in physical activity (pphysical activity in patients with COPD after a period of pulmonary rehabilitation. Copyright ©ERS 2016.

Time to adapt exercise training regimens in pulmonary rehabilitation – a review of the literature

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Lee AL

2014-11-01

Full Text Available Annemarie L Lee,1–4 Anne E Holland1–3 1Physiotherapy, Alfred Health, Melbourne, VIC, Australia; 2Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia; 3Physiotherapy, La Trobe University, Melbourne, VIC, Australia; 4Westpark Healthcare Centre, ON, Canada Abstract: Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD. Patients with a primary diagnosis of COPD often report comorbidities and other secondary manifestations, which diversifies the clinical presentation. Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs. Improvement in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are outcomes associated with exercise training in pulmonary rehabilitation, irrespective of the clinical state in which it is commenced. There may be benefits for the health care system as well as the individual patient, with fewer exacerbations and subsequent hospitalization reported with exercise training. The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients. Interval training, one-legged cycling (partitioning and non-linear periodized training appear to be equally or more effective than continuous training. Inspiratory muscle training may have a role as an adjunct to whole body training in selected patients. The benefits of balance training are also emerging. Strategies to ensure that health enhancing behaviors are adopted and maintained are essential. These may include training for an extended duration, alternative environments to undertake the initial program, maintenance programs following initial exercise training, program repetition

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

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

2017-02-01

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

Barriers to and facilitators of rehabilitation services for people with physical disabilities: A systematic review

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Nondwe B. Mlenzana

2013-09-01

Objectives: This article aimed to review the relevant literature regarding barriers to and facilitators of rehabilitation services for people with disabilities. Method: Articles for the period 1990–2010 using descriptors related to rehabilitation services, barriers, facilitators and the physically disabled population were retrieved for this review. Results: A total of 19 article titles were identified from references of other articles but following application of the inclusion criteria selected for this review, only six articles were chosen. Five of these articles were qualitative studies and one was a quantitative study. Barriers and facilitators regarding rehabilitation services highlighted by participants in the studies included a perception that health professionals have a lack of understanding of rehabilitation for people with disabilities and there was a lack of information sharing from health professionals about the rehabilitation process. On the other hand some participants reported that health professionals demonstrated confidence in the disability and rehabilitation process during consultation and highlighted that their needs were met by the rehabilitation professionals. Conclusion: Even though there were few studies highlighting the barriers to and facilitators of rehabilitation services, they highlighted that there are gaps in the process of rehabilitation services provided. It would be advisable for health professionals to take cognisance of the issues highlighted in this study in order to make rehabilitation services more effective.

Barriers and facilitators to cultural competence in rehabilitation services: a scoping review.

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Grandpierre, Viviane; Milloy, Victoria; Sikora, Lindsey; Fitzpatrick, Elizabeth; Thomas, Roanne; Potter, Beth

2018-01-15

There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner

Memory rehabilitation for the working memory of patients with multiple sclerosis (MS).

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Mousavi, Shokoufeh; Zare, Hossein; Etemadifar, Masoud; Taher Neshatdoost, Hamid

2018-05-01

The main cognitive impairments in multiple sclerosis (MS) affect the working memory, processing speed, and performances that are in close interaction with one another. Cognitive problems in MS are influenced to a lesser degree by disease recovery medications or treatments,but cognitive rehabilitation is considered one of the promising methods for cure. There is evidence regarding the effectiveness of cognitive rehabilitation for MS patients in various stages of the disease. Since the impairment in working memory is one of the main MS deficits, a particular training that affects this cognitive domain can be of a great value. This study aims to determine the effectiveness of memory rehabilitation on the working memory performance of MS patients. Sixty MS patients with cognitive impairment and similar in terms of demographic characteristics, duration of disease, neurological problems, and mental health were randomly assigned to three groups: namely, experimental, placebo, and control. Patients' cognitive evaluation incorporated baseline assessments immediately post-intervention and 5 weeks post-intervention. The experimental group received a cognitive rehabilitation program in one-hour sessions on a weekly basis for 8 weeks. The placebo group received relaxation techniques on a weekly basis; the control group received no intervention. The results of this study showed that the cognitive rehabilitation program had a positive effect on the working memory performance of patients with MS in the experimental group. These results were achieved in immediate evaluation (post-test) and follow-up 5 weeks after intervention. There was no significant difference in working memory performance between the placebo group and the control group. According to the study, there is evidence for the effectiveness of a memory rehabilitation program for the working memory of patients with MS. Cognitive rehabilitation can improve working memory disorders and have a positive effect on the

Rehabilitation of discharged patients with Chronic Obstructive Pulmonary Disease

DEFF Research Database (Denmark)

Morsø, Lars; Sall Jensen, Morten; von Plessen, Christian

2017-01-01

BACKGROUND: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD); still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting...... the referral, uptake, and completion for a program of early rehabilitation in the primary health-care sector. METHODS: We undertook targeted initiatives to make patients participate in an individualized rehabilitation program with gradual increased intensity. After discharge, primary care COPD nurses....... RESULTS: Sixteen (23% of discharged patients) patients were referred to rehabilitation. In comparison, only 1 (0.8%) in 131 patients from Vejle hospital was referred to Vejle hospital. Twelve patients completed rehabilitation, all having severe COPD. All started the program within 2 weeks and proceeded...

Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

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Ioana Petre

2014-07-01

Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

The International Classification of Functioning, Disability and Health: a unifying model for the conceptual description of physical and rehabilitation medicine.

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Stucki, Gerold; Melvin, John

2007-05-01

There is a need to develop a contemporary and internationally accepted conceptual description of physical and rehabilitation medicine (PRM). The process of evolving such a definition can now rely on the unifying conceptual model and taxonomy of the International Classification of Functioning, Disability and Health (ICF) and an ICF-based conceptual description of rehabilitation understood as a health strategy. The PRM section of the European Union of Medical Specialists (UEMS) has endorsed the application of the ICF as a unifying conceptual model for PRM and supports the process of moving towards an "ICF-based conceptual description and according definitions of PRM". With this goal in mind, the authors have developed a first tentative conceptual description in co-operation with the professional practice committee of the UEMS-PRM-section. A respective brief definition describes PRM as the medical specialty that, based on the assessment of functioning and including the diagnosis and treatment of health conditions, performs, applies and co-ordinates biomedical and engineering and a wide range of other interventions with the goal of optimizing functioning of people experiencing or likely to experience disability. Readers of the Journal of Rehabilitation Medicine are invited to contribute to the process of achieving an internationally accepted ICF-based conceptual description of PRM by submitting commentaries to the Editor of this journal.

[Company health promotion as a possible preparatory stage of effective rehabilitation].

Science.gov (United States)

Köpke, K-H

2012-01-01

In Section 20a of Book 5 of the German Social Code (SGB V), the legislator obliged the health insurance funds to carry out company health promotion in cooperation with the accident insurance agency in charge. He thus created a foundation for more health and secure earnings or employment potential in the companies. At the same time company health promotion permits detecting threats to this potential. That helps to identify a possible need for rehabilitation at an earlier stage and to take appropriate action.To verify whether and how this instrument of preventive health policy is being used, an empirical study explored the actual application of that legal provision in small and medium-sized enterprises in particular. The law, administrative measures and company everyday evidence were set against each other under legal and de facto aspects, which showed obvious deficits in applying the law. Proposals for better company health promotion are derived from these findings. In the first place, actors in administration and self-management of the statutory health and accident insurance schemes are addressed to this end, in anticipation of enhanced implementation. A premature reduction of earning capacity could thus be counteracted. Pension insurants could retain gainful employment for a longer time, companies would have a more reliable employee basis. Social insurance carriers, notably the health and pension insurance schemes, would have to spend less in the end. A development like that would be a benefit for all--including the state. © Georg Thieme Verlag KG Stuttgart · New York.

Importance of characteristics and modalities of physical activity and exercise in defining the benefits to cardiovascular health within the general population: recommendations from the EACPR (Part I).

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Vanhees, L; De Sutter, J; GeladaS, N; Doyle, F; Prescott, E; Cornelissen, V; Kouidi, E; Dugmore, D; Vanuzzo, D; Börjesson, M; Doherty, P

2012-08-01

Over the last decades, more and more evidence is accumulated that physical activity (PA) and exercise interventions are essential components in primary and secondary prevention for cardiovascular disease. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit in achieving cardiovascular health. The present paper, as the first of a series of three, will make specific recommendations on the importance of these characteristics for cardiovascular health in the population at large. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and the individual member of the public. Based on previous and the current literature, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and exercise.

Optimal Design of a Bio-Inspired Anthropocentric Shoulder Rehabilitator

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S. K. Mustafa

2006-01-01

Full Text Available This paper presents the design of a bio-inspired anthropocentric 7-DOF wearable robotic arm for the purpose of stroke rehabilitation. The proposed arm rehabilitator synergistically utilizes the human arm structure with non-invasive kinematically under-deterministic cable-driven mechanisms to form a completely deterministic structure. It offers the advantages of being lightweight and having high dexterity. Adopting an anthropocentric design concept also allows it to conform to the human anatomical structure. The focus of this paper is on the analysis and design of the 3-DOF-shoulder module, called the shoulder rehabilitator. The design methodology is divided into three main steps: (1 performance evaluation of the cable-driven shoulder rehabilitator, (2 performance requirements of the shoulder joint based on its physiological characteristics and (3 design optimization of the shoulder rehabilitator based on shoulder joint physiological limitations. The aim is to determine a suitable configuration for the development of a shoulder rehabilitator prototype.

Employee and work-related predictors for entering rehabilitation: a cohort study of civil servants.

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Lamminpää, Anne; Kuoppala, Jaana; Väänänen-Tomppo, Irma; Hinkka, Katariina

2012-07-01

The aim of this study was to determine how employee well-being, psychosocial factors at work, leadership and perceived occupational health services predict entering rehabilitation as modelled in the Job Well-being Pyramid. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. A total of 147 employees entered rehabilitation during the median follow-up time of 7 years. Permanent employment, large organizations, feedback from supervisors, client violence and physically monotonous work were associated with an increased rate of entering rehabilitation, whereas physical jobs, clear aims, high appreciation, job satisfaction and job enjoyment were associated with a decreased rate of entering rehabilitation. Employee well-being in general was also associated with entering rehabilitation, and this was decreased by good work ability, good health, mental well-being and physical fitness and increased by constant musculoskeletal symptoms. On the other hand, support from supervisors, job control, work pressure, team climate at work, communication, bullying and discrimination, physical work environment, and sense of coherence appeared to have no association. Various psychosocial factors at work and job well-being predict entering rehabilitation. The association between employee health and entering rehabilitation refers to the fact that the selection process for rehabilitation works reasonably well and those in need of rehabilitation are also granted it. In general, these findings coincide well with the Job Well-being Pyramid model. Improving job conditions and well-being at work is likely to decrease the need for rehabilitation.

Clinical and psychosocial predictors of exceeding target length of stay during inpatient stroke rehabilitation.

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Lai, Wesley; Buttineau, Mackenzie; Harvey, Jennifer K; Pucci, Rebecca A; Wong, Anna P M; Dell'Erario, Linda; Bosnyak, Stephanie; Reid, Shannon; Salbach, Nancy M

2017-10-01

In Ontario, Canada, patients admitted to inpatient rehabilitation hospitals post-stroke are classified into rehabilitation patient groups based on age and functional level. Clinical practice guidelines, called quality-based procedures, recommend a target length of stay (LOS) for each group. The study objective was to evaluate the extent to which patients post-stroke at an inpatient rehabilitation hospital are meeting LOS targets and to identify patient characteristics that predict exceeding target LOS. A quantitative, longitudinal study from an inpatient rehabilitation hospital was conducted. Participants included adult patients (≥18 years) with stroke, admitted to an inpatient rehabilitation hospital between 2014 and 2015. The percentage of patients exceeding the recommended target LOS was determined. Logistic regression was performed to identify clinical and psychosocial patient characteristics associated with exceeding target LOS after adjusting for stroke severity. Of 165 patients, 38.8% exceeded their target LOS. Presence of ataxia, recurrent stroke, living alone, absence of a caregiver at admission, and acquiring a caregiver during hospital LOS was each associated with significantly higher odds of exceeding target LOS in comparison to patients without these characteristics after adjusting for stroke severity (p stroke-specific factors may be helpful to adjust LOS expectations and promote efficient resource allocation. This exploratory study was limited to findings from one inpatient rehabilitation hospital. Cross-validation of results using data-sets from multiple rehabilitation hospitals across Ontario is recommended.

Cardiac Rehabilitation Enhancing Programs in Patients with Myocardial Infarction: A literature Review

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Ahyana Ahyana

2013-01-01

Full Text Available Background: Cardiac rehabilitation (CR is a process that involves a multidisciplinary team of health professionals in order to optimize the status of patients’ physical, psychological, social, and vocational well being. The CR program has been proven to influence health outcomes in patients with cardiac diseases, particularly myocardial infarction (MI and stable angina. However, patients’ compliance with cardiac rehabilitation programs remains a challenge.Purpose: The purpose of this study is to review and identify interventions that enhance cardiac rehabilitation behaviors in MI patients.Method: A literature review was conducted by analyzing related research reports published since 2000 to 2012. Only English language articles were included.Result: There were 10 experimental studies and 2 meta-analysis studies. Interventions widely used to enhance cardiac rehabilitation behaviors in MI patients were self-efficacy and self management derived programs. These programs involved interventions that enhance cardiac rehabilitation behaviors, including training exercise, behavioral change, education and psychological support, and lifestyle changing strategies. None have reported the use of culturally tailored intervention. Four phases of cardiac rehabilitation were accepted as each phase represents a different aspect of care: inpatient care, early post discharge period, exercise training, and long term follow up. Critical factors for patients in maintaining an optimum health condition after a cardiac event are, in order, status of patient’s physical, psychological, social, and vocational well being.Conclusion: Cardiac Rehabilitation program has been shown to improve quality of life and decrease mortality in MI patients. The development of culturally specific interventions to increase cardiac rehabilitation behaviors will provide a significant improvement for cardiac patient’s care that ultimately results in better health outcomes. Health care

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.

”What works” in rehabilitation? – Dominant patients’ strategies

DEFF Research Database (Denmark)

Guldager, Rikke

”What works” in rehabilitation? – Dominant patients’ strategies. OBJECTIVES: In Denmark, as part of the Nordic welfare states equality in social, educational and health care are an ideal. But quantitative studies have shown that high positioned patients in the health care system achieve better...... 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 of the empirical attention. RESULTS: The presented case is a 60...... capitals. That means that the couple’s knowledge is articulated and used in practice and furthermore that they have the ability to take advantage and make use of it in the rehabilitation process. CONCLUSIONS: Denmark as part of the Nordic welfare states is relatively equal in access to treatment in health...

Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

DEFF Research Database (Denmark)

Piepoli, Massimo Francesco; Corrà, Ugo; Benzer, Werner

2010-01-01

Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to card......Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR......) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic...... makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all...

Back- and fore-grounding ontology: exploring the linkages between critical realism, pragmatism, and methodologies in health & rehabilitation sciences.

Science.gov (United States)

DeForge, Ryan; Shaw, Jay

2012-03-01

Back- and fore-grounding ontology: exploring the linkages between critical realism, pragmatism, and methodologies in health & rehabilitation sciences As two doctoral candidates in a health and rehabilitation sciences program, we describe in this paper our respective paradigmatic locations along a quite nonlinear ontological-epistemological-axiological-methodological chain. In a turn-taking fashion, we unpack the tenets of critical realism and pragmatism, and then trace the linkages from these paradigmatic locations through to the methodological choices that address a community-based research problem. Beyond serving as an answer to calls for academics in training to demonstrate philosophical-theoretical-methodological integrity and coherence in their scholarship, this paper represents critical realism and its fore-grounding of a deeply stratified ontology in reflexive relation to pragmatism and its back-grounding of ontology. We conclude by considering the merits and challenges of conducting research from within singular versus proliferate paradigmatic perspectives. © 2011 Blackwell Publishing Ltd.

Performance of freestanding inpatient rehabilitation hospitals before and after the rehabilitation prospective payment system.

Science.gov (United States)

Thompson, Jon M; McCue, Michael J

2010-01-01

Inpatient rehabilitation hospitals provide important services to patients to restore physical and cognitive functioning. Historically, these hospitals have been reimbursed by Medicare under a cost-based system; but in 2002, Medicare implemented a rehabilitation prospective payment system (PPS). Despite the implementation of a PPS for rehabilitation, there is limited published research that addresses the operating and financial performance of these hospitals. We examined operating and financial performance in the pre- and post-PPS periods for for-profit and nonprofit freestanding inpatient rehabilitation hospitals to test for pre- and post-PPS differences within the ownership groups. We identified freestanding inpatient rehabilitation hospitals from the Centers for Medicare and Medicaid Services Health Care Cost Report Information System database for the first two fiscal years under PPS. We excluded facilities that had fiscal years less than 270 days, facilities with missing data, and government facilities. We computed average values for performance variables for the facilities in the two consecutive fiscal years post-PPS. For the pre-PPS period, we collected data on these same facilities and, once facilities with missing data and fiscal years less than 270 days were excluded, computed average values for the two consecutive fiscal years pre-PPS. Our final sample of 140 inpatient rehabilitation facilities was composed of 44 nonprofit hospitals and 96 for-profit hospitals both pre- and post-PPS. We utilized a pairwise comparison test (t-test comparison) to measure the significance of differences on each performance variable between pre- and post-PPS periods within each ownership group. Findings show that both nonprofit and for-profit freestanding inpatient rehabilitation hospitals reduced length of stay, increased discharges, and increased profitability. Within the for-profit ownership group, the percentage of Medicare discharges increased and operating expense per

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

Science.gov (United States)

Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

2017-04-01

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study.

OpenAIRE

Kool, Jan; Oesch, Peter; Bachmann, Stefan

2017-01-01

OBJECTIVE To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN Prospective cohort study. PATIENTS A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and ...

A comparison of discharge functional status after rehabilitation in skilled nursing, home health, and medical rehabilitation settings for patients after lower-extremity joint replacement surgery.

Science.gov (United States)

Mallinson, Trudy R; Bateman, Jillian; Tseng, Hsiang-Yi; Manheim, Larry; Almagor, Orit; Deutsch, Anne; Heinemann, Allen W

2011-05-01

To examine differences in outcomes of patients after lower-extremity joint replacement across 3 post-acute care (PAC) rehabilitation settings. Prospective observational cohort study. Skilled nursing facilities (SNFs; n=5), inpatient rehabilitation facilities (IRFs; n=4), and home health agencies (HHAs; n=6) from 11 states. Patients with total knee (n=146) or total hip replacement (n=84) not related to traumatic injury. None. Self-care and mobility status at PAC discharge measured by using the Inpatient Rehabilitation Facility Patient Assessment Instrument. Based on our study sample, HHA patients were significantly less dependent than SNF and IRF patients at admission and discharge in self-care and mobility. IRF and SNF patients had similar mobility levels at admission and discharge and similar self-care at admission, but SNF patients were more independent in self-care at discharge. After controlling for differences in patient severity and length of stay in multivariate analyses, HHA setting was not a significant predictor of self-care discharge status, suggesting that HHA patients were less medically complex than SNF and IRF patients. IRF patients were more dependent in discharge self-care even after controlling for severity. For the full discharge mobility regression model, urinary incontinence was the only significant covariate. For the patients in our U.S.-based study, direct discharge to home with home care was the optimal strategy for patients after total joint replacement surgery who were healthy and had social support. For sicker patients, availability of 24-hour medical and nursing care may be needed, but intensive therapy services did not seem to provide additional improvement in functional recovery in these patients. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma.

Science.gov (United States)

Khan, F; Amatya, B; Hoffman, K

2012-01-01

Multiple trauma is a cause of significant disability in adults of working age. Despite the implementation of trauma systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to trauma care processes. MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Physiotherapy Evidence Database, Latin American and Caribbean Literature on Health Sciences and Cochrane Library databases were searched up to May 2011 for randomized clinical trials, as well as observational studies, reporting outcomes of injured patients following multidisciplinary rehabilitation that addressed functional restoration and societal reintegration based on the International Classification of Functioning, Disability and Health. No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 participants with injuries were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although patients with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. Trauma care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of multiple trauma. Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities

Feasibility and changes in symptoms and functioning following inpatient cancer rehabilitation.

Science.gov (United States)

Bertheussen, Gro F; Kaasa, Stein; Hokstad, Anne; Sandmæl, Jon Arne; Helbostad, Jorunn L; Salvesen, Øyvind; Oldervoll, Line M

2012-11-01

The aim was to assess feasibility of a 3 + 1 week inpatient rehabilitation program for cancer survivors, to explore characteristics of the attending participants and examine changes in work status, symptoms and functioning, level of fatigue, exercise and physical performance following rehabilitation. This was an open intervention study involving cancer survivors having completed primary cancer treatment. The multidisiplinary program consisted of physical training, patient education and group sessions. Participant were assessed at primary stay (T0), at follow-up stay 8-12 weeks later (T1), and six months after T1 (T2). Symptoms and functioning were assessed by the European Organization for Research and Treatment Core Quality-of-Life Questionnaire, physical fatigue by Fatigue Questionnaire, physical exercise by The Nord- Trøndelag Health Study Physical Activity Questionnaire and physical performance by aerobic capacity (VO(2max)), 30 second Sit-to-stand (STS) and Maximum Step Length (MSL). Linear mixed models were used in analyses. One hundred and thirty-four of 163 included participants (82%) completed both rehabilitation stays and returned questionaires at T2. The majority of completers were females (81%), breast cancer survivors (60%), highly educated and with mean age of 52.8 years (SD of 8.1). Participants had higher level of symptoms and fatigue and lower functioning at admission compared to a Norwegian reference population. However, they reported higher physical exercise level and 47% reported improved work status from T0 to T2. Symptoms and functioning, fatigue, physical exercise and physical performance improved significantly from T0 to T1 and were maintained at T2. The rehabilitation program was feasible and symptoms and functioning normalized following rehabilitation. The program mainly recruited well-educated breast cancer survivors, reporting relative high level of physical exercise. More focus should be put on recruiting and selecting those who

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.

The therapeutic rehabilitation for paraplegic patients: Impact from the technologies

Directory of Open Access Journals (Sweden)

Ángelo Hidalgo Martínez

2017-04-01

Full Text Available The present article deals with the particularities of the treatment of medullar injuries as an antecedent of physical rehabilitation via health technologies. The organization of therapeutic activities and actions via these technologies, methods and techniques allows the treatment of paraplegic patients. In this research it is elaborated a programme of physical therapeutic exercises for the rehabilitation of paraplegic patients from the clinic Los Coihuesin Santiago de Chile, improving the health situation of the medullar injuries and other similar diseases. It si also included some exercises that the author considers very beneficial for rehabilitation and can be adjusted to each and every stages proposed in this research. For the development of this study it is carried out some methods such as observation, documentary revision about the technologies and techniques existing in different programmes of rehabilitation.

76 FR 5650 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting

Science.gov (United States)

2011-02-01

... Rehabilitation. March 1--Rehabilitation Engineering and Prosthetics/Orthotics. March 1-2--Psychological Health... DEPARTMENT OF VETERANS AFFAIRS Rehabilitation Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that a meeting of the Rehabilitation Research and Development...

Validation of the complex of measures of medical rehabilitation of children victims of Chernobyl accident

International Nuclear Information System (INIS)

Paramonov, Z.M.

1999-01-01

Special complex program including social medical, organizational and hygienic aspects of studying state of health of children and the characteristics of the system of medical service have been worked out. The peculiarities of changes in the state of health in children and its correlation with the level of the internal irradiation as well as the ways to form the latter in the chain 'soil-water complex - food stuffs - organism' have been determined. Special rehabilitation measures and their application in the network of therapeutic sanatorium centers for radiation protection are validated. The expediency and necessity of medico-hygienic protection of children was established

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

A case study comparing Positive Deviance/Hearth vs. the traditional health/nutrition education (Mother Care Groups) approach to prevent MAM and rehabilitate underweight children in Soroti, Uganda

International Nuclear Information System (INIS)

Baik, Diane

2014-01-01

Full text: BACKGROUND: Globally, 52 million children under 5 are moderately/severely wasted. To date, Supplementary Feeding Program (SFP) has been most commonly used to address moderate acute malnutrition (MAM) (low weight-for-height) where food rations are distributed. However, recently, high levels of wasting are being found even in areas with food security. Thus, rather than creating a dependence on food aid, different approaches need to be explored to address the global burden of MAM. World Vision (WV) has been implementing Positive Deviance/Hearth (PDH) since 1999 and has now expanded to more than 40 countries. WV believes PDH is an effective sustainable rehabilitation program for underweight children (low weight-for-age). However, since 2012, WV began using PDH to also rehabilitate MAM children, especially in areas with food security and no treatment for children with acute malnutrition. PDH is a behaviour change program that aims to rehabilitate children in the context of their own homes, to sustain the rehabilitation and prevent future malnutrition using existing resources, local solutions, and a food-based approach. Internationally, to date, there are mixed results in the effectiveness of PDH and the traditional health and nutrition education program called, “Mother Care Groups” (MCG), in successfully improving the behaviours of caregivers and rehabilitating underweight children. As PDH was being implemented in Soroti, Uganda, it was assessed and compared to MCG. METHODS: A comparative case study – quasi-experimental design was used to compare the effectiveness of the two programs in improving the knowledge, behaviour and confidence levels of primary caregivers of malnourished children aged 6-36 months of age in child feeding, hygiene, caring, and health-seeking practices in Soroti, Uganda. If change was seen, the improvement in the nutritional status of malnourished children was also assessed. 64 caregivers with underweight children were included in

[Patient care at the interface between rehabilitation and occupational health physicians--a systematic literature review focusing health care organization].

Science.gov (United States)

Völter-Mahlknecht, S; Rieger, M A

2014-08-01

Principal goal of rehabilitation arrangements for patients in employable age are the preservation of the ability to work, the rehabilitation of employability and the prompt reintegration into the professional life respectively. In practice, the reintegration is achieving unsatisfactory results.The systematic literature research (acquisition period: 1998-2013) was conducted on the basis of defined search keywords in electronic databases, online archives, relevant German magazines (via manual search), and in bibliographies of selected publications. The definition of research results has taken place in consensus procedures on the tier of abstracts.Reasons for the unsatisfying reintegration quota are current temporary latencies and qualitative deficits of rehabilitation discharge reports, unsatisfying communication and cooperation between rehabilitation and company doctors, insufficient presence of company doctors, and trust issues between rehabilitant and company doctor among other things.The company doctors have an objective role as mediator based on their internal knowledge, competences and opportunities to influence, and they are awarded with a role as connecting piece on setting the course for rehabilitation.Since the currently available data are dissatisfactory concerning the medical interfaces in the rehabilitation process, despite the high thematically relevance, research activities should absolutely be intensified in this field of interest. © Georg Thieme Verlag KG Stuttgart · New York.

Determinants of the most significant characteristics of reproductive health

Directory of Open Access Journals (Sweden)

Miljković Snežana

2010-01-01

Full Text Available Introduction. Reproductive health of women is determined by females’ demographic and socio-economic characteristics, their behavior, and the complex of environmental factors. Objective. The paper examines the predictive impact of personal and environmental characteristics, health and healthcare characteristics regarding the most important aspects of reproductive health. Methods From a sample of 2,718 women, aged 20-49 years, we collected information on various characteristics using a structured questionnaire. Based on factorial analysis (principal components method, Kaisser Varimax criterion we selected representative variables (factors, describing personal (demographic and socio-economic characteristics of women, their environment (family, household, community, health (attitudes towards health, life-style, health status, healthcare (independent and the characteristics of reproductive health (dependent variables. The predictors were analyzed by multiple regression and correlation. Results. Sexual behavior was determined by socio-economic status, personal tidiness, rest, presence of risk factor(s, health evaluation and attitude toward personal responsibility, trust in physicians etc. The predictors of contraception involved satisfaction with one’s own health, serious health problems, health evaluation. The presence and number of abortions were determined by personal psychological maturity, rest, risk factors, life-style, health evaluation and its manifestations, and the continuity and timely healthcare. The predictors of adequate protection of reproductive health involved the cultural level of the community, financial standing of the household, satisfaction with one’s own life, tidiness and rest, presence of risk factors, health evaluation, attitude towards personal responsibility, and trust in physicians. HIV control was determined by satisfaction with one’s own life, physical activity of women, presence of serious health problems, and

Cancer rehabilitation indicators for Europe

DEFF Research Database (Denmark)

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

2013-01-01

, but to obtain comparable data across European countries it will be necessary to administer a questionnaire to randomly selected samples of patients from population-based cancer registry databases. However, three factors complicate questionnaire studies: patients may not be aware that they have cancer......Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel...... reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data...

Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program.

Science.gov (United States)

Güngen, Belma Doğan; Tunç, Abdulkadir; Aras, Yeşim Güzey; Gündoğdu, Aslı Aksoy; Güngen, Adil Can; Bal, Serdar

2017-07-11

The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients. One-hundred patients participated in the pulmonary rehabilitation program, 81 of whom served as a control group. Statistically, one- and three-month mortality was associated with NIHSS and MRS scores at admission and three months (pstroke patients. We believe that a pulmonary rehabilitation program, in addition to general stroke rehabilitation programs, can play a critical role in improving survival and functional outcomes. NCT03195907 . Trial registration date: 21.06.2017 'Retrospectively registered'.

Comorbidities and Psychosocial Characteristics as Determinants of Dropout in Outpatient Cardiac Rehabilitation.

Science.gov (United States)

Pardaens, Sofie; De Smedt, Delphine; De Bacquer, Dirk; Willems, Anne-Marie; Verstreken, Sofie; De Sutter, Johan

Despite the clear benefits of cardiac rehabilitation (CR), a considerable number of patients drop out early. Therefore, we wanted to evaluate dropout in CR with a special focus on comorbidities and psychosocial background. Patients who attended CR after acute coronary syndrome, cardiac surgery, or heart failure (N = 489) were prospectively included. Dropout was defined as attending 50% of the training sessions or less (n = 96 [20%]). Demographic and clinical characteristics, exercise parameters, and psychosocial factors were analyzed according to dropout, and those with a trend toward a significant difference (P dropout, and a comparable trend was seen for the presence of chronic obstructive pulmonary disease (2.55 [0.99-6.54]). Attending the training program only twice per week also implicated a higher risk of an early withdrawal (3.76 [2.23-6.35]). In contrast, patients on β-blockers were less likely to withdraw prematurely (0.47 [0.22-0.98]). Singles were more likely to drop out (2.89 [1.56-5.35]), as well as those patients who were dependent on others to get to CR (2.01 [1.16-3.47]). Finally, the reporting of severe problems on the anxiety/depression subscale of the EuroQOL-5D questionnaire involved a higher odds for dropout (7.17 [1.46-35.29]). Neither demographic characteristics nor clinical status or exercise capacity could independently identify patients who were at risk of dropout. The presence of comorbidities and a vulnerable psychosocial background rather seem to play a key role in dropout.

Patient perceptions of experience with cardiac rehabilitation after isolated heart valve surgery

DEFF Research Database (Denmark)

Hansen, Tina B; Berg, Selina K; Sibilitz, Kirstine L

2018-01-01

in a cardiac rehabilitation programme, and none have analysed their experiences with it. AIMS: The purpose of this qualitative analysis was to gain insight into patients' experiences in cardiac rehabilitation, the CopenHeartVR trial. This trial specifically assesses patients undergoing isolated heart valve...... to take active personal responsibility for their health. Despite these benefits, participants experienced existential and psychological challenges and musculoskeletal problems. Participants also sought additional advice from healthcare professionals both inside and outside the healthcare system....... CONCLUSIONS: Even though the cardiac rehabilitation programme reduced insecurity and helped participants take active personal responsibility for their health, they experienced existential, psychological and physical challenges during recovery. The cardiac rehabilitation programme had several limitations...

[The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

Science.gov (United States)

Povazhnaia, E A; Bobrovnitskiĭ, I P

2013-01-01

The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

The Importance of Patient Involvement in Stroke Rehabilitation

Science.gov (United States)

2016-01-01

Objective To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. Method Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. Results The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. Conclusions The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health

Several facts concerning health and questions about rehabilitative-restorative treatment of miners of the BAM zone

Energy Technology Data Exchange (ETDEWEB)

German, G N

1985-06-01

The Yuzhnaya-Yakutiya coal basin containing one of the largest deposits of coking coal (40 billion tons to a depth of 600 m, 60% of this to a depth of 300 m) in the USSR lies in the BAM zone. Average yearly temperature of the region is 7-10 C. Brittle enclosing rock, longterm frozen soil, concentration of coal deposits and machinery in small areas increase vibration, noise, dust and gas in working areas. Surveys revealed predominant illnesses are diseases of the nervous system: osteochondrosis, with secondary neuritis, and radiculitis. Eighty-two percent of miners with osteochondrosis work in occupations with high vibration risk. To prevent disease and rehabilitate miners with degenerative changes of motor apparatus and osteochondrosis, a network of rehabilitation rooms was created at health centers near the workplace. Miners with osteochondrosis, myositis and arthritis receive heat treatments, massage and curative physical culture. A course of treatment is given 2 or 3 times a year. The courses are given after work without interrupting employment. Miners are directed to take vacations every year. Preventive-rehabilitative treatment of miners of the Far North makes it possible to keep highly qualified workers actively employed which is important considering the shortage of miners in these regions. 2 references.

Work disabilities and unmet needs for health care and rehabilitation among jobseekers: a community-level investigation using multidimensional work ability assessments.

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Kerätär, Raija; Taanila, Anja; Jokelainen, Jari; Soukainen, Jouko; Ala-Mursula, Leena

2016-12-01

Comprehensive understanding of the prevalence and quality of work disabilities and unmet needs for health care and rehabilitation to support return to work (RTW) among jobseekers. Community-level, cross-sectional analysis with multidimensional clinical work ability assessments. Paltamo, Finland. Unemployed citizens either participating in the Full-Employment Project or long-term unemployed (n = 230, 81%). Based on data from theme interviews, patient records, supervisors' observations of work performance and clinical examinations, a physician concluded the individual's work ability, categorised into four groups: good work ability, good work ability expected after RTW support, able to transitional work only or unable to work. These groups were cross tabulated with primary diagnoses, types of plans to support RTW, as well as categories of social functioning and motivation, for which sensitivity and specificity scores in detecting work disability were calculated. Only about half of the jobseekers had good work ability, 27% were found unable to work in the open labour market and 15% even eligible for a disability pension. For 20%, care or rehabilitation was seen necessary to enable RTW. Poor supervisor- and self-rated performance at work or poor social functioning appeared as sensitive measures in detecting work disability. Work disabilities and unmet needs for health care and rehabilitation are highly prevalent among jobseekers, as depicted using a multidimensional work ability assessment procedure inspired by the International Classification of Functioning (ICF). Further development of work ability assessment practices is clearly needed. KEY POINTS Although the association of unemployment with poor health is well known, evidence on the work ability of the unemployed remains scarce. Work disabilities are common among the unemployed. Multidimensional work ability assessment among the unemployed reveals unmet needs for care and rehabilitation to support return to

The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation.

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Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

2014-12-01

To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Not applicable. Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales' classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively). An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. © The Author(s) 2014.

Rehabilitation needs for older adults with stroke living at home: perceptions of four populations

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Viscogliosi Chantal

2007-08-01

Full Text Available Abstract Background Many people who have suffered a stroke require rehabilitation to help them resume their previous activities and roles in their own environment, but only some of them receive inpatient or even outpatient rehabilitation services. Partial and unmet rehabilitation needs may ultimately lead to a loss of functional autonomy, which increases utilization of health services, number of hospitalizations and early institutionalization, leading to a significant psychological and financial burden on the patients, their families and the health care system. The aim of this study was to explore partially met and unmet rehabilitation needs of older adults who had suffered a stroke and who live in the community. The emphasis was put on needs that act as obstacles to social participation in terms of personal factors, environmental factors and life habits, from the point of view of four target populations. Methods Using the focus group technique, we met four types of experts living in three geographic areas of the province of Québec (Canada: older people with stroke, caregivers, health professionals and health care managers, for a total of 12 groups and 72 participants. The audio recordings of the meetings were transcribed and NVivo software was used to manage the data. The process of reducing, categorizing and analyzing the data was conducted using themes from the Disability Creation Process model. Results Rehabilitation needs persist for nine capabilities (e.g. related to behaviour or motor activities, nine factors related to the environment (e.g. type of teaching, adaptation and rehabilitation and 11 life habits (e.g. nutrition, interpersonal relationships. The caregivers and health professionals identified more unmet needs and insisted on an individualized rehabilitation. Older people with stroke and the health care managers had a more global view of rehabilitation needs and emphasized the availability of resources. Conclusion Better

The Transcultural Wellness Center: rehabilitation and recovery in Asian and Pacific Islander mental health care.

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Cameron, Rebecca P; Ton, Hendry; Yang, Cynthia; Endriga, Marya C; Lan, Mei-Fang; Koike, Alan K

2008-01-01

Asian and Pacific Islander Americans (APIAs) are a diverse group, representing many cultures of origin, a range of immigration experiences, and varying access to economic and other resources. Despite stereotypes such as the "model minority" and cultural values that stigmatize mental illness and complicate mental health help-seeking, APIAs' psychiatric rehabilitation and recovery needs are significant. These needs are inadequately treated within existing systems of care. Passage of California's Mental Health Services Act (MHSA) in 2004 created the opportunity for Sacramento County to fund a full-service mental health clinic designed to meet the needs of the APIA community. The process by which this clinic, the Transcultural Wellness Center, was conceptualized, advocated for, and launched is described. This clinic is considered a best practice model within the MHSA system redesign effort.

Choosing the right rehabilitation setting after herniated disc surgery: Motives, motivations and expectations from the patients' perspective.

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Margrit Löbner

Full Text Available This study aims to investigate (1 motives, motivations and expectations regarding the choice for a specific rehabilitation setting after herniated disc surgery and (2 how rehabilitation-related motivations and expectations are associated with rehabilitation outcome (ability to work, health-related quality of life and satisfaction with rehabilitation three months after disc surgery.The longitudinal cohort study refers to 452 disc surgery patients participating in a subsequent rehabilitation. Baseline interviews took part during acute hospital stay (pre-rehabilitation, follow-up interviews three months later (post-rehabilitation. Binary logistic regression and multiple linear regression analyses were applied.(1 Motives, motivations and expectations: Inpatient rehabilitation (IPR patients stated "less effort/stress" (40.9%, more "relaxation and recreation" (39.1% and greater "intensity of care and treatment" (37.0% regarding their setting preference, whereas outpatient rehabilitation (OPR patients indicated "family reasons" (45.3%, the wish for "staying in familiar environment" (35.9% as well as "job-related reasons" (11.7% as most relevant. IPR patients showed significantly higher motivation/expectation scores regarding regeneration (p < .001, health (p < .05, coping (p < .001, retirement/job (p < .01, psychological burden (p < .05 and physical burden (p < .001 compared to OPR patients. (2 Associations with rehabilitation outcome: Besides other factors (e.g. age, gender and educational level rehabilitation-related motivations/expectations were significantly associated with rehabilitation outcome measures. For example, patients with less motivations/expectations to achieve improvements regarding "physical burden" showed a better health-related quality of life (p < .01 three months after disc surgery. Less motivations/expectations to achieve improvements regarding "psychological burden" was linked to a better mental health status (p < .001 and a

Effect of Inpatient Multicomponent Occupational Rehabilitation Versus Less Comprehensive Outpatient Rehabilitation on Sickness Absence in Persons with Musculoskeletal- or Mental Health Disorders: A Randomized Clinical Trial.

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Aasdahl, Lene; Pape, Kristine; Vasseljen, Ottar; Johnsen, Roar; Gismervik, Sigmund; Halsteinli, Vidar; Fleten, Nils; Nielsen, Claus Vinther; Fimland, Marius Steiro

2018-03-01

Purpose To assess effects of an inpatient multicomponent occupational rehabilitation program compared to less comprehensive outpatient rehabilitation on sickness absence in persons with musculoskeletal- or mental health disorders. Methods Randomized clinical trial with parallel groups. Participants were individuals 18-60 years old on sick-leave for 2-12 months with a sick-leave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC-2, identified in a national register. The inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy (ACT), physical training and work-related problem-solving including creating a return to work plan and a workplace visit if considered relevant. The outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Both programs were group based. Primary outcome was cumulated number of sickness absence days at 6 and 12 months follow-up. Secondary outcome was time until sustainable return to work. Results 168 individuals were randomized to the inpatient program (n = 92) or the outpatient program (n = 76). We found no statistically significant difference between the programs in median number of sickness absence days at 6 and 12 months follow-up. In the outpatient program 57% of the participants achieved sustainable return to work (median time 7 months), in the inpatient program 49% (log rank, p = 0.167). The hazard ratio for sustainable return to work was 0.74 (95% CI 0.48-1.32, p = 0.165), in favor of the outpatient program. Conclusions This study provided no support that the more comprehensive 4 + 4 days inpatient multicomponent occupational rehabilitation program reduced sickness absence compared to the outpatient rehabilitation program.

Exploring engagement in a virtual community of practice in pediatric rehabilitation: who are non-users, lurkers, and posters?

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Hurtubise, Karen; Pratte, Gabrielle; Rivard, Lisa; Berbari, Jade; Héguy, Léa; Camden, Chantal

2017-12-20

Communities of practice are increasingly recognized in rehabilitation as useful knowledge transfer tools; however, little is known about their users. This exploratory study describes the characteristics of participants and non-participants invited to engage in a pediatric rehabilitation virtual community of practice. In addition, we explored virtual community of practice utilization behaviors, engagement predictors, and the impact of strategies designed to foster engagement. Participants' demographics including information-seeking style and organization e-readiness, as well as online platform frequency of use data were collected and analyzed using descriptive, comparative, and predictive statistics. Seventy-four percent of those invited used the virtual community of practice. Users had less years of experience in pediatric rehabilitation than non-users. Among the users, 71% were classified as "lurkers," who engaged through reading content only; while 29% were classified as "posters," editing online content. Predictive factors were not uncovered, however an increased number of forum visits correlated with being a poster, a non-information seeker, an employee of an organization demonstrating e-readiness, and regularly working with children with the virtual community of practice specific condition. User-engagement strategies increased visits to the forum. These findings will assist rehabilitation leaders in leveraging rehabilitation-specific virtual community of practice to improve knowledge transfer and practice in pediatric rehabilitation and disability management. Implications for Rehabilitation Communities of practice are increasingly recognized as useful knowledge transfer tools for rehabilitation professionals and are made more accessible thanks to virtual technologies. Our virtual community of practice was found to be optimized in health care organizations with an electronic culture, when the topic area had daily relevance to its target audience, and was

Rehabilitation of language in expressive aphasias: a literature review

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Denise Ren da Fontoura

Full Text Available ABSTRACT Objective: This paper reviews the methodological characteristics of studies on rehabilitation of expressive aphasia, describing the techniques of rehabilitation used. Methods: The databases Medline, Science Direct and PubMed were searched for relevant articles (January 1999 to December 2011 using the keywords Expressive / Broca / Nonfluent Aphasia, combined with Language or Speech Rehabilitation / Therapy / Intervention. Results: A total of 56 articles were retrieved describing rehabilitation techniques, including 22 with a focus on lexical processing, 18 on syntax stimulation, seven with the aim of developing speech and nine with multiple foci. Conclusion: A variety of techniques and theoretical approaches are available, highlighting the heterogeneity of research in this area. This diversity can be justified by the uniqueness of patients' language deficits, making it difficult to generalize. In addition, there is a need to combine the formal measures of tests with measures of pragmatic and social skills of communication to determine the effect of rehabilitation on the patient's daily life.

Measuring patterns of disability using the International Classification of Functioning, Disability and Health in the post-acute stroke rehabilitation setting.

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Goljar, Nika; Burger, Helena; Vidmar, Gaj; Leonardi, Matilde; Marincek, Crt

2011-06-01

To determine whether the International Classification of Functioning, Disability and Health (ICF) model is adequate for assessing disability patterns in stroke survivors in the sub-acute rehabilitation setting in terms of potential changes in functional profiles over time. Functional profiles of 197 stroke patients were assessed using the ICF Checklist and the Functional Independence Measure (FIMTM) at admission and discharge from rehabilitation hospital. The ICF Checklist was applied based on medical documentation and rehabilitation team meetings. Descriptive analyses were performed to identify changes in ICF categories and qualifiers from admission to discharge, and correlations between different improvement measures were calculated. Mean rehabilitation duration was 60 days; patients' mean age was 60 years, with mean FIM-score 75 at admission. Mean FIM-score improvement at discharge was 12.5. Within Body Functions, changes in at least 10% of patients were found regarding 13 categories; no categories within Body Structures, 24 within Activities and Participation, and 2 within Environmental Factors. Changes were mostly due to improvement in qualifiers, except for within Environmental Factors, where they were due to use of additional categories. Correlations between improvements in Body Functions and Activities and Participation (regarding capacity and performance), as well as between capacity and performance within Activities and Participation, were approximately 0.4. Rating ICF categories with qualifiers enables the detection of changes in functional profiles of stroke patients who underwent an inpatient rehabilitation programme. :

Disability Policy Must Espouse Medical as well as Social Rehabilitation

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Andrew J. Haig

2013-12-01

Full Text Available A confident statement in Social Inclusion by Mannon and MacLacLan that disability is not a health problem places doubt on the rationale of their otherwise well-written research agenda for disability studies. Both by definition and in practice disability is in part about the impact of health on a person's functioning. The consequence of this misperception among social policy makers is a decreased emphasis on the resources and research needed to build medical rehabilitation programs. This is especially true in lower resource countries where naive inclusion of medical rehabillitation within community based rehabilitation strategies has resulted in fewer resources and less expertise to deliver the distinctly different, and well validated services of a medical rehabilitation team. Any rational research agenda on disability must focus on disease and medical rehabilitation as well as the psychological, social, and environmental factors discussed in this article.

International Journal of Health Research - Vol 2, No 4 (2009)

African Journals Online (AJOL)

International Journal of Health Research - Vol 2, No 4 (2009) ... Psychosocial characteristics of patients admitted to a drug rehabilitation unit in Nigeria · EMAIL ... Hepatoprotective and antioxidant activities of fruit pulp of limonia acidissima linn ...

VISTA-Rehab: a resource for stroke rehabilitation trials.

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Ali, Myzoon; Ashburn, Ann; Bowen, Audrey; Brodie, Eric; Corr, Susan; Drummond, Avril; Edmans, Judi; Gladman, John; Kalra, Lalit; Langhorne, Peter; Lees, Kennedy R; Lincoln, Nadina; Logan, Pip; Mead, Gillian; Patchick, Emma; Pollock, Alex; Pomeroy, Val; Sackley, Catherine; Sunnerhagen, Katherina S; van Vliet, Paulette; Walker, Marion; Brady, Marian

2010-12-01

Stroke rehabilitation is a complex intervention. Many factors influence the interaction between the patient and the elements of the intervention. Rehabilitation interventions are aimed at altering different domains of patient outcome including body functions, activity and participation. As a consequence, randomised clinical trials in this area are difficult to design. We developed an archive of stroke rehabilitation trials (VISTA-Rehab) to act as a resource to help trialists model and design future rehabilitation studies. We developed specific eligibility criteria for the entry of stroke rehabilitation trials into the archive. We established a Steering Committee to oversee projects and publications and commenced the recruitment of rehabilitation trials into this resource. As of August 2009, VISTA-Rehab contains data from 23 stroke rehabilitation trials (>3400 patients). Demographic data, including age [median=73, interquartile range (63,79)], gender (male=53%) and initial dependency [median baseline Barthel index score=6, interquartile range (9,19)], are available for all patients. Outcome measures include the modified Rankin Scale, Barthel Index, Rivermead Motor Assessment, Fugl-Meyer Assessment, General Health Questionnaire and Nottingham Extended Activities of Daily Living Scale. VISTA-Rehab expands the Virtual International Stroke Trials Archive to include rehabilitation trials. Anonymised data can be used to examine questions specific to stroke rehabilitation and to generate novel hypotheses. © 2010 The Authors. International Journal of Stroke © 2010 World Stroke Organization.

Measuring Patients' Experience of Rehabilitation Services Across the Care Continuum. Part I: A Systematic Review of the Literature.

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McMurray, Josephine; McNeil, Heather; Lafortune, Claire; Black, Samantha; Prorok, Jeanette; Stolee, Paul

2016-01-01

To identify empirically tested survey instruments designed to measure patient experience across a rehabilitative care system. A comprehensive search was conducted of the MEDLINE (PubMed), CINAHL (EBSCO), and PsycINFO (APA PsycNET) databases from 2004 to 2014. Further searches were conducted in relevant journals and the reference lists of the final accepted articles. Of 2472 articles identified, 33 were selected for inclusion and analysis. Articles were excluded if they were unrelated to rehabilitative care, were anecdotal or descriptive reports, or had a veterinary, mental health, palliative care, dental, or pediatric focus. Four reviewers performed the screening process. Interrater reliability was confirmed through 2 rounds of title review (30 articles each) and 1 round of abstract review (10 articles), with an average κ score of .69. Data were extracted related to the instrument, study setting, and patient characteristics, including treated disease, type of rehabilitation (eg, occupational or physical therapy), methodology, sample size, and level of evidence. There were 25 discrete measurement instruments identified in the 33 articles evaluated. Seven of the instruments originated outside of the rehabilitative care sector, and only 1 measured service experience across the care continuum. As providers move to integrate rehabilitative care across the continuum from hospital to home, patients experience a system of care. Research is required to develop psychometrically tested instruments that measure patients' experience across a rehabilitative system. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Employment characteristics and health status among men and women.

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Hibbard, J H; Pope, C R

1987-01-01

This study examines the characteristics of jobs held by women as compared to men during the 1970s and assesses associations between job characteristics and family status with health status by sex. Sex differences in perceptions about the meaning of work, commitment to the work role, and stresses and rewards are considered. Survey data on 1490 employed men and women, ages 18-64, drawn from a random sample of enrollees of a large health maintenance organization in 1970-71 are linked with medical record data covering seven years of outpatient and inpatient services. The findings suggest important differences in the characteristics of jobs held by men and women and in the relative importance of these job characteristics in relation to health. Men held jobs with higher quality intrinsic work characteristics and perceived their jobs to be less stressful and less physically and mentally tiring than did women. Social support and integration through work and occupational status were significantly related to health status for both sexes, however, family responsibilities interact with job characteristics to affect health status for women. Single motherhood, in combination with low social support and integration through work, was related to poor health among women.

Megan's Law and Durkheim’s Perspective of Punishment: Retribution, Rehabilitation or Both?

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Tanni Chaudhuri

2017-07-01

Full Text Available The victimization of Adam Walsh, Jacob Wetterling and Megan Kanka has been instrumental in designing sex offender laws. Registration and Community Notification Laws (RCNLs are informally known as Megan’s Law (Terry 2011. This paper explores sex offender legislation from the Durkheimian framework of retribution versus rehabilitation.  In this paper I attempt to answer the research question: Does sex offender legislation respond to the diluted stance of punishment, which Durkheim envisioned is characteristic of modern societal sentiments (rehabilitation replacing retribution?  Why or why not? I first outline a brief history of sex offender legislation, followed by a discussion of select characteristics of societies that exhibit retributive and rehabilitative justice. Based on scholastic evidence presented in this paper, I conclude the punitive tendencies of current sex offender legislations are more retributive than rehabilitative. Current policies do not conform to the progress of punishment which Durkheim envisioned is concomitant to social evolution, and in many ways, demonstrates taking  a step backwards.

South American Guidelines for Cardiovascular Disease Prevention and Rehabilitation

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AH Herdy

2014-08-01

Full Text Available In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR. In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO, which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.

[Application of advanced engineering technologies to medical and rehabilitation fields].

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Fujie, Masakatsu

2012-07-01

The words "Japan syndrome" can now be heard increasingly through the media. Facing the approach of an elderly-dominated society, Robot Technology(RT)is expected to play an important role in Japan's medical, rehabilitation, and daily support fields. The industrial robot, which has already spread through the world with a great success in certain isolated environments by doing the work which is specialized for the thing with the hard known characteristic. By comparison, in the medical and rehabilitation fields, environments always change intricately, and individual characteristics differ from person to person. Furthermore, there are many times when a robot will be asked to directly interact with people. Moreover, the relation between a robot and a person turns into a relation which should involve contact flexibly according to a situation, and also turns into a relation which should avoid contact. In our group, we have so far developed practical rehabilitation and medical robots which can respond to difficulties such as environmental change and individual specificity. In developing rehabilitation robots, it is especially important to consider intuitive operability and individual differences. In addition, in developing medical robots, it is important to replace the experimental knowledge of surgeons to the mechanical quantitative properties. In this article, we introduce some practical examples of rehabilitation and medical robots interweaving several detailed technologies we have so far developed.

PROBLEMS AND CHANCES AT THE INTERFACE BETWEEN HOSPITAL CARE AND GERIATRIC REHABILITATION

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Fastenmeier Heribert

2011-07-01

Full Text Available Available statistical data offer valuable information on recent demographic changes and developments within European healthcare and welfare systems. The demographic evolution is expected to have considerable impact upon various, major aspects of the economic and social life in all European countries. The healthcare system plays an important role especially in the context of ageing societies, such as Germany. This paper focuses on the evolution of the prevention or rehabilitation service sector during the last years in Germany, analyzes the specific characteristics of the elderly patients being cared for in these facilities and underlines important aspects at the interface between (acute hospital and geriatric rehabilitative care. Networking, integrated care services and models will be of even greater importance in the future demographic setting generating (most probably increasing numbers and percentages of elderly, multimorbid hospitalized patients. More than this, the cooperation at regional level between acute geriatric hospital departments and geriatric rehabilitation facilities has become a mandatory quality criterion in the Free State of Bavaria. This paper presents and analyzes issues referring to a precise cooperation model (between acute and rehabilitative care recommended for implementation even by the Free State of Bavaria while emphasizing several examples of good practice that have guaranteed the success of this cooperation model. The analysis of the main causes leading to longer length of stay (and thus delayed discharges for the elderly patients transferred to geriatric rehabilitation facilities within the reference model for acute-rehabilitative care provides important information and points at the existing potential for optimization in the acute hospital setting. Vicinity, tight communication and cooperation, early screening, implementation of standard procedures and case management are some of the activities that have

Oral health-related quality of life in patients with stroke: a randomized clinical trial of oral hygiene care during outpatient rehabilitation.

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Dai, Ruoxi; Lam, Otto L T; Lo, Edward C M; Li, Leonard S W; McGrath, Colman

2017-08-09

This study was to evaluate the effectiveness of oral hygiene care in improving oral health- and health-related quality of life (OHRQoL and HRQoL) among patients receiving outpatient stroke rehabilitation. Subjects were randomized to: (1) a conventional oral hygiene care programme (COHCP) comprising a manual toothbrush, and oral hygiene instruction, or (2) an advanced oral hygiene care programme (AOHCP) comprising a powered toothbrush, 0.2% chlorhexidine mouthrinse, and oral hygiene instruction. The interventional period lasted for 3 months, followed by a 3-month observational period. HRQoL was assessed by SF-12, and OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14), General Oral Health Assessment Index (GOHAI), and Oral Health Transitional Scale (OHTS). Participants in AOHCP group had significantly better OHRQoL at the end of clinical trial as assessed by OHTS (p < 0.01), and at the end of observational study as assessed by GOHAI (p < 0.05) than those in the COHCP. Participants in the AOHCP group had significantly better HRQoL as assessed by physical component summary score (PCS) the end of both 3 and 6 months (both p < 0.05). This study provided the evidence that the AOHCP was more effective than the COHCP within stroke rehabilitation in improving subjective health.

No Racial Difference in Rehabilitation Therapy Across All Post-Acute Care Settings in the Year Following a Stroke.

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Skolarus, Lesli E; Feng, Chunyang; Burke, James F

2017-12-01

Black stroke survivors experience greater poststroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity, and the number of post-acute care settings in the first year after a stroke. We used national Medicare data to study 186 168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011. We tabulated the proportion of stroke survivors receiving physical, occupational, and speech and language therapy in each post-acute care setting (inpatient rehabilitation facility, skilled nursing facility, and home health agency), minutes of therapy, and number of transitions between settings. We then used generalized linear models to determine whether racial differences in minutes of physical therapy were influenced by demographics, comorbidities, thrombolysis, and markers of stroke severity. Black stroke patients were more likely to receive each type of therapy than white stroke patients. Compared with white stroke patients, black stroke patients received more minutes of physical therapy (897.8 versus 743.4; P rehabilitation therapy utilization or intensity after accounting for patient characteristics. It is unlikely that differences in rehabilitation utilization or intensity are important contributors to racial disparities in poststroke disability. © 2017 American Heart Association, Inc.

Client and family engagement in rehabilitation research: a framework for health care organizations.

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Anderson, James; Williams, Laura; Karmali, Amir; Beesley, Lori; Tanel, Nadia; Doyle-Thomas, Krissy; Sheps, Gideon; Chau, Tom

2018-04-01

To describe the development and implementation of an organizational framework for client and family-centered research. Case report. While patient-centered care is now well established, patient-centered research remains underdeveloped. This is particularly true at the organizational level (e.g., hospital based research institutes). In this paper we describe the development of an organizational framework for client and family centered research at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada. It is our hope that, by sharing our framework other research institutions can learn from our experience and develop their own research patient/client/family engagement programs. Implications for rehabilitation Family engagement in rehabilitation research •Rehabilitation research is crucial to the development and improvement of rehabilitative care. •The relevance, appropriateness, and accountability of research to patients, clients and families could be improved. •Engaging clients and families as partners in all aspects of the research process is one way to address this problem. •In this paper, we describe a framework for engaging clients and families in research at the organizational level.

Standards in Neurological Rehabilitation, June 1997

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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

Exercise training characteristics in cardiac rehabilitation programmes: a cross-sectional survey of Australian practice.

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Abell, Bridget; Glasziou, Paul; Briffa, Tom; Hoffmann, Tammy

2016-01-01

Exercise training is a core component of cardiac rehabilitation (CR), however, little information exists regarding the specific exercise interventions currently provided for coronary heart disease in Australian practice. We aimed to analyse the current status of exercise-based CR services across Australia. Cross-sectional survey. Australian sites offering exercise-based CR were identified from publically available directories. All sites were invited by email to participate in an online Survey Monkey questionnaire between October 2014 and March 2015, with reminders via email and phone follow-up. Questions investigated the demographics and format of individual programmes, as well as specific exercise training characteristics. 297 eligible programmes were identified, with an 82% response rate. Most sites (82%) were based at hospital or outpatient centres, with home (15%), community (18%) or gym-based options (5%) less common. While CR was most often offered in a comprehensive format (72% of sites), the level of exercise intervention varied greatly among programmes. Most frequently, exercise was prescribed 1-2 times per week for 60 min over 7 weeks. Almost one-quarter (24%) had a sole practitioner supervising exercise, although the majority used a nurse/physiotherapist combination. Low to moderate exercise intensities were used in 60% of programmes, however, higher intensity prescriptions were not uncommon. Few sites (technology, such as mobile phones or the internet, to deliver or support exercise training. While advances have been made towards providing flexible and accessible exercise-based CR, much of Australia's service remains within traditional models of care. A continuing focus on service improvement and evidence-based care should, therefore, be considered a core aim of those providing exercise for CR in order to improve health service delivery and optimise outcomes for patients.

Application progress of virtual reality rehabilitation technology in upper limb dysfunction after stroke

Directory of Open Access Journals (Sweden)

Bing-jie LI

2017-07-01

Full Text Available  Virtual reality (VR rehabilitation technology is a kind of integrated technology which simulates the real world via computer. It has three characteristics: immersion, interaction and imagination. It is widely used in the field of stroke rehabilitation. This review briefly describes the application of virtual reality rehabilitation technology in upper limb dysfunction after stroke. DOI: 10.3969/j.issn.1672-6731.2017.04.002

Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.

Science.gov (United States)

Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A

2016-01-08

The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their

Skilled nursing and rehabilitation facilities - choosing

Science.gov (United States)

... gov/ency/patientinstructions/000436.htm Choosing a skilled nursing and rehabilitation facility To use the sharing features ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

Assessment of health-related quality of life of clients in vocational rehabilitation : association with depressive symptoms and type of services

NARCIS (Netherlands)

Ferdiana, A.; Post, M. W. M.; Finger, M.; Bultmann, U.; Escorpizo, R.

Background. Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). Aim. To evaluate HRQOL in VR clients and identify factors associated with their HRQOL Design, setting

Is impaired control of reactive stepping related to falls during inpatient stroke rehabilitation?

Science.gov (United States)

Mansfield, Avril; Inness, Elizabeth L; Wong, Jennifer S; Fraser, Julia E; McIlroy, William E

2013-01-01

Individuals with stroke fall more often than age-matched controls. Although many focus on the multifactorial nature of falls, the fundamental problem is likely the ability for an individual to generate reactions to recover from a loss of balance. Stepping reactions to recover balance are particularly important to balance recovery, and individuals with stroke have difficulty executing these responses to prevent a fall following a loss of balance. The purpose of this study is to determine if characteristics of balance recovery steps are related to falls during inpatient stroke rehabilitation. We conducted a retrospective review of individuals with stroke attending inpatient rehabilitation (n = 136). Details of falls experienced during inpatient rehabilitation were obtained from incident reports, nursing notes, and patient interviews. Stepping reactions were evoked using a "release-from-lean" postural perturbation. Poisson regression was used to determine characteristics of stepping reactions that were related to increased fall frequency relative to length of stay. In all, 20 individuals experienced 29 falls during inpatient rehabilitation. The characteristics of stepping reactions significantly related to increased fall rates were increased frequency of external assistance to prevent a fall to the floor, increased frequency of no-step responses, increased frequency of step responses with inadequate foot clearance, and delayed time to initiate stepping responses. Impaired control of balance recovery steps is related to increased fall rates during inpatient stroke rehabilitation. This study informs the specific features of stepping reactions that can be targeted with physiotherapy intervention during inpatient rehabilitation to improve dynamic stability control and potentially prevent falls.

Independence, institutionalization, death and treatment costs 18 months after rehabilitation of older people in two different primary health care settings.

Science.gov (United States)

Johansen, Inger; Lindbak, Morten; Stanghelle, Johan K; Brekke, Mette

2012-11-14

The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson's χ2, ANCOVA, Regression and Kaplan-Meier analyses. Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for rehabilitation (prehabilitation and care were 18702€ (=1

Independence, institutionalization, death and treatment costs 18 months after rehabilitation of older people in two different primary health care settings

Directory of Open Access Journals (Sweden)

Johansen Inger

2012-11-01

Full Text Available Abstract Background The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Methods Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202 versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100. Participants: 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Outcome measures: Primary: Independence, assessed by Sunnaas ADL Index(SI. Secondary: Hospital and short-term nursing home length of stay (LOS; institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson’s χ2, ANCOVA, Regression and Kaplan-Meier analyses. Results Overall SI scores were 26.1 (SD 7.2 compared to 27.0 (SD 5.7 at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5. The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7. Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6, p=0.05. The institutionalization increased in PCNHR (from 12%-28%, p=0.001, but not in PCDIR (from 16.9%-19.3%, p= 0.45. The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient

Factors associated with access to physical rehabilitation for victims of traffic accidents

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Kelienny de Meneses Sousa

Full Text Available ABSTRACT OBJECTIVE Evaluate the level of access to physical rehabilitation for survivors of traffic accidents and the associated factors. METHODS A cross-sectional study performed in Natal, Northeastern Brazil, through a telephone survey of 155 victims of traffic accidents admitted to an emergency hospital between January and August of 2013, with a diagnosis of fracture, traumatic brain injury or amputation. Participants were identified in the database of the reference hospital for care of traffic accident victims. We calculated point estimates and confidence interval (95%CI for the frequency of subjects who had access, in addition to multivariate analysis (logistic regression between access (dependent variable and sociodemographic, clinical, and assistance variables. RESULTS Among the 155 respondents, the majority were adolescents and adults between 15–29 years of age (47.7%, men (82.6%, education up to high school (92.3%, income of up to two minimum wages (78.0% and bikers (75.5%. Although 85.8% of traffic accident survivors reported the need for physical rehabilitation, there was little access (51.6%; 95%CI 43.7–59.4 and a delay to start the physical rehabilitation (average = 67 days. We classified factors associated with access to physical rehabilitation as: (i unmodifiable individuals in the short term – family income greater than two minimum wages (OR = 3.7, informal worker (OR = 0.11 or unemployed (OR = 0.15 and possession of a private health care plan (OR = 0.07; and (ii assistance modifiable by service management – written referral for physical rehabilitation (OR = 27.5 and perceived need of physical rehabilitation (OR = 10. CONCLUSIONS This study found a low and slow access to physical rehabilitation for individuals potentially in need. The associated factors were the organizational processes of health care (health information and referral and social determinants (income, occupation and private health care plan.

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

Rehabilitation of Low Back Pain in Golfers

OpenAIRE

Finn, Christopher

2013-01-01

Context: Low back injuries are the most common injury in golf. Best practice guidelines for rehabilitation and prevention of these injuries are helpful for health care professionals and all golfers. Objective: To establish a best practice clinical model for low back pain in golfers from diagnosis through treatment and rehabilitation to return to golf. Evidence Acquisition: The PubMed database and Google Scholar were searched from 1993 to 2012 with the following keywords: golf and low back inj...

Medical rehabilitation in low and middle income countries for adult acquired disability: challenges posed by rapidity of health system change and position on the individualistic-collectivist axis

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Karl Sandin

2015-01-01

Full Text Available Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions. While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid. As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values. While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism. The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.

Exercise-based cardiac rehabilitation for coronary heart disease

Science.gov (United States)

Heran, Balraj S; Chen, Jenny MH; Ebrahim, Shah; Moxham, Tiffany; Oldridge, Neil; Rees, Karen; Thompson, David R; Taylor, Rod S

2014-01-01

Background The burden of coronary heart disease (CHD) worldwide is one of great concern to patients and healthcare agencies alike. Exercise-based cardiac rehabilitation aims to restore patients with heart disease to health. Objectives To determine the effectiveness of exercise-based cardiac rehabilitation (exercise training alone or in combination with psychosocial or educational interventions) on mortality, morbidity and health-related quality of life of patients with CHD. Search methods RCTs have been identified by searching CENTRAL, HTA, and DARE (using The Cochrane Library Issue 4, 2009), as well as MEDLINE (1950 to December 2009), EMBASE (1980 to December 2009), CINAHL (1982 to December 2009), and Science Citation Index Expanded (1900 to December 2009). Selection criteria Men and women of all ages who have had myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA), or who have angina pectoris or coronary artery disease defined by angiography. Data collection and analysis Studies were selected and data extracted independently by two reviewers. Authors were contacted where possible to obtain missing information. Main results This systematic review has allowed analysis of 47 studies randomising 10,794 patients to exercise-based cardiac rehabilitation or usual care. In medium to longer term (i.e. 12 or more months follow-up) exercise-based cardiac rehabilitation reduced overall and cardiovascular mortality [RR 0.87 (95% CI 0.75, 0.99) and 0.74 (95% CI 0.63, 0.87), respectively], and hospital admissions [RR 0.69 (95% CI 0.51, 0.93)] in the shorter term (< 12 months follow-up) with no evidence of heterogeneity of effect across trials. Cardiac rehabilitation did not reduce the risk of total MI, CABG or PTCA. Given both the heterogeneity in outcome measures and methods of reporting findings, a meta-analysis was not undertaken for health-related quality of life. In seven out of 10 trials reporting health

The Canadian Heart Health Strategy and Action Plan: Cardiac rehabilitation as an exemplar of chronic disease management.

Science.gov (United States)

Arthur, H M; Suskin, N; Bayley, M; Fortin, M; Howlett, J; Heckman, G; Lewanczuk, R

2010-01-01

In October 2006, federal funding was announced for the development of a national strategy to fight cardiovascular disease (CVD) in Canada. The comprehensive, independent, stakeholder-driven Canadian Heart Health Strategy and Action Plan (CHHS-AP) was delivered to the Minister of Health on February 24, 2009. The mandate of CHHS-AP Theme Working Group (TWG) 6 was to identify the optimal chronic disease management model that incorporated timely access to rehabilitation services and end-of-life planning and care. The purpose of the present paper was to provide an overview of worldwide approaches to CVD and cardiac rehabilitation (CR) strategies and recommendations for CR care in Canada, within the context of the well-known Chronic Care Model (CCM). A separate paper will address end-of-life issues in CVD. TWG 6 was composed of content representatives, primary care representatives and patients. Input in the area of Aboriginal and indigenous cardiovascular health was obtained through individual expert consultation. Information germane to the present paper was gathered from international literature and best practice guidelines. The CCM principles were discussed and agreed on by all. Prioritization of recommendations and overall messaging was discussed and decided on within the entire TWG. The full TWG report was presented to the CHHS-AP Steering Committee and was used to inform the recommendations of the CHHS-AP. Specific actionable recommendations for CR are made in accordance with the key principles of the CCM. The present CR blueprint, as part of the CHHS-AP, will be a first step toward reducing the health care burden of CVD in Canada.

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

Science.gov (United States)

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

2015-01-01

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

The effect of exercise repetition on the frequency characteristics of motor output force: implications for Achilles tendinopathy rehabilitation.

Science.gov (United States)

Grigg, Nicole L; Wearing, Scott C; O'Toole, John M; Smeathers, James E

2014-01-01

To investigate the frequency characteristics of the ground reaction force (GRF) recorded throughout the eccentric Achilles tendon rehabilitation programme described by Alfredson. Controlled laboratory study, longitudinal. Nine healthy adult males performed six sets (15 repetitions per set) of eccentric ankle exercise. Ground reaction force was recorded throughout the exercise protocol. For each exercise repetition the frequency power spectrum of the resultant ground reaction force was calculated and normalised to total power. The magnitude of peak relative power within the 8-12 Hz bandwidth and the frequency at which this peak occurred was determined. The magnitude of peak relative power within the 8-12 Hz bandwidth increased with each successive exercise set and following the 4th set (60 repetitions) of exercise the frequency at which peak relative power occurred shifted from 9 to 10 Hz. The increase in magnitude and frequency of ground reaction force vibrations with an increasing number of exercise repetitions is likely connected to changes in muscle activation with fatigue and tendon conditioning. This research illustrates the potential for the number of exercise repetitions performed to influence the tendons' mechanical environment, with implications for tendon remodelling and the clinical efficacy of eccentric rehabilitation programmes for Achilles tendinopathy. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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.

Research in Danish cancer rehabilitation

DEFF Research Database (Denmark)

Høybye, Mette Terp; Dalton, Susanne Oksbjerg; Christensen, Jane

2008-01-01

rate at baseline was 86% (n = 1876). Most participants were younger women with breast cancer. They were generally well educated and working. The cancer survivors reported having comprehensive social networks and being physically active. Several cancer-related symptoms were reported by women...... site, sex, age, family, working status and social position. These challenges might be addressed optimally in multi-dimensional rehabilitation programmes....... of the cancer survivors with respect to cancer site, sociodemographic variables, social network, lifestyle, self-rated health and the prevalence of cancer-related late effects. The study is part of the FOCARE research project, in which the long-term effects of the rehabilitation programme are evaluated...

DISABILITY AND MEDICAL REHABILITATION. ANALYSIS OF BARRIERS AND RECOMMENDATIONS PROPOSED BY THE WORLD HEALTH ORGANIZATION

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DOGARU Gabriela

2014-02-01

Full Text Available Disability is part of human condition. Anyone can suffer at a certain point in life a temporary or permanent disability. Disability refers to difficulties found in any of the three areas of functioning and is the term for impairments, activity limitations, and participation restrictions, which refer to the negative aspects of the interaction between an individual (with a certain health condition and the contextual factors of that individual (personal factors – motivation, self-esteem, and environmental factors – products and technology, service systems, policies, relations with the others. The concept of disability is related to human rights because: people with disabilities are confronted with injustice when they are denied employment, education, political participation; they are subject to violence, abuse, prejudice, disrespect. Medical rehabilitation measures are aimed at functions and structures of the body, activities and social participation, environmental and personal factors. The results of rehabilitation are the benefits and changes in the functioning of an individual during the course of time, which can be attributed to a single measure or to a set of measures.

EDUCATION AND HEALTH PROMOTION AS A STRATEGY FOR THE REHABILITATION OF patients with sequelae of stroke - Case Study.

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Hélder Fonseca Mendes

2011-04-01

Full Text Available Introduction: The education and promotion of health she make guaranteeing knowledge, aptitudes and opportunities to the people so that they can make decisions and to have attitudes that improve your conditions of health. The training for promotion of patients' health with sequels of BIRD (it Alters Vascular Encefálico and patients' caretakers with sequels of BIRD, it can contribute to improve the life quality and to promote the solemnity-care. Methods: They were made case studies with five patient and your respective caretakers. The patients answered to the Functional Index of Barthel and the caretakers to a questionnaire of knowledge regarding the pathology and they participated of weekly encounters in the Regional Hospital of Planaltina, where they were answered your doubts, they received training and orientations in agreement with the theme proposed for each meeting and the patients' main needs. Results: Four patients concluded the study. We observed that all had it gets better in your functional state. The Index of medium initial Barthel was of 52,5 and the end of 85,0 points. The caretakers were shown disposed to participate in the process of the patients' rehabilitation in spite of they have not previous knowledge regarding the disease. Conclusion: We concluded that the presented data showthe relevance of the education and of the promotion of health as strategies for the patients' rehabilitation with sequel of BIRD.

Religiousness affects mental health, pain and quality of life in older people in an outpatient rehabilitation setting.

Science.gov (United States)

Lucchetti, Giancarlo; Lucchetti, Alessandra Granero; Badan-Neto, Antonio M; Peres, Patricia T; Peres, Mario F P; Moreira-Almeida, Alexander; Gomes, Cláudio; Koenig, Harold G

2011-03-01

To evaluate the relationship between religiousness and mental health, hospitalization, pain, disability and quality of life in older adults from an outpatient rehabilitation setting in Sao Paulo, Brazil. Cross-sectional study. A total of 110 patients aged 60 years or older were interviewed during attendance at an outpatient rehabilitation service. Researchers administered a standardized questionnaire that assessed socio-demographic data, religiousness, self-reported quality of life, anxiety, physical activity limitation, depression, pain and cognition. Predictors were included in each model analysis, and a backward conditional method was used for variable selection using logistic regression (categorical outcomes) or linear regression (continuous outcomes). Thirty-one patients (28.2%) fulfilled criteria for significant depressive symptoms, 27 (24.5%) for anxiety, and 10 (9.6%) for cognitive impairment. Pain was present in 89 (80.7%) patients. Limited depressive symptoms (as assessed by the Geriatric Depression Scale), and greater self-reported quality of life were related to greater self-reported religiousness, as were scores on the Mini-Mental State Examination (less cognitive impairment), and lower ratings of pain. Religiousness is related to significantly less depressive symptoms, better quality of life, less cognitive impairment, and less perceived pain. Clinicians should consider taking a spiritual history and ensuring that spiritual needs are addressed among older patients in rehabilitation settings.

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

Science.gov (United States)

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

2015-11-01

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

Understanding consumer preferences for communication channels to create consumer-directed health promotion efforts in psychiatric rehabilitation settings.

Science.gov (United States)

DiFranco, Evelina; Bressi, Sara K; Salzer, Mark S

2006-01-01

People with serious mental illnesses experience increased rates of physical illnesses. Drop-in centers and psychosocial rehabilitation programs can serve as important settings for health promotion efforts, but such efforts should utilize communication strategies that are used by consumers and are perceived to be reliable. Focus groups involving 23 consumers at drop-in centers in Philadelphia were conducted to assess the perceived usefulness of health information from a variety of sources. Consumers especially liked getting information from other people, including health care professionals, friends, and family, and found the information to be reliable and useful. Print literature, the Internet, and a library had various limitations. Respondents were generally unfamiliar with community health fairs and related events. Consumers considered trustworthiness, proximity and availability, and the specificity and depth of information provided by a communication source when getting health information. Implications for health promotion efforts are discussed.

Comorbidities in patients over 60 years of age treated at the rehabilitation clinic

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Pietrzyńska Magdalena

2015-12-01

Full Text Available Patients aged above 60 represent a very diversified population group with respect to their health condition. This may result from multimorbidity. In the rehabilitation process of elderly patients it is especially crucial to identify not only the underlying diseases which constituted the grounds for referral to the rehabilitation clinic, but also the comorbidities that have to be taken into consideration while planning their rehabilitation. The aim of the present paper is the assessment of comorbidities in patients of the rehabilitation clinic. The study population included 1616 patients (447 man and 1169 women treated at the rehabilitation clinic. The factors put through analysis were the age and gender of the patient, the main diagnosed (underlying illness subject to rehabilitation treatment, as well as comorbidities. All diseases, both the underlying conditions and the comorbidities have been classified according to the International Statistical Classification of Diseases and Related Health Problems (10th revised edition. The main reasons for the treatment at the rehabilitation outpatient clinic were arthrosis of the spine, knee and hip joints, polyarthritis, osteoporosis, diseases of the central nervous system diseases and paralytic syndromes as consequences of strokes, hypertension or atherosclerosis, as well as post-traumatic conditions.

Does the NRS Capture Changes in Communication during Inpatient Stroke Rehabilitation?

Science.gov (United States)

Barr, Leigh G; Kubilius, Barbra; Ansley, Barb; Whiteman, Rhonda; Sahlas, Demetrios J

2017-10-01

In Ontario, the National Rehabilitation Reporting System (NRS) is mandated for use as a measurement of change for stroke patients after admission to and discharge from rehabilitation. The NRS includes the functional independence measure (FIM) and supplementary measurement items developed by the Canadian Institute for Health Information (CIHI). Uncertainty exists regarding the efficacy of the NRS as the sole measure of outcome for communication in stroke rehabilitation patients. The use of additional speech-language pathology outcome measurement tools for this population has therefore been suggested. This study sought to establish whether the FIM and CIHI communication items capture quantifiable gains during stroke rehabilitation and therefore whether additional measures are needed to assess outcomes. A retrospective analysis was completed of 1252 complete data records of stroke patients discharged from inpatient rehabilitation at Hamilton Health Sciences between 2006 and 2011. Statistically significant improvements were observed in all total matched FIM scores (M = 72.68 to M = 96.39, P communication are therefore not required to assess outcomes in rehabilitation of stroke patients, although additional research is necessary to evaluate the clinical significance of the improvements that are observed using existing measurements of change. Copyright © 2017 National Stroke Association. All rights reserved.

Outcome quality of in-patient cardiac rehabilitation in elderly patients--identification of relevant parameters.

Science.gov (United States)

Salzwedel, Annett; Nosper, Manfred; Röhrig, Bernd; Linck-Eleftheriadis, Sigrid; Strandt, Gert; Völler, Heinz

2014-02-01

Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome. From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation. The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale). The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.

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.

Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility?

Science.gov (United States)

Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E

2012-01-01

There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.

[Medical Rehabilitation as an Attractive Field of Work for Medical Doctors? - A Qualitative Survey].

Science.gov (United States)

Lederle, Mareike; Kotzjan, Priscilla Simone; Niehues, Christiane; Brüggemann, Silke; Bitzer, Eva-Maria

2017-10-01

In the German Health system there is an increasing competition in the recruitment of specialised staff, especially for rehabilitation centres, which are deemed less attractive. Therefore, this study examines the attractiveness of the field of medical rehabilitation from the point of view of medical professionals. We conducted 16 semi-structured interviews with doctors from 7 rehabilitation centres with different medical specialisations. The interviews were digitized and transcribed. A structured content analysis was carried out using the software MAXQDA 11. 745 codes were identified and assigned to the categories "attractiveness", "unfavourable aspects" and "special features" of rehabilitation. Regarding medical rehabilitation, the interviewees appreciated especially the predictable, flexible working environment with little time pressure. Other than working with rehabilitative patients working as part of an interdisciplinary team was of high importance for the interviewees. Among the special features of rehabilitation in comparison with acute care were the higher relevance of the bio-psycho-social model of health and illness as well as the higher proportion of communication and organisation. Medical rehabilitation in Germany is an attractive field of work for medical doctors. This fact should be considered more with regards to rehabilitation's public image. © Georg Thieme Verlag KG Stuttgart · New York.

Type D patients report poorer health status prior to and after cardiac rehabilitation compared to non-type D patients

OpenAIRE

Pelle, Aline; Erdman, Ruud; Domburg, Ron; Spiering, Marquita; Kazemier, Marten; Pedersen, Susanne

2008-01-01

textabstractBackground: Type D personality is an emerging risk factor in coronary artery disease (CAD). Cardiac rehabilitation (CR) improves outcomes, but little is known about the effects of CR on Type D patients. Purpose: We examined (1) variability in Type D caseness following CR, (2) Type D as a determinant of health status, and (3) the clinical relevance of Type D as a determinant of health status compared to cardiac history. Methods: CAD patients (n = 368) participating in CR completed ...

Quality of Longer Term Mental Health Facilities in Europe : Validation of the Quality Indicator for Rehabilitative Care against Service Users' Views

NARCIS (Netherlands)

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose Miguel; Cardoso, Graca; King, Michael

2012-01-01

Background: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise

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...

Core competencies for cardiac rehabilitation/secondary prevention professionals: 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation.

Science.gov (United States)

Hamm, Larry F; Sanderson, Bonnie K; Ades, Philip A; Berra, Kathy; Kaminsky, Leonard A; Roitman, Jeffrey L; Williams, Mark A

2011-01-01

Cardiac rehabilitation/secondary prevention (CR/SP) services are typically delivered by a multidisciplinary team of health care professionals. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that to provide high-quality services, it is important for these health care professionals to possess certain core competencies. This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency. These core competency areas are consistent with the current list of core components for CR/SP programs published by the AACVPR and the American Heart Association and include comprehensive cardiovascular patient assessment; management of blood pressure, lipids, diabetes, tobacco cessation, weight, and psychological issues; exercise training; and counseling for psychosocial, nutritional, and physical activity issues.

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

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)

[The effectiveness of early rehabilitation of the patients presenting with ischemic stroke].

Science.gov (United States)

Kulishova, T V; Shinkorenko, O V

2014-01-01

In this paper we evaluate the clinical effectiveness of rehabilitation of 92 patients who survived after acute ischemic stroke and received the combined treatment with the use of transcranial magnetic stimulation (the study group, n=32). The first control group (n=30) included the patients given transcranial magnetic stimulation in the function of placebo (n=30) and the second control group was comprised of the patients who received low-frequency magnetic therapy (n=30). The course of transcranial magnetic stimulation (TMS) resulted in the significant regression of the locomotor deficiency in the patients of the study group compared with those in both control groups (χ2>3,8). In addition, a significant decrease in anxiety and depression was documented in the patients of the study group. Dynamics of these characteristics in the patients of the control groups group was significantly less pronounced (χ2>3,8). The well apparent improvement of the cognitive function evaluated with the help of the MMSE test was observed in the patients of the study group and control group 2, but this effect of transcranial magnetic stimulation was significantly more pronounced than that of low-frequency magnetic therapy (χ2>3,8). Transcranial magnetic stimulation significantly normalized cerebral hemodynamics on the side of the stroke-affected hemisphere and improved the daily activities of the patients. Studying the long-term results within 6 months after the onset of rehabilitation in the hospital environment, most patients rated their health with improving. The evaluation of long-term results of the treatment during the 6 month rehabilitation period demonstrated that the majority of the patients reported the marked improvement of their health status.

Religious views of the 'medical' rehabilitation model: a pilot qualitative study.

Science.gov (United States)

Yamey, Gavin; Greenwood, Richard

2004-04-22

To explore the religious beliefs that patients may bring to the rehabilitation process, and the hypothesis that these beliefs may diverge from the medical model of rehabilitation. Qualitative semi-structured interviews with representatives of six major religions--Islam, Buddhism, Christianity, Judaism, Sikhism, and Hinduism. Representatives were either health care professionals or religious leaders, all with an interest in how their religion approached health issues. There were three recurrent themes in the interviews: religious explanations for injury and illness; beliefs about recovery; religious duties of care towards family members. The Buddhist, Sikh, and Hindu interviewees described beliefs about karma--unfortunate events happening due to a person's former deeds. Fatalistic ideas, involving God having control over an individual's recovery, were expressed by the Muslim, Jewish, and Christian interviewees. All interviewees expressed the fundamental importance of a family's religious duty of care towards ill or injured relatives, and all expressed some views that were compatible with the medical model of rehabilitation. Religious beliefs may both diverge from and resonate with the medical rehabilitation model. Understanding these beliefs may be valuable in facilitating the rehabilitation of diverse religious groups.

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.

[Immediate and late results of rehabilitation at the climatic health resorts on the southern coast of the Crimea with sunlight- and meteorolabile patients with chronic bronchitis].

Science.gov (United States)

Logvionenko, I I; Sidorova, L D; Logvinenko, A S

1988-01-01

A study of the social, socioeconomic and economic indices of rehabilitation of patients with chronic obstructive and nonobstructive bronchitis has shown that one should take account of a degree of expression of heliometeolability when selecting patients with chronic bronchitis residing in West Siberia for climatic treatment in the Crimean South Coast. It has been shown that rehabilitation in the Crimean South Coast health resort area is advisable for heliometeostable patients and patients with mild and marked degrees of heliometeolability. Patients with chronic bronchitis should not be sent to the Crimea in winter and late autumn as the rehabilitation effect in this period is lowered.

COPD online-rehabilitation versus conventional COPD rehabilitation

DEFF Research Database (Denmark)

Hansen, Henrik; Bieler, Theresa; Beyer, Nina

2017-01-01

BACKGROUND: Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program......, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline assessments. DISCUSSION: The study will likely contribute to knowledge regarding COPD tele...... accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). METHODS: This study is a randomized assessor- and statistician blinded superiority multicenter...

Rehabilitation Trends After Lower Extremity Amputations in Canada.

Science.gov (United States)

Kayssi, Ahmed; Dilkas, Steven; Dance, Derry L; de Mestral, Charles; Forbes, Thomas L; Roche-Nagle, Graham

2017-05-01

The heterogeneity of medical complications that lead to amputation has resulted in a diverse patient population with differing rehabilitation needs; however, the rehabilitation trends for patients with lower extremity amputations across Canada have not been studied previously. To describe trends in rehabilitation after lower extremity amputations and the factors affecting rehabilitation length of stay in Canada. Retrospective cohort analysis. Canadian inpatient rehabilitation facilities that received persons with lower extremity amputations discharged from academic or community hospitals. Patients underwent lower extremity amputations between 2006 and 2009 for nontraumatic indications and were then discharged to a rehabilitation facility. Patients were identified from the Canadian Institute for Health Information's Discharge Abstract Database that includes hospital admissions across Canada except Quebec. Inpatient rehabilitation after lower extremity amputations. Length of stay, discharge destination, and change in total and motor function scores. The analysis included 5342 persons who underwent lower extremity amputations, 1904 of whom were transferred to a rehabilitation facility (36%). Patients most commonly underwent single below-knee (74%) and above-knee (17%) amputations. The duration of rehabilitation varied by whether the amputation was performed by a vascular (median = 36 days), orthopedic (median = 38 days), or general surgeon (median = 35 days). The overall median length of stay was 36 days. Most patients (72%) subsequently were discharged home and 9% were readmitted to hospital. Predictors of longer rehabilitation included amputation by an orthopedic surgeon (beta = 5.0, P ≤ .01), older age (beta = 0.2, P ≤ .01), and a history of ischemic heart disease (beta = 3.8, P = .03) or congestive heart failure (beta = 5, P = .04). Patients who spent Canada after lower extremity amputation varies by the type of surgeon performing the amputation. Advanced age

Psychosocial aspects of cardiac rehabilitation in Europe.

Science.gov (United States)

Maes, S

1992-11-01

While the present objectives of cardiac rehabilitation include recovery or restoration of everyday behaviour and secondary prevention, the effects of the traditional exercise-based, cardiac rehabilitation programmes are quite modest. It is argued that psychological interventions may affect these targets more easily, since there is evidence from controlled studies that psychological interventions may have beneficial effects on psychosocial recovery, compliance with medical advice and cardiovascular morbidity and mortality. As a consequence one may expect that psychologists would be at least part-time members of most cardiac rehabilitation teams in European countries. In order to get an impression of the position of psychologists and the share of psychosocial care in cardiac rehabilitation in Europe, a questionnaire was sent out to two or three individuals in each European country. Health care professionals from 16 European countries returned their completed questionnaires on time. Among other things, the results show that in general social workers and psychologists, who may be considered the main potential agents for psychosocial care, are largely underrepresented in cardiac rehabilitation teams. As far as psychologists are concerned, the number involved in cardiac rehabilitation varies significantly from country to country. Three groups of countries could be distinguished: a group consisting of The Netherlands, Austria, and Italy, where psychologists are fairly well represented; a second one consisting of Norway, Finland and Belgium, where small numbers of psychologists are involved in cardiac rehabilitation; and a third group (the largest) consisting of Switzerland, Poland, Czechoslovakia, Denmark, Ireland, Sweden, the UK, Greece, Portugal and Turkey, where the number of psychologists is negligible.

VREPAR projects: the use of virtual environments in psycho-neuro-physiological assessment and rehabilitation.

Science.gov (United States)

Riva, G; Bacchetta, M; Baruffi, M; Borgomainerio, E; Defrance, C; Gatti, F; Galimberti, C; Fontaneto, S; Marchi, S; Molinari, E; Nugues, P; Rinaldi, S; Rovetta, A; Ferretti, G S; Tonci, A; Wann, J; Vincelli, F

1999-01-01

Due, in large part, to the significant advances in PC hardware that have been made over the last 3 years, PC-based virtual environments are approaching reality. Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation (VREPAR) are two European Community funded projects (Telematics for health-HC 1053/HC 1055, http:// www.psicologia.net) that are trying to develop a PC-based virtual reality system (PC-VRS) for the medical market that can be marketed at a price that is accessible to its possible endusers (hospitals, universities, and research centres) and that would have the modular, connectability, and interoperability characteristics that the existing systems lack. In particular, the projects are developing three hardware/software modules for the application of the PCVRS in psycho-neuro-physiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia, and obesity), movement disorders (Parkinson's disease and torsion dystonia) and stroke disorders (unilateral neglect and hemiparesis). This article describes the rationale of the modules and the preliminary results obtained.

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…

Priority Scale of Drainage Rehabilitation of Cilacap City

Science.gov (United States)

Rudiono, Jatmiko

2018-03-01

Characteristics of physical condition of Cilacap City is relatively flat and low to sea level (approximately 6 m above sea level). In the event of a relatively heavy rainfall resulting in inundation at several locations. The problem of inundation is a serious problem if there is in a dense residential area or occurs in publicly-used infrastructure, such as roads and settlements. These problems require improved management of which include how to plan a sustainable urban drainage system and environmentally friendly. The development of Cilacap City is increasing rapidly, this causes drainage system based on the Drainage Masterplan Cilacap made in 2006 has not been able to accommodate rain water, so, it is necessary to evaluate the drainage masterplan for subsequent rehabilitation. Priority scale rehabilitation of the drainage sections as a guideline is an urgent need of rehabilitation in the next time period.

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.

Malnutrition in Geriatric Rehabilitation: Prevalence, Patient Outcomes, and Criterion Validity of the Scored Patient-Generated Subjective Global Assessment and the Mini Nutritional Assessment.

Science.gov (United States)

Marshall, Skye; Young, Adrienne; Bauer, Judith; Isenring, Elizabeth

2016-05-01

Accurate identification and management of malnutrition is essential so that patient outcomes can be improved and resources used efficaciously. In malnourished older adults admitted to rehabilitation: 1) report the prevalence, health and aged care use, and mortality of malnourished older adults; 2) determine and compare the criterion (concurrent and predictive) validity of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Mini Nutritional Assessment (MNA) in diagnosing malnutrition; and 3) identify the Scored PG-SGA score cut-off value associated with malnutrition. Observational, prospective cohort. Participants were 57 older adults (65 years and older; mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Scored PG-SGA; MNA; and the International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition were compared to establish concurrent validity and report malnutrition prevalence. Length of stay, discharge location, rehospitalization, admission to a residential aged care facility, and mortality were measured to report health-related outcomes and to establish predictive validity. Malnutrition prevalence varied according to assessment tool (ICD-10-AM: 46%; Scored PG-SGA: 53%; MNA: 28%). Using the ICD-10-AM as the reference standard, the Scored PG-SGA ratings (sensitivity 100%, specificity 87%) and score (sensitivity 92%, specificity 84%, ROC AUC [receiver operating characteristics area under the curve]=0.910±0.038) showed strong concurrent validity, and the MNA had moderate concurrent validity (sensitivity 58%, specificity 97%, receiver operating characteristics area under the curve=0.854±0.052). The Scored PG-SGA rating, Scored PG-SGA score, and MNA showed good predictive validity. Malnutrition can increase the risk of longer rehospitalization length of stay, admission to a residential

Cognitive Rehabilitation for Executive Dysfunction in Parkinson's Disease: Application and Current Directions

Directory of Open Access Journals (Sweden)

Jessica Calleo

2012-01-01

Full Text Available Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits.

Focus on health, motivation, and pride: A discussion of three theoretical perspectives on the rehabilitation of sick-listed people.

Science.gov (United States)

Svensson, Tommy; Björklund, Anita

2010-01-01

During the last decades sickness absence from work has become a great societal problem. Questions of how rehabilitation processes should become successful and how peoples' ability to work can be improved have become of great public interest. In this paper we discuss three well-known theoretical perspectives regarding their usefulness when it comes to research on rehabilitation for return to work. The three perspectives are: Antonovsky's salutogenic model of health, Kielhofner's model of human occupation and Scheff's sociological theory of "shame and pride". Each of these can be applied to increase understanding and knowledge concerning sickness absence and return to work. We discuss points of affinity among the three perspectives, as well as significant differences, and we propose that a very essential common denominator is the importance of self-experience.

Computer-Vision-Assisted Palm Rehabilitation With Supervised Learning.

Science.gov (United States)

Vamsikrishna, K M; Dogra, Debi Prosad; Desarkar, Maunendra Sankar

2016-05-01

Physical rehabilitation supported by the computer-assisted-interface is gaining popularity among health-care fraternity. In this paper, we have proposed a computer-vision-assisted contactless methodology to facilitate palm and finger rehabilitation. Leap motion controller has been interfaced with a computing device to record parameters describing 3-D movements of the palm of a user undergoing rehabilitation. We have proposed an interface using Unity3D development platform. Our interface is capable of analyzing intermediate steps of rehabilitation without the help of an expert, and it can provide online feedback to the user. Isolated gestures are classified using linear discriminant analysis (DA) and support vector machines (SVM). Finally, a set of discrete hidden Markov models (HMM) have been used to classify gesture sequence performed during rehabilitation. Experimental validation using a large number of samples collected from healthy volunteers reveals that DA and SVM perform similarly while applied on isolated gesture recognition. We have compared the results of HMM-based sequence classification with CRF-based techniques. Our results confirm that both HMM and CRF perform quite similarly when tested on gesture sequences. The proposed system can be used for home-based palm or finger rehabilitation in the absence of experts.

Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review.

Science.gov (United States)

Srikesavan, Cynthia; Bryer, Catherine; Ali, Usama; Williamson, Esther

2018-01-01

Background Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis. Methods Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported. Conclusion Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.

Health-Related Quality-of-Life in patients with chronic rheumatic disease after a multidisciplinary rehabilitation regimen

DEFF Research Database (Denmark)

Couppé, C; Comins, J.; Beyer, N.

2017-01-01

-, and 12-month follow-ups. Multivariable linear regression models using generalized estimating equations to account for repeated measurement were employed. A weighting procedure to account for differential dropouts was applied. Results: Three hundred fifty-six women and 74 men with chronic rheumatic......Introduction: Multidisciplinary rehabilitation has beneficial effects on health-related quality of life (HRQoL) in patients with chronic rheumatic diseases. However, whether this intervention benefits different age groups in women or men is largely unknown. Purpose: To investigate HRQoL in patients...

Australian cardiac rehabilitation exercise parameter characteristics and perceptions of high-intensity interval training: a cross-sectional survey

Science.gov (United States)

Hannan, Amanda L; Hing, Wayne; Climstein, Mike; Coombes, Jeff S; Furness, James; Jayasinghe, Rohan; Byrnes, Joshua

2018-01-01

Purpose This study explored current demographics, characteristics, costs, evaluation methods, and outcome measures used in Australian cardiac rehabilitation (CR) programs. It also determined the actual usage and perceptions of high-intensity interval training (HIIT). Methods A cross-sectional observational web-based survey was distributed to 328 Australian CR programs nationally. Results A total of 261 programs completed the survey (79.6% response rate). Most Australian CR programs were located in a hospital setting (76%), offered exercise sessions once a week (52%) for 6–8 weeks (49%) at moderate intensity (54%) for 46–60 min (62%), and serviced 101–500 clients per annum (38%). HIIT was reported in only 1% of programs, and 27% of respondents believed that it was safe while 42% of respondents were unsure. Lack of staff (25%), monitoring resources (20%), and staff knowledge (18%) were the most commonly reported barriers to the implementation of HIIT. Overall, Australian CR coordinators are unsure of the cost of exercise sessions. Conclusion There is variability in CR delivery across Australia. Only half of programs reassess outcome measures postintervention, and cost of exercise sessions is unknown. Although HIIT is recommended in international CR guidelines, it is essentially not being used in Australia and clinicians are unsure as to the safety of HIIT. Lack of resources and staff knowledge were perceived as the biggest barriers to HIIT implementation, and there are inconsistent perceptions of prescreening and monitoring requirements. This study highlights the need to educate health professionals about the benefits and safety of HIIT to improve its usage and patient outcomes. PMID:29750058

Comparison between group and personal rehabilitation for dementia in a geriatric health service facility: single-blinded randomized controlled study.

Science.gov (United States)

Tanaka, Shigeya; Honda, Shin; Nakano, Hajime; Sato, Yuko; Araya, Kazufumi; Yamaguchi, Haruyasu

2017-05-01

The aim of this study was to compare the effects of rehabilitation involving group and personal sessions on demented participants. This single-blinded randomized controlled trial included 60 elderly participants with dementia in a geriatric health service facility, or R oken. Staff members, who did not participate in the intervention, examined cognitive function, mood, communication ability, severity of dementia, objective quality of life, vitality, and daily behaviour. After a baseline assessment, participants were randomly divided into three groups: (i) group intervention; (ii) personal intervention; and (iii) control. The 1-h group intervention (3-5 subjects) and 20-min personal intervention (one staff member per participant) were performed twice a week for 12 weeks (24 total sessions). The cognitive rehabilitation programme consisted of reminiscence, reality orientation, and physical exercise, and it was based on five principles of brain-activating rehabilitation; (i) pleasant atmosphere; (ii) communication; (iii) social roles; (iv) praising; and (v) errorless support. Data were analyzed after the second assessment. Outcome measures were analyzed in 43 participants-14 in the control group, 13 in group intervention, and 16 in personal intervention. Repeated measure ancova showed a significant interaction for cognitive function score (Mini-Mental State Examination) between group intervention and controls ( F  = 5.535, P = 0.029). In the post-hoc analysis, group intervention showed significant improvement (P = 0.016). Global severity of dementia tended to improve (P = 0.094) in group intervention compared to control (Mann-Whitney U -test). There were no significant interactions or improvements for other measurements. Group rehabilitation for dementia is more effective for improving cognitive function and global severity of dementia than personal rehabilitation in Roken. © 2016 Japanese Psychogeriatric Society.

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...

Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

OpenAIRE

Özhayat, Esben Boeskov

2013-01-01

Background The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. Methods OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthe...

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

Effectiveness of geriatric rehabilitation among patients with secondary diagnosis dementia [Effektivität der ambulanten und stationären geriatrischen Rehabilitation bei Patienten mit der Nebendiagnose Demenz

Directory of Open Access Journals (Sweden)

Korczak, Dieter

2012-09-01

Full Text Available [english] Often geriatric patients with secondary diagnosis dementia do not receive a rehabilitation treatment, although it is an obligatory service offered by the statutory health insurance. Scientists have examined the benefit of relevant measures for patients who are slightly or moderately affected with dementia. Thus, also these patients would profit by a rehabilitation.[german] Geriatrische Patienten mit Nebendiagnose Demenz erhalten oft keine Rehabilitation, obwohl diese zu den Pflichtleistungen der gesetzlichen Krankenkasse gehört. Wissenschaftler haben untersucht, ob und wenn ja, welchen Nutzen entsprechende Maßnahmen für leicht bis moderat demenzkranke Patienten haben. Demnach profitieren durchaus auch diese Patienten von einer Rehabilitation.

Self-healing method as strategy to promote health and rehabilitation of people with multiple sclerosis in the context of occupational therapy

Directory of Open Access Journals (Sweden)

Paula Pozzi Pimentel

2017-09-01

Full Text Available Introduction: Multiple sclerosis is a neurological chronic disease with continuous and differentiated evolution, it demands body self-knowledge for better understanding of preserved capacities, gradual losses and repercussion in the performance of activities and social participation. Objective: To analyze the group experience of the application of physical techniques based on self-healing method for health promotion and rehabilitation of people with multiple sclerosis, developed by Occupational Therapy. Method: Documental qualitative research referring to written records and audio transcripts of group sessions. Data analysis used the Collective Subject Discourse method. Results: Ten adults with multiple sclerosis, with varying ages and disease times, participated in the therapeutic group. Five participants reported representations and experiences due to the disease and the effect of learning the physical techniques of self-sealing. The benefits include a greater body awareness, decreased symptoms, improved functional capacity and recognition of the need of body practice routine. Conclusion: The therapeutic use of self-healing method demonstrated its applicability to promote the health benefits, rehabilitation, according to health policies. Due to limited literature on the benefits of using the self-healing method indicates the development of new studies.

Choosing the right rehabilitation setting after herniated disc surgery: Motives, motivations and expectations from the patients' perspective.

Science.gov (United States)

Löbner, Margrit; Stein, Janine; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans Jörg; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G

2017-01-01

This study aims to investigate (1) motives, motivations and expectations regarding the choice for a specific rehabilitation setting after herniated disc surgery and (2) how rehabilitation-related motivations and expectations are associated with rehabilitation outcome (ability to work, health-related quality of life and satisfaction with rehabilitation) three months after disc surgery. The longitudinal cohort study refers to 452 disc surgery patients participating in a subsequent rehabilitation. Baseline interviews took part during acute hospital stay (pre-rehabilitation), follow-up interviews three months later (post-rehabilitation). Binary logistic regression and multiple linear regression analyses were applied. (1) Motives, motivations and expectations: Inpatient rehabilitation (IPR) patients stated "less effort/stress" (40.9%), more "relaxation and recreation" (39.1%) and greater "intensity of care and treatment" (37.0%) regarding their setting preference, whereas outpatient rehabilitation (OPR) patients indicated "family reasons" (45.3%), the wish for "staying in familiar environment" (35.9%) as well as "job-related reasons" (11.7%) as most relevant. IPR patients showed significantly higher motivation/expectation scores regarding regeneration (p job (p example, patients with less motivations/expectations to achieve improvements regarding "physical burden" showed a better health-related quality of life (p satisfaction with rehabilitation (OR = .806; p < .05). Rehabilitation-related motivations and expectations differed substantially between IPR and OPR patients before rehabilitation and were significantly associated with rehabilitation outcome. Taking motivational and expectation-related aspects into account may help to improve allocation procedures for different rehabilitation settings and may improve rehabilitation success.

Physical therapy 2.0: leveraging social media to engage patients in rehabilitation and health promotion.

Science.gov (United States)

Knight, Emily; Werstine, Robert J; Rasmussen-Pennington, Diane M; Fitzsimmons, Deborah; Petrella, Robert J

2015-03-01

Care for chronic conditions and noncommunicable diseases is dominating health systems around the globe. For physical therapists, this strain presents a substantial opportunity for engaging patients in health promotion and disease management in the years to come. Examples of social media being used to engage consumers in the business landscape are pervasive, and research reports suggest that patients are ready for social media to be incorporated into the way health care systems deliver care. We propose that leveraging the power and utility of existing technologies, such as social media, could innovate the way physical therapists engage patients in rehabilitation and health promotion practices, thus contributing to the evolution of the profession: Physical Therapy 2.0. To continue to be relevant in the community, physical therapist practice must respond to patients' needs and expectations. Incorporating social media into how physical therapists are both designing and delivering care holds potential for enhancing patient engagement in prescribed health behaviors and improving treatment outcomes. This conceptual article presents the perspective that physical therapists can utilize social media to enhance care delivery and treatment outcomes. © 2015 American Physical Therapy Association.

A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil.

Science.gov (United States)

Sousa, Kelienny de Meneses; Oliveira, Wagner Ivan Fonsêca de; Melo, Laiza Oliveira Mendes de; Alves, Emanuel Augusto; Piuvezam, Grasiela; Gama, Zenewton André da Silva

2017-03-01

Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the

42 CFR 412.604 - Conditions for payment under the prospective payment system for inpatient rehabilitation facilities.

Science.gov (United States)

2010-10-01

... payment system for inpatient rehabilitation facilities. 412.604 Section 412.604 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment for Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.604 Conditions for payment under the prospective payment system for inpatient...

Cognitive rehabilitation for patients with schizophrenia in Korea.

Science.gov (United States)

Lee, Won Hye; Lee, Woo Kyeong

2017-02-01

Psychosocial rehabilitation programs received mental health professional support in addition to traditional medication therapy. Many psychosocial programs were developed since the 1990s, including cognitive remediation therapy. In this review, we focus on cognitive remediation therapy in Korea since the 1990s. We review several cognitive rehabilitation programs developed in Korea and their outcome studies and suggest future research directions and prospects. We reviewed cognitive rehabilitation programs including social cognitive training as well as more recent forms of computerized cognitive rehabilitation. Although there are differences in cognitive domains by training targets, almost all neurocognitive remediation trainings in Korea have beneficial effects on early visual processing, various attention types, and executive function. Future studies need to investigate the mechanisms and various mediators underlying the relationships between cognitive functions and functional outcomes. With more comprehensive cognitive and social cognitive programs, we can enhance both cognition and functional outcomes of the patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

Prevention and rehabilitation in Swedish public sector workplaces: Effects on co-workers' and leaders' health and psychosocial working conditions.

Science.gov (United States)

Vinberg, Stig; Romild, Ulla; Landstad, Bodil J

2015-01-01

Leaders and co-workers in Swedish public sector organizations are exposed to demanding psychosocial working conditions; more knowledge about workplace-based interventions in this sector of working life is needed. To compare co-workers' and leaders' self-ratings of health and psychosocial working conditions, and investigate how prevention and rehabilitation in Swedish public sector workplaces affects these ratings. The longitudinal panel data consisted of 311 individuals (20 leaders, 291 co-workers) at 19 workplaces. Based on questionnaire data, statistical analyses were performed using Mann-Whitney U-Test, pair-wise Spearman correlations, a mixed between-within subjects ANOVA and Friedman's test. Results indicate differences in how the leaders and the co-workers judge their health and psychosocial working conditions. Leaders report work content that is more varied and interesting as well as more possibilities for personal development through work, yet they also report more tiredness, concern over managing their work situation and time pressure at work. Comparisons of mean values for used indicators show some improvements after one year, but also several non-significant or negative time trends two years after the interventions were initiated. The study provides some support for experienced differences between co-workers' and leaders' health and psychosocial working conditions in public sector workplaces, indicating the importance of different workplace-oriented prevention and rehabilitation interventions for these two categories of employees.

'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics.