Retrospective results of radiation therapy of the Eustachian tube in chronic otitis media; Retrospektive Ergebnisse der perkutanen Strahlentherapie der Tuba Eustachii bei chronischer Otitis media

Energy Technology Data Exchange (ETDEWEB)

Schultze, J.; Reinke, C.; Kimmig, B. [Klinik fuer Strahlentherapie (Radioonkologie), Universitaetsklinikum Kiel (Germany); Frese, K.A. [Klinik fuer Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitaetsklinikum Kiel (Germany)

2003-01-01

Background: The treatment results of symptomatic radiation therapy of the Eustachian tube in chronic otitis media had to be evaluated retrospectively. Patients and Methods: Between 1980 and 1997, 66 patients were referred for therapy. The median age was 58 years. In the clinical presentation, all the patients had a hearing impairment, 35 patients complained of pain, 21 had otorrhea. In their history, 20 patients indicated chronic recurrent infections. The complaints lasted for 4.7 years in the median, primary conservative (adstringentia, antibiotics) and surgical treatment (paracentesis, tympanic tubule, tympanoplastic) did not lead to lasting cure. In 40 of 66 patients, finally radiation therapy was done of both Eustachian tubes. With opposed fields and cobalt-60 photons a total dose of 6 Gy at single doses of 1 Gy, three times a week, was applied. Under the causes for exclusion of radiation therapy were non-acceptance of the patients (nine), prior radiation therapies (six) or spontaneous improvement after initial presentation in our department. The treatment results were evaluated by interviews of the patients and regular otorhinolaryngological examinations. Results: There were no side effects noticed. 28 of 40 (70%) patients reported a significant improvement that could be verified by objective otorhinolaryngological examinations. In the group of 26 nonirradiated patients, 22 could be interviewed indicating in 16 cases (72%) that the complaints were unchanged and chronic otitis media was lasting. In a subgroup analysis concerning the duration of otitis media radiation therapy proved more effective in an acute and subacute stadium of disease of up to 5 years duration, while the patients resistant to radiation therapy were entirely in a chronic stage of disease exceeding 5 years duration. (orig.) [German] Hintergrund: Die Behandlungsergebnisse der symptomatischen Radiotherapie bei chronischer Otitis media sollten retrospektiv evaluiert werden. Patienten und

Movement-based interaction applied to physical rehabilitation therapies.

Science.gov (United States)

Garrido Navarro, Juan Enrique; Ruiz Penichet, Victor Manuel; Lozano Pérez, María Dolores

2014-12-09

Health care environments are continuously improving conditions, especially regarding the use of current technology. In the field of rehabilitation, the use of video games and related technology has helped to develop new rehabilitation procedures. Patients are able to work on their disabilities through new processes that are more motivating and entertaining. However, these patients are required to leave their home environment to complete their rehabilitation programs. The focus of our research interests is on finding a solution to eliminate the need for patients to interrupt their daily routines to attend rehabilitation therapy. We have developed an innovative system that allows patients with a balance disorder to perform a specific rehabilitation exercise at home. Additionally, the system features an assistive tool to complement the work of physiotherapists. Medical staff are thus provided with a system that avoids the need for them to be present during the exercise in specific cases in which patients are under suitable supervision. A movement-based interaction device was used to achieve a reliable system for monitoring rehabilitation exercises performed at home. The system accurately utilizes parameters previously defined by the specialist for correct performance of the exercise. Accordingly, the system gives instructions and corrects the patient's actions. The data generated during the session are collected for assessment by the specialist to adapt the difficulty of the exercise to the patient's progress. The evaluation of the system was conducted by two experts in balance disorder rehabilitation. They were required to verify the effectiveness of the system, and they also facilitated the simulation of real patient behavior. They used the system freely for a period of time and provided interesting and optimistic feedback. First, they evaluated the system as a tool for real-life rehabilitation therapy. Second, their interaction with the system allowed us to obtain

[Exercise Therapy in German Medical Rehabilitation - an Analysis based on Quantitative Routine Data].

Science.gov (United States)

Brüggemann, Silke; Sewöster, Daniela; Kranzmann, Angela

2018-02-01

This study describes the quantitative importance of exercise therapy in German medical rehabilitation based on 2014 routine data of the German Pension Insurance. It also shows changes in comparison with data from 2007. Data from 710012 rehabilitation discharge letters comprising 83677802 treatments from central indications in medical rehabilitation were analysed descriptively. Overall 35.4% of treatments could be classified as exercise therapy. Total and relative duration, percentage of individual treatment and kind of exercise treatment varied between indications in 2007 as well as in 2014. There were also differences between sexes, age groups and settings. During the period examined the high importance of exercise therapy in German medical rehabilitation has increased. The results point at a meaningful concept behind the composition of exercise therapy taking indications and disease related factors into account. © Georg Thieme Verlag KG Stuttgart · New York.

Physical therapy methods in the treatment and rehabilitation of cancer patients

International Nuclear Information System (INIS)

Kucherova, T. Ya.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.

2016-01-01

The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

Adjuvant chemo- and radiotherapy in gastrointestinal tumors; Adjuvante Chemo- und Strahlentherapie bei gastrointestinalen Tumoren

Energy Technology Data Exchange (ETDEWEB)

Sendler, A. [Technische Univ. Muenchen (Germany). Chirurgische Klinik und Poliklinik; Feldmann, H.J. [Technische Univ. Muenchen (Germany). Inst. und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Fink, U. [Technische Univ. Muenchen (Germany). Chirurgische Klinik und Poliklinik; Molls, M. [Technische Univ. Muenchen (Germany). Inst. und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Siewert, J.R. [Technische Univ. Muenchen (Germany). Chirurgische Klinik und Poliklinik

1995-04-21

In modern surgical oncology, adjuvant therapies are important complementary strategies. In local advanced carcinomas of the gastrointestinal tract, 5-year survival data are still disappointing despite standardized surgery. In this context, it has to be differentiated between adjuvant therapy following complete tumor exstirpation (so-called UICC R{sub 0} resection) and additive therapies following incomplete tumor resections (UICC R{sub 1} or R{sub 2} resection). Modalities in the adjuvant setting are chemotherapy, radiotherapy or the combined radio-/chemotherapy. In esophageal and gastric cancer there is up to now no benefit of postoperative adjuvant therapy. In pancreatic cancer, there are studies indicating a benefit of combined radio-/chemotherapy after complete tumor resection. A standard adjuvant chemotherapeutic treatment is proven in colon cancer stage III (Dukes C) with levamisole and 5-FU. Completely resected rectal carcinoma should be treated postoperatively with combined radio-/chemotherapy. In the common clinical or practical setting, adjuvant therapy is indicated only in locally advanced gastrointestinal tumors following R{sub 0} resection. Postoperative therapy following incomplete tumor resection has its reason only in a palliative intention. (orig.) [Deutsch] Adjuvante Therapiestrategien sind wichtige flankierende Massnahmen der modernen onkologischen Chirurgie, da u.a. die 5-Jahres-Ueberlebensquoten bei lokal fortgeschrittenen Tumoren des Gastrointestinaltraktes nach wie vor unbefriedingend sind. Dabei muss grundsaetzlich zwischen adjuvanten Behandlungen nach kompletter Tumorexstirpation (UICC-R{sub 0}-Resektion) und der additiven Therapie nach palliativer Resektion (UICC-R{sub 1}- oder -R{sub 2}-Resektion) unterschieden werden. Als Modalitaeten kommen Chemotherapie, Strahlentherapie und ihre Kombination in Frage. Bei Oesophagus- und Magenkarzinomen kann derzeit keine gueltige Empfehlung zur adjuvanten Therapie gegeben werden. Die Radio

Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.

Science.gov (United States)

Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary

2017-03-06

To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

Science.gov (United States)

Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

2017-07-01

New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

Research progress of rehabilitation therapy in Parkinson's disease and its mechanism

Directory of Open Access Journals (Sweden)

Jin LIU

2017-07-01

Full Text Available Parkinson's disease (PD is characterized by the progressive degeneration of dopaminergic neurons in substantia nigra pars compacta. Rehabilitation therapy can delay the development of disease, improve motor symptoms and non - motor symptoms (NMS, and consequently improve the activities of daily living (ADL in patients with PD. The mechanism of rehabilitation improving the symptoms of PD is very complex, involving a variety of molecular mechanisms. Thus, this review will focus on the effect of rehabilitation therapy on PD and the underlying molecular mechanism including neurotransmitters, trophic factors, synaptic plasticity and immune system. DOI: 10.3969/j.issn.1672-6731.2017.06.003

Video games and rehabilitation: using design principles to enhance engagement in physical therapy.

Science.gov (United States)

Lohse, Keith; Shirzad, Navid; Verster, Alida; Hodges, Nicola; Van der Loos, H F Machiel

2013-12-01

Patient nonadherence with therapy is a major barrier to rehabilitation. Recovery is often limited and requires prolonged, intensive rehabilitation that is time-consuming, expensive, and difficult. We review evidence for the potential use of video games in rehabilitation with respect to the behavioral, physiological, and motivational effects of gameplay. In this Special Interest article, we offer a method to evaluate effects of video game play on motor learning and their potential to increase patient engagement with therapy, particularly commercial games that can be interfaced with adapted control systems. We take the novel approach of integrating research across game design, motor learning, neurophysiology changes, and rehabilitation science to provide criteria by which therapists can assist patients in choosing games appropriate for rehabilitation. Research suggests that video games are beneficial for cognitive and motor skill learning in both rehabilitation science and experimental studies with healthy subjects. Physiological data suggest that gameplay can induce neuroplastic reorganization that leads to long-term retention and transfer of skill; however, more clinical research in this area is needed. There is interdisciplinary evidence suggesting that key factors in game design, including choice, reward, and goals, lead to increased motivation and engagement. We maintain that video game play could be an effective supplement to traditional therapy. Motion controllers can be used to practice rehabilitation-relevant movements, and well-designed game mechanics can augment patient engagement and motivation in rehabilitation. We recommend future research and development exploring rehabilitation-relevant motions to control games and increase time in therapy through gameplay.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A61) for more insights from the authors.

Supportive treatment with megestrol acetate during radio-(chemo-)therapy. A randomized trial; Supportive Behandlung mit Megestrolacetat waehrend der Radio-(Chemo-)Therapie bei Patienten mit Tumoren im Kopf-Hals-Bereich. Eine randomisierte Studie

Energy Technology Data Exchange (ETDEWEB)

Fietkau, R [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Riepl, M [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Kettner, H [Bristol Arzneimittel GmbH, Muenchen (Germany). Medizinische Abt.; Hinke, A [Wissenschaftlicher Service Pharma, Monheim (Germany); Sauer, R [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik

1996-03-01

Tumoranorexie und -kachexie bei Patienten mit infauster Prognose ist bekannt. Ob sich ein supportiver Effekt von Megestrolacetat waehrend einer intensiven Radio-(Chemo-)Therapie ergibt, wurde bislang noch nicht untersucht. Dies erfolgte jetzt bei Patienten mit fortgeschritten Tumoren im Kopf-Hals-Bereich. Waehrend und bis sechs Wochen nach der Strahlentherapie erhielten die Patienten des Therapiearmes 160 mg/d Megestrolacetat. Vor, waehrend und nach der Strahlentherapie wurden anthropometrische und laborchemische Parameter bestimmt sowie die subjektive Lebensqualitaet der Patienten mittels des `Quality of life`-Index nach Padilla et al. erfasst. Ergebnisse: Zur endgueltigen Auswertung standen 61 Patienten (Kontrollarm: n=30, Therapiearm: n=31) zur Verfuegung. Ein Patient lehnte nach Randomisation die weitere Teilnahme ab. Je ein Patient im Kontroll- und Placeboarm schieden bei Verdacht auf Nebenwirkungen (Impotenz, Diarrhoe) aus. Weitere Nebenwirkungen wurden nicht beobachtet. Im Kontrollarm verschlechterten sich die Ernaehrungsparameter (Koerpergewicht, Trizepshautfaltendicke) und das subjektive Befinden unter der Bestrahlung sehr schnell und erholten sich anschliessend kaum. Im Gegensatz dazu konnten die mit Megestrolacetat behandelten Patienten diese Werte auf dem Ausgangsniveau stabiliseren. Dieser Unterschied zeigt sich am deutlichsten bei den ausschliesslich oral ernaehrten Patienten (Gewichtsverlust waehrend der Therapie im Kotrollarm: -4,1 kg; im Therapiearm: -0,8 kg; p=0,004), weniger bei den mittels perkutaner endoskopisch kontrollierten Gastrostomie (PEG) versorgten Patienten (Gewichtsverlust im Kontrollarm: -2,4 kg; im Therapiearm: -0,8 kg; p=0,14). Schlussfolgerungen: Die prophylaktische Gabe von Megestrolacetat kann bei Patienten mit Kopf-Hals-Tumoren waehrend einer Radio/(Chemo-)Therapie eine Verschlechterung des Ernaehrungszustands und tendenziell der Lebensqualitaet verhindern.

Occupational, Physical, and Speech Therapy Treatment Activities During Inpatient Rehabilitation for Traumatic Brain Injury.

Science.gov (United States)

Beaulieu, Cynthia L; Dijkers, Marcel P; Barrett, Ryan S; Horn, Susan D; Giuffrida, Clare G; Timpson, Misti L; Carroll, Deborah M; Smout, Randy J; Hammond, Flora M

2015-08-01

To describe the use of occupational therapy (OT), physical therapy (PT), and speech therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injury. Multisite prospective observational cohort study. Inpatient rehabilitation settings. Patients (N=2130) admitted for initial acute rehabilitation after traumatic brain injury. Patients were categorized on the basis of admission FIM cognitive scores, resulting in 5 fairly homogeneous cognitive groups. Not applicable. Percentage of patients engaged in specific activities and mean time patients engaged in these activities for each 10-hour block of time for OT, PT, and ST combined. Therapy activities in OT, PT, and ST across all 5 cognitive groups had a primary focus on basic activities. Although advanced activities occurred in each discipline and within each cognitive group, these advanced activities occurred with fewer patients and usually only toward the end of the rehabilitation stay. The pattern of activities engaged in was both similar to and different from patterns seen in previous practice-based evidence studies with different rehabilitation diagnostic groups. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of a Music Therapy Service in an Australian Public Rehabilitation Hospital

OpenAIRE

Jeanette Tamplin

2006-01-01

It is often challenging to find information about the details and development of clinical music therapy programs in other parts of the world. This article addresses a gap in the literature by describing the evolution of a neurological rehabilitation program over the past two years in Melbourne, Australia. After providing some local details on the development of rehabilitation music therapy in this part of the world, a brief rationale is offered for the place of music therapy in clinical rehab...

Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

International Nuclear Information System (INIS)

Tuomi, Lisa; Andréll, Paulin; Finizia, Caterina

2014-01-01

Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons with 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors

Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

Energy Technology Data Exchange (ETDEWEB)

Tuomi, Lisa, E-mail: lisa.tuomi@vgregion.se [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Andréll, Paulin [Department of Molecular and Clinical Medicine/Multidisciplinary Pain Center, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Finizia, Caterina [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden)

2014-08-01

Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons with 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors.

MRI for therapy control in patients with aortic isthmus stenosis; MRT zur Therapiekontrolle bei Patienten mit Aortenisthmusstenose

Energy Technology Data Exchange (ETDEWEB)

Wintersperger, B.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Toronto General Hospital, University of Toronto, Department of Medical Imaging, University Health Network, Toronto M5G 2N2 (Canada); Theisen, D.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

2011-01-15

Aortic isthmus stenosis is the most common congenital aortic anomaly and is often a problem for therapy surveillance. In addition to possible comorbidities (e.g. bicuspid aortic valve) it is accompanied by various middle and long-term complications depending on the primary choice of the therapeutic procedure. Magnetic resonance imaging (MRI) plays an important role for the mostly young patients in the control of the aortic isthmus stenosis and therapy because it is non-invasive and there is no X-ray exposure. Radiologists should be well-informed on the principles of the therapeutic procedure in order to be competent in the interpretation of MRI findings. Due to the continuous development of MRI technology, techniques for functional evaluation (e.g. dynamic MRA, 4D PC flow measurement) are increasingly becoming available in addition to high-resolution MR angiography (MRA), which could predict the risk of possible complications, such as aneurysms. However, in this aspect further studies are necessary. Interventional therapy with stents and stent grafts is often employed for the therapy of possible complications following an operation (aneurysms, restenosis) but because of massive metal artefacts the use of MRI is often sometimes severely limited. (orig.) [German] Die Aortenisthmusstenose als haeufigste angeborene Aortenanomalie stellt ein haeufiges Problem der Therapieueberwachung dar und ist neben moeglichen begleitenden Anomalien (z. B. bikuspidale Aortenklappe) in Abhaengigkeit vom primaer gewaehlten Therapieverfahren mit verschiedenen Komplikationen im mittel- bis laengerfristigem Verlauf vergesellschaftet. Bei der Kontrolle der Aortenisthmusstenose bzw. deren Therapie spielt die Magnetresonanztomographie (MRT) aufgrund der Nichtinvasivitaet und fehlenden Strahlenexposition bei den meist juengeren Patienten eine wichtige Rolle. Der Radiologe sollte ueber die Grundzuege der Therapieverfahren informiert sein, um die MRT-Befunde kompetent zu befunden. Durch stetige

The use of alternative therapies in the Saskatchewan stroke rehabilitation population

Directory of Open Access Journals (Sweden)

Jefromova Ludmilla

2002-07-01

Full Text Available Abstract Background Many patients use alternative therapies. The purpose of this study was to determine the percentage of stroke rehabilitation patients in Saskatchewan using alternative therapies, whether patients found these therapies effective in alleviating stroke-related symptoms, how often those patients who used alternative therapies discuss this fact with their primary care doctor and the main reason why patients might not do so. Methods Telephone questionnaire surveys were conducted with 117 patients who had suffered a stroke and undergone inpatient or outpatient rehabilitation at Saskatoon City Hospital. Results The study revealed that 26.5% of 117 stroke rehabilitation patients visited alternative practitioners at least once or used some form of unconventional therapy. Only 16.1% of patients found that alternative therapy made them feel much better. Of those who used alternative therapy, 61.3% did not discuss this fact with their primary physician. Many of the respondents (47.3% who did not inform their physician stated that they did not see the necessity of talking about these treatments and 21.1% did not discuss the issue with their physician because they felt that he or she might disapprove of alternative therapies. Conclusion A relatively small percentage of stroke patients found alternative therapies beneficial. Doctors should be aware that a significant number of patients will try alternative treatment without discussion with their primary care physician or specialist. The current study suggests that after completing routine questioning, doctors should also ask their patients about their use of alternative therapies and, when appropriate, review issues of safety and efficacy.

PROGame: A process framework for serious game development for motor rehabilitation therapy.

Science.gov (United States)

Amengual Alcover, Esperança; Jaume-I-Capó, Antoni; Moyà-Alcover, Biel

2018-01-01

Serious game development for rehabilitation therapy is becoming increasingly popular because of the motivational advantages that these types of applications provide. Consequently, the need for a common process framework for this category of software development has become increasingly evident. The goal is to guarantee that products are developed and validated by following a coherent and systematic method that leads to high-quality serious games. This paper introduces a new process framework for the development of serious games for motor rehabilitation therapy. We introduce the new model and demonstrate its application for the development of a serious game for the improvement of the balance and postural control of adults with cerebral palsy. The development of this application has been facilitated by two technological transfer contracts and is being exploited by two different organizations. According to clinical measurements, patients using the application improved from high fall risk to moderate fall risk. We believe that our development strategy can be useful not only for motor rehabilitation therapy, but also for the development of serious games in many other rehabilitation areas.

BCI and FES Based Therapy for Stroke Rehabilitation Using VR Facilities

Directory of Open Access Journals (Sweden)

Robert Gabriel Lupu

2018-01-01

Full Text Available In recent years, the assistive technologies and stroke rehabilitation methods have been empowered by the use of virtual reality environments and the facilities offered by brain computer interface systems and functional electrical stimulators. In this paper, a therapy system for stroke rehabilitation based on these revolutionary techniques is presented. Using a virtual reality Oculus Rift device, the proposed system ushers the patient in a virtual scenario where a virtual therapist coordinates the exercises aimed at restoring brain function. The electrical stimulator helps the patient to perform rehabilitation exercises and the brain computer interface system and an electrooculography device are used to determine if the exercises are executed properly. Laboratory tests on healthy people led to system validation from technical point of view. The clinical tests are in progress, but the preliminary results of the clinical tests have highlighted the good satisfaction degree of patients, the quick accommodation with the proposed therapy, and rapid progress for each user rehabilitation.

Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

Science.gov (United States)

Chen, Jia-Ching; Shaw, Fu-Zen

2014-01-01

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

Horticultural therapy: the 'healing garden'and gardening in rehabilitation measures at Danderyd Hospital Rehabilitation Clinic, Sweden.

Science.gov (United States)

Söderback, Ingrid; Söderström, Marianne; Schälander, Elisabeth

2004-01-01

Objectives were to review the literature on horticultural therapy and describe the Danderyd Hospital Horticultural Therapy Garden and its associated horticultural therapy programme. The literature review is based on the search words 'gardening', 'healing garden' and 'horticultural therapy'. The description is based on the second author's personal knowledge and popular-scientific articles initiated by her. The material has been integrated with acknowledged occupational therapy literature. The setting was the Danderyd Hospital Rehabilitation Clinic, Sweden, Horticultural Therapy Garden. Forty-six patients with brain damage participated in group horticultural therapy. Horticulture therapy included the following forms: imagining nature, viewing nature, visiting a hospital healing garden and, most important, actual gardening. It was expected to influence healing, alleviate stress, increase well-being and promote participation in social life and re-employment for people with mental or physical illness. The Horticultural Therapy Garden was described regarding the design of the outdoor environment, adaptations of garden tools, cultivation methods and plant material. This therapy programme for mediating mental healing, recreation, social interaction, sensory stimulation, cognitive re-organization and training of sensory motor function is outlined and pre-vocational skills and the teaching of ergonomical body positions are assessed. This study gives a broad historic survey and a systematic description of horticultural therapy with emphasis on its use in rehabilitation following brain damage. Horticulture therapy mediates emotional, cognitive and/or sensory motor functional improvement, increased social participation, health, well-being and life satisfaction. However, the effectiveness, especially of the interacting and acting forms, needs investigation.

Cost-effectiveness-analysis: radioiodine or antithyroid drugs as first-line therapy of hyperthyroidism due to Graves` disease; Kosten-Effektivitaets-Analyse: Radioiod oder thyreostatische Medikation bei der Primaerbehandlung der Immunhyperthyreose

Energy Technology Data Exchange (ETDEWEB)

Dietlein, M.; Moka, D.; Dederichs, B.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hunsche, E.; Lauterbach, K.W. [Koeln Univ. (Germany). Inst. fuer Gesundheitsoekonomie, Medizin und Gesellschaft

1999-06-01

Aim: As first-line therapy of hyperthyroidism caused by Graves` disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. Method: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq I-131 residual activity. Result: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. Conclusion: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake). (orig.) [Deutsch] Ziel: Die Erstmanifestation einer Immunhyperthyreose wird in Europa ueberwiegend thyreostatisch, in den USA mehrheitlich mit Radioiod definitiv behandelt. Diese beiden Alternativen wurden auf dem Hintergrund neuer nationaler Entlassungsrichtwerte nach einer Radioiodtherapie (RITh) verglichen. Methode: Aus Sicht der Gesellschaft entscheiden einerseits die langfristigen Rezidivraten, andererseits die Menge medizinischer Leistungen, der Versicherungsstatus und der Produktivitaetsausfall des Patienten (Fehlzeiten, Einkommen) sowie die zeitliche Verteilung der Kosten (Diskontierung) ueber die Kosten

The efficiency of balneokinetic rehabilitation therapy for the post-traumatic hip

Directory of Open Access Journals (Sweden)

Carmen Enescu

2016-12-01

Full Text Available The aim of this study was to determine the efficiency of balneokinetic therapy for post-traumatic hip disorders in Calimanesti-Caciulata spa and climatic resort. Material and method: the case study of a 23-year-old man with post-traumatic hip sequelae following an airplane accident, present in our clinic in the period April-October 2014, who attended a complex rehabilitation program including drug therapy, massage, kinesiotherapy and hydrokinesiotherapy. Functional assessment was performed at admission, at 4 months, and at discharge. Results: An obvious improvement of joint mobility and muscle recovery was obtained. Conclusions: The time required for recovery and socio-professional reintegration depends on the collaboration between the patient and the rehabilitation team, as well as on the timely and correct referral of the patient by the orthopedist to rehabilitation services.

Unique Role of Occupational Therapy in Rehabilitation of the Hand

Science.gov (United States)

... tendonitis, rheumatoid arthritis and osteoarthritis, and carpal tunnel syndrome also are treated by occupational therapy practitioners specializing in hand rehabilitation. Practitioners who treat ...

Magnetic resonance tomography in eclampsia; Magetresonanztomographie bei Eklampsie

Energy Technology Data Exchange (ETDEWEB)

Uhlig, U. [St.-Vincentius-Krankenhaeuser, Karlsruhe (Germany). Radiologische Klinik

1995-05-01

Eclampsia is a rare but severe complication during the course of a pregnancy. The CT-findings at the brain are well known. Reports on MRT-findings are limited, however, especially in German literature. We describe the MRT picture of the cerebral changes caused by eclampsia and discuss the advantages of MRT in comparison with CT. The use of contrast agents with MRT shows breakdown of blood-brain barrier but does not provide any information of therapeutical consequences and should be avoided during pregnancy. An early and targeted use of MRT in any case of unclear or suspicious neurological symptoms during pregnancy is recommended. MRT supports differential diagnosis regarding non pregnancy-related cerebral disease and can be helpful for therapy planning in cases of preeclampsia. Additionally, MRT offers the possibility to control the effect of therapy with regard to brain damage. (orig.) [Deutsch] Die Eklampsie ist eine seltene aber erhebliche Komplikation im Verlauf einer Schwangerschaft. Die computertomographischen Veraenderungen im Gehirn sind bekannt. Mitteilungen von kernspintomographischen Befunden finden sich vor allem in der deutschen Literatur noch selten. Wir beschreiben das kernspintomographische Bild der zerebralen Veraenderungen bei Eklampsie und diskutieren die Vorteile der MRT im Vergleich zur CT. Die Gabe von Kontrastmittel bei der MRT weist zwar die Blut-Hirn-Schrankenstoerung nach, bringt aber keine therapeutisch relevanten Informationen. Sie sollte waehrend der Schwangerschaft vermieden werden. Ein frueher und gezielter Einsatz der MRT bei unklaren oder verdaechtigen neurologischen Symptomen waehrend der Schwangerschaft ist sinnvoll. Die MRT unterstuetzt die Differentialdiagnose in bezug auf nicht schwangerschaftsbezogene zerebrale Leiden und kann fuer die Therapie richtungweisend sein, wenn die Gestose noch nicht ausgepraegt ist. (orig.)

Medical Rehabilitation and Occupational Therapy in Patients with Lesion of Plexus Brachialis

Directory of Open Access Journals (Sweden)

Vacheva D.

2015-05-01

Full Text Available Causes for plexus brachialis damage are versatile, and in some cases remain unknown, but mostly result from degenerative and inflammatory processes. Treatment of brachial plexus dysfunction is often conservative and is subject to a team of specialists - neurologists, traumatologists, rehabilitation physicians, kinesitherapists and occupational therapists. The objective of the research is to report the recovery of patients with lesion of plexus brachialis after a complex physiotherapy and rehabilitation treatment program that includes electrostimulation, remedial massage, kinesitherapy, electrotherapy and occupational therapy. A total of 159 patients, treated at the Clinic of Physical Therapy, University Hospital of Pleven, were included in the study. Improvement of measured indexes: pain assessment, centimetry, assessment of upper limb muscle weakness, dynamometry and functional test of activities of daily living, was registered in all patients under observation. In order to achieve good results in the rehabilitation of patients with injured plexus brachialis, timely diagnosis, good medication therapy and early start of complex physiotherapy and rehabilitation are of crucial importance, so that performance of daily living activities improves. The good results come slowly and with difficulties, but the quality of life of patients and the quality of labor performed by them, improves significantly.

Concurrent Complementary and Alternative Medicine CAM and Conventional Rehabilitation Therapy in the Management of Children with Developmental Disorders

Directory of Open Access Journals (Sweden)

Soo Yeon Kim

2013-01-01

Full Text Available Background. We investigated the concurrent use of conventional rehabilitations and complementary and alternative medicine (CAM therapies for the long-term management of children with developmental disorders (DDs. Methods. The parents or caregivers of 533 children with DDs (age range, 1–19 years who visited the rehabilitation centers were surveyed using in depth face-to-face interviews. Results. Of the 533 patients enrolled, 520 completed the questionnaire (97% response rate. A total of 292 (56% children were receiving multiple therapies, more than two conventional rehabilitations and CAM, at the time of the interview. A total of 249 (48% children reported lifetime CAM use, 23% used CAM at the time of the interview, and 62% of the patients planned to use CAM therapy in the future. Conventional rehabilitation therapies used at the time of the interview included physical therapy (30%, speech therapy (28%, and occupational therapy (19%, and the CAM therapies included herbal medicine (5% and acupuncture or moxibustion (3%. The respondents indicated that in the future they planned to use acupuncture or moxibustion (57%, occupational therapy (18%, cognitive behavioral therapy (16%, speech therapy (10%, and physical therapy (8%. Conclusion. Concurrent management as conventional rehabilitations and CAM therapies is widely used by children with DDs.

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.

Regenerative Rehabilitation: Combining Stem Cell Therapies and Activity-Dependent Stimulation.

Science.gov (United States)

Moritz, Chet T; Ambrosio, Fabrisia

2017-07-01

The number of clinical trials in regenerative medicine is burgeoning, and stem cell/tissue engineering technologies hold the possibility of becoming the standard of care for a multitude of diseases and injuries. Advances in regenerative biology reveal novel molecular and cellular targets, with potential to optimize tissue healing and functional recovery, thereby refining rehabilitation clinical practice. The purpose of this review is to (1) highlight the potential for synergy between the fields of regenerative medicine and rehabilitation, a convergence of disciplines known as regenerative rehabilitation; (2) provide translational examples of regenerative rehabilitation within the context of neuromuscular injuries and diseases; and (3) offer recommendations for ways to leverage activity dependence via combined therapy and technology, with the goal of enhancing long-term recovery. The potential clinical benefits of regenerative rehabilitation will likely become a critical aspect in the standard of care for many neurological and musculoskeletal disorders.

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

Osteoporose bei Mb. Bechterew - neue Ansätze

Directory of Open Access Journals (Sweden)

Obermayer-Pietsch B

1999-01-01

Full Text Available Eine axiale Osteoporose und daraus resultierende vertebrale Kompressionsfrakturen sind häufige Symptome eines Mb. Bechterew (MbB, Spondylarthritis ankylosans. Als ein möglicher genetischer Faktor der Osteoporose wurde eine Assoziation der Knochendichte (BMD mit BsmI- und FokI-Polymorphismen im Vitamin D-Rezeptor-(VDR-Gen publiziert. In der vorliegenden Studie wurden die Beziehungen zwischen diesen Polymorphismen, Knochenstoffwechsel, BMD und Aktivitätsindizes bei Patienten mit MbB untersucht. Bei 47 MbB-Patienten wurden Aktivitätsindizes und morphologische Parameter sowie BMD-Messungen (Dual-Röntgen-Absorptiometrie an Wirbelsäule und Schenkelhals im Vergleich zu 52 gesunden, altersgleichen Personen erhoben. Die Laborbestimmungen umfaßten biochemische Aktivitätsparameter, HLA-Typisierung sowie Knochenan- und -abbaumarker. Aus peripheren Leukozyten wurde genomische DNA präpariert und mittels Polymerase-Kettenreaktion (PCR und anschließender FokI- und BsmI-Restriktion der VDR-Genotyp nach vorhandenen bzw. fehlenden Schnittstellen (f/b bzw. F/B bestimmt. Bei MbB-Patienten fand sich eine Osteoporose deutlich häufiger als in der Kontrollgruppe. Eine Zuordnung von Aktivitätsindizes, BMD und Knochenstoffwechselparametern zu den Genotypen zeigte bei männlichen MbB-Patienten sowohl eine Assoziation der WS-Knochendichte als auch der Entzündungsmarker mit FokI-, nicht jedoch mit BsmI-Genotypen des VDR. Die pathophysiologischen Mechanismen dieser Assoziation, insbesondere mit der entzündlichen Aktivität des Mb. Bechterew, sind noch ungeklärt. Eine frühzeitige Erfassung des Osteoporoserisikos bei MbB-Patienten mittels molekularbiologischer Tests könnte eine rechtzeitige Prophylaxe und Therapie dieser Komplikation ermöglichen.

Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform.

Science.gov (United States)

Sucar, Luis Enrique; Orihuela-Espina, Felipe; Velazquez, Roger Luis; Reinkensmeyer, David J; Leder, Ronald; Hernández-Franco, Jorge

2014-05-01

Virtual reality platforms capable of assisting rehabilitation must provide support for rehabilitation principles: promote repetition, task oriented training, appropriate feedback, and a motivating environment. As such, development of these platforms is a complex process which has not yet reached maturity. This paper presents our efforts to contribute to this field, presenting Gesture Therapy, a virtual reality-based platform for rehabilitation of the upper limb. We describe the system architecture and main features of the platform and provide preliminary evidence of the feasibility of the platform in its current status.

Music therapy in neurological rehabilitation settings.

Science.gov (United States)

Galińska, Elżbieta

2015-01-01

The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be used as an alternative modality to access functions unavailable through non-musical stimulus. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions. Therefore, in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic musical exercises is performed. They make use of the executive peculiarity of musical instruments and musical structures to prime, cue and coordinate movements. Among musical components, a repetitive rhythm plays a significant role. It regulates physiologic and behavioural functions through the mechanism of entrainment (synchronization of biological rhythms with musical rhythm based on acoustic resonance). It is especially relevant for patients with a deficient internal timing system in the brain. Additionally, regular rhythmic patterns facilitate memory encoding and decoding of non-musical information hence music is an efficient mnemonic tool. The music as a hierarchical, compound language of time, with its unique ability to access affective/motivational systems in the brain, provides time structures enhancing perception processes, mainly in the range of cognition, language and motor learning. It allows for emotional expression and improvement of the motivation for rehabilitation activities. The new technologies of rhythmic sensory stimulation (i.e. Binaural Beat Stimulation) or rhythmic music in combination with rhythmic light therapy appear. This multimodal forms of stimulation are used in the treatment of stroke, brain injury, dementia and other cognitive deficits. Clinical outcome studies provide evidence of the significant superiority of rehabilitation with music over the one without music.

Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.

Science.gov (United States)

Leland, Natalie E; Lepore, Michael; Wong, Carin; Chang, Sun Hwa; Freeman, Lynn; Crum, Karen; Gillies, Heather; Nash, Paul

2018-03-01

The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach. Seven themes emerged: objectives of care; first 72 h; positioning, pain, and precautions; use of standardized assessments; episode of care practices; facilitating insight into progress; and interdisciplinary collaboration. Clinical guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The findings of this study highlight the practitioners' perspective on what constitutes high quality hip fracture rehabilitation. This work provides critical information to advance the development of stakeholder-driven rehabilitation clinical guidelines. Future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes. Implications for Rehabilitation This study highlights occupational and physiotherapy therapy practitioners' perspectives on the cumulative best

Effect of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction

Directory of Open Access Journals (Sweden)

Ling Kong

2017-11-01

Full Text Available Objective: To discuss the influence of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction. Methods: A total of 110 patients with cerebral infarction who received rehabilitation therapy in the hospital between January 2015 and May 2017 were divided into routine group (n=55 and hyperbaric oxygen group (n=55 according to random number table. Routine group received regular rehabilitation training, and hyperbaric oxygen group underwent rehabilitation training combined with hyperbaric oxygen therapy. The differences in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes were compared between the two groups at immediately after admission (T0 and after 14 d of treatment (T1. Results: At T0, there was no statistically significant difference in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes between the two groups. At T1, serum nerve factors MBP and NSE contents of hyperbaric oxygen group were lower than those of routine group while NGF content was higher than that of routine group; serum neurotransmitter Glu content was lower than that of routine group while GABA content was higher than that of routine group; serum oxidative stress indexes ROS and LHP contents were lower than those of routine group while CAT and SOD contents were higher than those of routine group. Conclusion: Rehabilitation training combined with hyperbaric oxygen therapy can effectively optimize the nerve function and inhibit the systemic oxidative stress response in rehabilitation period of patients with cerebral infarction.

Anwendung der extrakorporalen Stoßwellentherapie bei kalzifizierender Periathropathia humeroscapularis, Fersensporn und Epicondylitis humeri - Erfahrungsbericht aus dem Wilhelminenspital

Directory of Open Access Journals (Sweden)

Feyertag J

2004-01-01

Full Text Available Die Stoßwellentherapie wird bei verschiedenen Indikationen, die unter konservativen Therapien schwer zu schwer zu behandeln sind, eingesetzt. Dazu zählen die kalzifizierenden Schultererkrankungen (Tendinitis calcarea, Epicondylitis humeri (EHR und die plantare Fasciitis mit/ohne plantarem Fersensporn (FSP. Berichtet werden die Ergebnisse von 147 Patienten (102 Frauen/45 Männer, mittleres Alter betrug 57,8 Jahre, die mittels einer einmaligen extrakorporalen Stoßwellentherapie (ESWT (Tend. calc. 82 %, FSP 11 % oder EHR 7 % mittels eines HMT-ReflecTron therapiert wurden. Verabreicht wurden im Mittel 1.800 Stoßwellen. Untersucht wurde die subjektive Verbesserung der Schmerzen anhand einer visuellen Analogskala vor und 6 Wochen nach der Therapie bei allen Patienten. Bei Patienten mit Tendinitis calcarea wurde auch eine Verbesserung der Funktion sowie Veränderungen der Kalzifizierungen untersucht. Bei allen Patienten konnte eine statistisch signifikante Verbesserung der Schmerzen sowie des Bewegungsumfanges beobachtet werden (p 0,0001. Röntgenaufnahmen ergaben eine partielle Verkleinerung der Kalkdepots bei ca. 80 % der Patienten. Aufgrund der geringen Zahl der Patienten fand sich für die EHR keine signifikante Verbesserung der Schmerzsymptomatik. Eine einmalige ESWT kann zu einer deutlichen Verbesserung der Schmerzsymptomatik und zu einer Verbesserung des Bewegungsumfanges führen. Bei 80 % der Patienten mit einer Tendinitis calcarea findet sich weiter eine partielle Verkleinerung der Kalkdepots 6 Wochen nach Therapie.

Design Issues and Application of Cable-Based Parallel Manipulators for Rehabilitation Therapy

Directory of Open Access Journals (Sweden)

E. Ottaviano

2008-01-01

Full Text Available In this study, cable-based manipulators are proposed for application in rehabilitation therapies. Cable-based manipulators show good features that are very useful when the system has to interact with humans. In particular, they can be used to aid motion or as monitoring/training systems in rehabilitation therapies. Modelling and simulation of both active and passive cable-based parallel manipulators are presented for an application to help older people, patients or disabled people in the sit-to-stand transfer and as a monitoring/training system. Experimental results are presented by using built prototypes.

Pasireotid: Eine neue Therapieoption bei Morbus Cushing

Directory of Open Access Journals (Sweden)

Luger A

2012-01-01

Full Text Available Im Behandlungsalgorithmus des Morbus Cushing war bisher keine zugelassene pharmakologische Behandlungsmöglichkeit verfügbar. Mit dem Multirezeptor-Somatostatinanalogon Pasireotid steht nun mit der im April 2012 erfolgten Zulassung die erste, spezifisch für die Therapie dieses Krankheitsbildes entwickelte Substanz zur Verfügung. Die Studienevidenz belegt eine schnelle und nachhaltige Reduktion der ACTH- und Kortisolproduktion mit klinischer Besserung bei einem Großteil der Patienten.

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

Science.gov (United States)

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.

F-18-FDG PET of the thyroid in Graves` disease; F-18-FDG-PET der Schilddruese bei Morbus Basedow

Energy Technology Data Exchange (ETDEWEB)

Boerner, A.R.; Voth, E.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Koeln Univ. (Germany); Wienhard, K.; Wagner, R. [Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

1998-12-31

This study evaluates F-18-FDG PET of the thyroid in Graves` disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves` disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves` disease as well as on early radiation effects. (orig.) [Deutsch] Ziel: Diese Studie evaluiert F-18-Fluoro-Deoxy-Glukose (F-18-FDG) PET der Schilddruese bei Patienten mit M. Basedow. Methoden: 30 Patienten wurden am Tag vor Radioiod-Therapie, 15 Patienten am 3.-10. Tag nach Radioiodtherapie untersucht. 20 Patienten mit Kopf/Halstumoren und normaler Schilddruesenfunktion dienten als Kontrollgruppe. Ergebnisse: Die F-18-FDG-Aufnahme in der Schilddruese war signifikant hoeher bei Patienten mit M-Basedow im Vergleich zu den Kontrollen. Sie stieg mit hoeheren, antithyreoidalen Antikoerpern und sank bei laengerer I-131-Halbwertzeit. Es bestand eine Korrelation einer reduzierten Glukose-Utilisation bei hoeherer absorbierter Schilddruesendosis nach Radioiod-Therapie. Schlussfolgerung: Damit erscheint die F-18-FDG-PET-Untersuchung zur biologischen Aktivitaetsbeurteilung des M. Basedow und Darstellung von fruehen Strahleneffekten geeignet. (orig.)

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.

Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions.

Science.gov (United States)

Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

This article is the second part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the use of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work. Strong evidence indicates that multidisciplinary rehabilitation benefits cancer survivors and that psychosocial strategies can reduce anxiety and depression. Moderate evidence indicates that interventions can support survivors in returning to the level of sexuality desired and help with return to work. Part 1 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

PET/CT in lymphoma patients; PET-CT bei Lymphompatienten

Energy Technology Data Exchange (ETDEWEB)

Steinert, H.C. [Universitaetsspital Zuerich, Klinik und Poliklinik fuer Nuklearmedizin (Switzerland)

2004-11-01

First results of PET/CT in Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) are reported. From March 2001 to August 2004 822 PET/CT were performed at our clinic in lymphoma patients for primary staging, restaging after therapy, and diagnosis of recurrence. For coregistration non contrast-enhanced low-dose CT were used. Due to the exact anatomic localization of {sup 18}F-FDG accumulating lesions equivocal or false positive PET findings are avoided. In comparison to contrast enhanced CT, PET/CT has a higher sensitivity and specificity in patients with HD and aggressive NHL. Integration of PET/CT in treatment planning of radiation therapy optimizes the field volume. Even in the initial phase of clinical evaluation, PET/CT has proven useful in staging and restaging of lymphoma. The exact anatomic localization of the PET findings is essential for a precise report, for treatment planning of radiation therapy, and for planning surgical biopsy. (orig.) [German] Erste Ergebnisse der PET-CT bei Morbus Hodgkin (HD) und den aggressiven Non-Hodgkin-Lymphomen (NHL) werden beschrieben. Von Maerz 2001 bis August 2004 wurden 822 PET-CT bei Lymphompatienten zum primaeren Staging, zum Restaging nach Therapie und zur Rezidivdiagnostik an unserer Klinik durchgefuehrt. Fuer die Koregistration wurde ein Low-dose-CT ohne i.v.-Kontrastmittel verwendet. Durch die exakte anatomische Zuordnung der {sup 18}F-FDG aufnehmenden Laesionen wurden unklare oder falsch-positive PET-Befunde vermieden. Die PET-CT erzielte im Vergleich zur KM-verstaerkten CT eine hoehere Sensitivitaet und Spezifitaet bei Patienten mit HD und aggressiven NHL. Die Integration der PET-CT in die Planung der Strahlentherapie fuehrte zu einer Optimierung der Feldgrenzen. Die PET-CT hat sich bereits in der Phase der initialen klinischen Evaluation als wertvoll beim Staging und Restaging von Lymphomen erwiesen. Die exakte anatomische Zuordnung der PET-Informationen ist fuer eine sichere Befundung

Some aspects of using expressive arts-therapies in education and rehabilitation

Directory of Open Access Journals (Sweden)

Miholić Damir

2013-01-01

Full Text Available Contemporary approaches in different fields of expressive arts-therapies (art-therapy, music therapy, dance movement therapy, bibliotherapy, psychodrama and drama therapy are presented in this article. In that way, theoretical background, some elements of observation and assessment, as well as specific methods of therapy interventions are described. Relevant knowledge about different aspects of expressive art-therapies is presented by reviewing some recent references and results of different investigations. Results of previous researches pointed out that expressive arts-therapy may have positive influence on different aspects of psychosocial functioning. Also, further investigations are needed in order to achieve best practice in different fields of education and rehabilitation.

[Non-pharmaceutical therapy of candidates for geriatric rehabilitation: Non-pharmaceutical therapy prescribed by SHI-accredited doctors after application for outpatient geriatric rehabilitative care].

Science.gov (United States)

Krupp, Sonja; Schnoor, Maike; Lohse, Kristina; Katalinic, Alexander; Willkomm, Martin

2015-06-01

The rejection of an application for ambulant geriatric rehabilitation (AGRV) is usually justified by the argument that non-pharmaceutical therapy prescribed by doctors accredited by social housing institutions (SHI) would suffice. The reality in healthcare during the 6 months following an application is unknown. In this study 203 patients who had made an application for AGRV in the second half of 2010 in Flensburg, Lübeck or Ratzeburg were interviewed by telephone. The survey revealed that 25.7% of the applications for AGRV had been rejected. The majority of these patients received no ambulant non-pharmaceutical therapy (e.g. physical therapy, physiotherapy, occupational therapy, speech therapy or psychological therapy), less than 20% received more than 12 therapy sessions and in most cases exclusively physiotherapy. The 141 successful AGRV applicants received additional ambulant therapies of a similar magnitude. The difference between the intensified interdisciplinary therapy offered in the AGRV and additionally and the offer to rejected applicants is substantial.

Association of antidepressant medication therapy with inpatient rehabilitation outcomes for stroke, traumatic brain injury, or traumatic spinal cord injury.

Science.gov (United States)

Weeks, Douglas L; Greer, Christopher L; Bray, Brenda S; Schwartz, Catrina R; White, John R

2011-05-01

To study whether outcomes in patients who have undergone inpatient rehabilitation for stroke, traumatic brain injury (TBI), or traumatic spinal cord injury (TSCI) differ based on antidepressant medication (ADM) use. Retrospective cohort study of 867 electronic medical records of patients receiving inpatient rehabilitation for stroke, TBI, or TSCI. Four cohorts were formed within each rehabilitation condition: patients with no history of ADM use and no indication of history of depression; patients with no history of ADM use but with a secondary diagnostic code for a depressive illness; patients with a history of ADM use prior to and during inpatient rehabilitation; and patients who began ADM therapy in inpatient rehabilitation. Freestanding inpatient rehabilitation facility (IRF). Patients diagnosed with stroke (n=625), TBI (n=175), and TSCI (n=67). Not applicable. FIM, rehabilitation length of stay (LOS), deviation between actual LOS and expected LOS, and functional gain per day. In each impairment condition, patients initiating ADM therapy in inpatient rehabilitation had longer LOS than patients in the same impairment condition on ADM at IRF admission, and had significantly longer LOS than patients with no history of ADM use and no diagnosis of depression (Pstroke and TBI groups initiating ADM in IRF than their counterparts with no history of ADM use, illustrating that the group initiating ADM therapy in rehabilitation significantly exceeded expected LOS. Increased LOS did not translate into functional gains, and in fact, functional gain per day was lower in the group initiating ADM therapy in IRF. Explanations for unexpectedly long LOS in patients initiating ADM in inpatient rehabilitation focus on the potential for ADM to inhibit therapy-driven remodeling of the nervous system when initiated close in time to nervous system injury, or the possibility that untreated sequelae (eg, depressive symptoms or fatigue) were limiting progress in therapy, which triggered

REHABILITATION THERAPY VERSUS DRUG THERAPY IN PATIENTS WITH LUMBAR DISC DEGENERATION

Directory of Open Access Journals (Sweden)

BROSCATEAN, Emanuela-Flavia

2013-12-01

Full Text Available Lumbar disc degeneration is a disorder whose clinical manifestations are represented by episodic pain in the lumbar spine, without lumbar blockage and minor muscle contraction. Because lumbalgia caused by lumbar disc degeneration is not always very high intensity pain, the easiest to apply treatment is drug therapy. The aim of this study was to analyze the potential role of rehabilitation treatment in the recovery of patients and the prevention of complications compared to drug therapy alone. The study included 28 patients (17 women and 11 men aged between 23-60 years, assigned to two groups: 20 patients who received rehabilitation treatment (consisting of massage, kinesiotherapy, hydrokinesiotherapy, electrotherapy and medication and 8 patients who received drug treatment consisting of anti-inflammatory and analgesic drugs. The treatment duration was 10 days. For the evaluation of pain, the visual analogue scale was used, for the degree of disability, the Oswestry questionnaire, and for joint mobility and muscle strength, articular and muscular testing. At the end of treatment, the study group compared to the control group had a statistically significant result for pain (p=0.001, as well as for the Oswestry score (p=0.030. The mean age of the patients was 35.51±3.026, which shows an increased incidence among young adults. A possible connection between the development of the disease in women and age less than 45 years was also investigated, but the result was not statistically significant, p=0.22. Our data suggest the fact that rehabilitation treatment plays an important role in the reduction of pain and the improvement of the quality of life of patients with lumbar disc degeneration by decreasing the degree of disability. In the future, it can be proposed to monitor patients with lumbar disc degeneration over a longer time period in order to see the effects of kinetic rehabilitation programs in relation to the delay of chronicization. As

[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.

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.

Zeitlicher Verlauf der avaskulären Nekrose des Hüftkopfes bei Patienten mit Pemphigus vulgaris.

Science.gov (United States)

Balighi, Kamran; Daneshpazhooh, Maryam; Aghazadeh, Nessa; Saeidi, Vahide; Shahpouri, Farzam; Hejazi, Pardis; Chams-Davatchi, Cheyda

2016-10-01

Pemphigus vulgaris (PV) wird in der Regel mit systemischen Corticosteroiden und Immunsuppressiva behandelt. Avaskuläre Nekrose (AVN) des Hüftkopfes ist eine gut bekannte schwerere Komplikation einer Corticosteroid-Therapie. Die Charakteristika dieser schweren Komplikation bei PV sind nach wie vor unbekannt. Nicht kontrollierte, retrospektive Untersuchung aller PV-bedingten AVN-Fälle, die in einer iranischen Klinik für bullöse Autoimmunerkrankungen zwischen 1985 und 2013 diagnostiziert wurden. Anhand der Krankenakten von 2321 untersuchten PV-Patienten wurden 45 Fälle (1,93 %) von femoraler AVN identifiziert. Dreißig davon waren Männer. Das mittlere Alter bei der Diagnose der AVN betrug 47,4 ± 14,2 Jahre. Der mittlere Zeitraum zwischen der Diagnose des PV und dem Einsetzen der AVN lag bei 25,3 ± 18,3 Monaten. Mit Ausnahme von acht Fällen (17,8 %) setzte die AVN bei der Mehrheit der Patienten innerhalb von drei Jahren nach Diagnose des PV ein. Die mittlere kumulative Dosis von Prednisolon bei Patienten mit AVN betrug 13.115,8 ± 7041,1 mg. Zwischen der Prednisolon-Gesamtdosis und dem Zeitraum bis zum Einsetzen der AVN bestand eine starke Korrelation (p = 0,001). Bei Patienten mit Alendronateinnahme in der Vorgeschichte war dieser Zeitraum signifikant kürzer (p = 0,01). Die AVN ist eine schwere Komplikation einer Corticosteroid-Behandlung bei Patienten mit PV. Sie wird bei 2 % der Patienten beobachtet und tritt vor allem in den ersten drei Behandlungsjahren auf. Bei Patienten, die höhere Dosen von Prednisolon erhalten, setzt die AVN tendenziell früher ein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Outcome of Rehabilitation and Swallowing Therapy after Percutaneous Endoscopic Gastrostomy in Dysphagia Patients.

Science.gov (United States)

Toh Yoon, Ezekiel Wong; Hirao, Jun; Minoda, Naoko

2016-12-01

The objective of this study was to investigate the outcomes of rehabilitation (with swallowing therapy) after percutaneous endoscopic gastrostomy (PEG) in patients with neurogenic dysphagia. Forty-seven patients (29 males and 18 females) who were transferred to the rehabilitation ward of our hospital after receiving PEG tube placements during a 5-year period were enrolled in this study. Patients' demographic data, comorbidities, nutritional statuses, and laboratory biomarkers before the PEG procedure were collected. Rehabilitation (with swallowing therapy) outcomes such as changes in Functional Independence Measure (FIM) and dysphagia grade (using Fujishima's classification) were evaluated. Significant improvements in FIM scores and dysphagia grades after rehabilitation therapy were observed. Twenty-seven patients (57.4 %) were discharged with some oral intake and 10 patients (21.3%) were discharged PEG-free (defined as the PEG tube not being used or removed). Factors associated with being discharged with some oral intake were increase in FIM score (adjusted OR 1.10, 95 % CI 1.02-1.19) and higher baseline dysphagia grade (adjusted OR 1.88, 95 % CI 1.04-3.39). Factors associated with being discharged PEG-free were longer rehabilitation period (OR 1.03, 95 % CI 1.01-1.04), absence of respiratory disorders (OR 0.12, 95 % CI 0.03-0.35), and increase in FIM score (OR 1.17, 95 % CI 1.08-1.28). Changes in dysphagia grade were significantly correlated with changes in FIM score (r 2  = 0.46, p dysphagia.

Factors indicating need of rehabilitation--occupational therapy among persons with long-term and/or recurrent pain.

Science.gov (United States)

Müllersdorf, M

2000-12-01

The aim of the study was to elucidate selection criteria for need of rehabilitation/occupational therapy, and to state criteria for participation in occupational therapy, among persons with long-term and/or recurrent pain causing activity limitations or restricting participation in daily life. The study involved 914 persons aged 18-58 years who answered a postal questionnaire concerning demography, pain, occupations in daily life, work, treatments and health care staff visited. The direct method in logistic regression analysis was used to test two models: (1) need of rehabilitation/occupational therapy and (2) participation in occupational therapy. The results for the first model revealed the selection criteria (1) 'feelings of irresolution', (2) 'gnawing/searing pain' and (3) 'use of technical aids'. The odds for need of rehabilitation/occupational therapy were higher for women than for men. The criteria derived from the second model, participation in occupational therapy, were whether (1) the participants had 'used tricks and/or compensated ways to perform tasks', (2) the participants had 'pain in shoulders' and (3) 'changes had been made at work due to health conditions'.

Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

Science.gov (United States)

Martínez-Moreno, J M; Sánchez-González, P; Luna, M; Roig, T; Tormos, J M; Gómez, E J

2016-01-01

Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current

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

Science.gov (United States)

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

2014-03-01

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

Behandlung von Herzrhythmusstörungen mit Magnesium bei Patienten mit Herzinsuffizienz

Directory of Open Access Journals (Sweden)

Wink K

2002-01-01

Full Text Available Die medikamentöse Behandlung von Herzrhythmusstörungen ist unbefriedigend, da bei guter Wirksamkeit durch die Proarrhythmie eine Verbesserung der Prognose gefährdet und nicht gesichert ist. Man kann davon ausgehen, daß Magnesiumsalze keine arrhythmogene Effekte aufweisen. Bei Patienten mit einer Herzinsuffizienz besteht häufig ein Mg-Mangel, der durch gastrointestinale Störungen, neurohormonale Regulationen, aber auch durch die Therapie (Diuretika,Digitalisbedingt ist. An Patienten mit einer Herzinsuffizienz müßte sich demnach zeigen lassen, ob die Mg-Substitution einen antiarrhythmischen Effekt aufweist. In fünf placebokontrollierten Studien konnte gezeigt werden, daß sich teil weise signifikant und mit ausreichen der Aussagekraft (PowerArrhythmien bei Patienten mit Herzinsuffizienz durch orale und parenterale Gabe von Mg-Salzen reduzieren lassen. Trotz Einschränkungen wie z.B. inadäquates Design, fehlende Vermeidung von Bias, ungenügende Vergleichbarkeit der Behandlungsgruppen, inadäquate Auswertung und ungenügende Berücksichtigung der Spontanvariation läßt sich aufgrund der Ergebnisse der Studien die Hypothese aufstellen, daß Magnesiumsalze bei Patienten mit Herzinsuffizienz Herzrhythmusstörungen günstig beeinflussen können. Prospektive, randomisierte,verblindete und kontrollierte konfirmatorische Studien mit ausreichenden Fallzahlen sind jedoch notwendig, um diese Hypothese zu bestätigen.

Group therapy use and its impact on the outcomes of inpatient rehabilitation following traumatic brain injury: Data from TBI-PBE project

Science.gov (United States)

Hammond, Flora M.; Barrett, Ryan; Dijkers, Marcel P.; Zanca, Jeanne M.; Horn, Susan D.; Smout, Randall J.; Guerrier, Tami; Hauser, Elizabeth; Dunning, Megan R.

2015-01-01

Objective To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and assess the relationships of group therapy with patient, injury, and treatment factors as well as outcomes. Design Prospective observational cohort. Setting Inpatient rehabilitation. Participants 2,130 consecutive admissions for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in US and 1 Canada) from October 2008 to September 2011. Interventions n/a Main Outcome Measure(s) proportion of sessions that were group therapy (two or more patients were treated simultaneously by one or more clinicians); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay (RLOS); discharge location; FIM Cognitive and Motor scores at discharge. Results 79% of patients received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9 hours per week in group therapy. The greatest proportion of treatment time in group format was in Therapeutic Recreation (25.6%), followed by Speech Therapy (16.2%), Occupational Therapy (10.4%), Psychology (8.1%), and Physical Therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. Conclusion(s) Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained

Biogenic Emission Inventory System (BEIS)

Science.gov (United States)

Biogenic Emission Inventory System (BEIS) estimates volatile organic compound (VOC) emissions from vegetation and nitric oxide (NO) emission from soils. Recent BEIS development has been restricted to the SMOKE system

Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis.

Science.gov (United States)

Gauthier, Lynne V; Kane, Chelsea; Borstad, Alexandra; Strahl, Nancy; Uswatte, Gitendra; Taub, Edward; Morris, David; Hall, Alli; Arakelian, Melissa; Mark, Victor

2017-06-08

Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in

Die Bandscheibenprothese bei schmerzhafter Diskusdegeneration

Directory of Open Access Journals (Sweden)

Ogon M

2004-01-01

Full Text Available Bandscheibenprothesen sind indiziert bei Patienten mit einer schmerzhaften Bandscheibendegeneration, einer sogenannten DDD (degenerative disc disease, bei gut erhaltenen Facettengelenken. Kontraindikationen stellen eine Instabilität, eine Spondylarthrose, eine spinale Stenose und eine Osteoporose dar. Bei 19 Patienten mit einem Follow-up von mindestens 12 Monaten fand sich eine durchschnittliche Verbesserung des Oswestry Disability Index von präoperativ 50,8 auf 19,8. Der SF-36 Score zur Erfassung der Lebensqualität besserte sich von 31,5 auf 48,8 (Physical Component Summary Score bzw. von 37,8 auf 44,5 (Mental Component Summary Score im 1-Jahres-Follow-up. Nachhaltige Komplikationen traten nicht auf. Bandscheibenprothesen können heute bei Patienten mit therapieresistenten Kreuzschmerzen als gute Alternative zu einer Wirbelfusion angesehen werden.

Sound therapy and aural rehabilitation for tinnitus: a person centred therapy framework based on an ecological model of tinnitus.

Science.gov (United States)

Searchfield, Grant D; Linford, Tania; Durai, Mithila

2018-03-23

Tinnitus is a common oto-neurological complaint often accompanying hearing loss. In this perspective on rehabilitation we describe a framework for sound therapy and aural rehabilitation of tinnitus based on the ecological model of tinnitus. A thematic network analysis-based approach was used to relate aural rehabilitation methods to the ecological model of tinnitus and the client-oriented scale of improvement in tinnitus. Aural rehabilitation methods were mapped to concepts of: (1) Context, (2) presence of sound and (3) reaction to sound. A global theme was: adaptation to sound. The framework is the result of an iterative and cumulative research program exploring tinnitus as the outcome of the relationship between individual psychoacoustics and psychosocial factors including context of perception. The intent of this framework is to help guide audiologists managing tinnitus. The framework has been useful in our clinic as illustrated by a case study. The benefits of this approach relative to standard care needs to be independently ascertained. Implications for Rehabilitation Tinnitus is a common oto-neurological complaint that when severe can be very disabling. Tinnitus is very heterogeneous as a consequence of this no one treatment is suitable for everyone. The sound therapy and aural rehabilitation for tinnitus framework is designed to assist audiologists in clinical planning that addresses individual needs. The framework is the result of an iterative and cumulative research program exploring tinnitus as the outcome of the relationship between individual psychoacoustics and psychosocial factors including context of perception.

Clinical Guide to Music Therapy in Physical Rehabilitation Settings

Science.gov (United States)

Wong, Elizabeth

2004-01-01

Elizabeth Wong, MT-BC presents tools and information designed to arm the entry-level music therapist (or an experienced MT-BC new to rehabilitation settings) with basic knowledge and materials to develop or work in a music therapy program treating people with stroke, brain injury, and those who are ventilator dependent. Ms. Wong offers goals and…

Radioiodine therapy in veterinary medicine: treatment of hyperthyroidism in a cat; Die Radioiodtherapie in der Veterinaermedizin: Behandlung der Schilddruesenueberfunktion bei einer Katze

Energy Technology Data Exchange (ETDEWEB)

Reinartz, P.; Sabri, O.; Zimny, M.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Kinzel, S.; Kuepper, W. [Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde; Bachmann, T. [Tierarztpraxis Dr. med. vet. Thomas Bachmann, Glashhuetten (Germany)

1999-06-01

A nine-year-old cat with symptoms of a distinct hyperthyroidism was presented at the University Hospital of the RWTH Aachen. The clinical symptoms as well as the diagnostic procedures performed at the hospital confirmed the diagnosis. After five weeks of thyreostatic medication a regular metabolism of the thyroid gland was established, followed by a radioiodine therapy with 70.3 MBq 131-iodine. Subsequently, the cat was hospitalized for two days before it could be released in good condition. Six weeks after treatment the former drastically reduced weight of the cat recovered to near normal. Even though the chemical analysis detected a discrete hyperthyroidism, clinical symptoms were no longer prominent. Three months after treatment, the final examination showed a regular metabolism of the thyroid gland without a specific thyroidal medication. The presented case illustrates that radioiodine therapy is a safe and efficient treatment of thyroidal dysfunctions in veterinary medicine. (orig.) [Deutsch] Eine neun Jahre alte, europaeische Langhaarkatze wurde mit Symptomen einer ausgepraegten Schilddruesenueberfunktion im Universitaetsklinikum der RWTH Aachen vorgestellt. Sowohl die klinische Symptomatik als auch die Labordiagnostik und die apparativ erhobenen Befunde belegten das Vorliegen einer Hyperthyreose. Im Anschluss an eine fuenfwoechige thyreostatische Therapie, mit der eine euthyreote Stoffwechsellage erreicht werden konnte, wurde eine Radioiodtherapie mit 70,3 MBq 131-Iod durchgefuehrt. Nach einer nur zweitaegigen komplikationslosen Hospitalisierung konnte die Katze in gutem Allgemeinzustand entlassen werden. Sechs Wochen nach der Therapie hatte sich das zuvor deutlich reduzierte Koerpergewicht auf nahezu normgerechte Werte erhoeht; klinische Symptome der Schilddruesenueberfunktion liessen sich trotz einer laborchemisch diagnostizierten diskreten Gesamtthyroxiderhoehung nicht mehr nachweisen. Bei einer abschliessenden Kontrolle drei Monate nach Entlassung wies

Rehabilitating torture survivors

DEFF Research Database (Denmark)

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

2009-01-01

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

Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA.

Science.gov (United States)

Levine, Michael; McElroy, Karen; Stakich, Valerie; Cicco, Jodie

2013-03-01

Rehabilitation following total knee arthroplasty (TKA) is a costly, cumbersome, and often painful process. Physical therapy contributes to the successful outcome of TKA but can be expensive. Alternative methods of obtaining good functional results that help minimize costs are desirable. Neuromuscular electrical stimulation (NMES) is a potential option. Neuromuscular electrical stimulation has been shown to increase quadriceps muscle strength and activation following TKA. Functional scores also improve following TKA when NMES is added to conventional therapy protocols vs therapy alone. The authors hypothesized that rehabilitation managed by a physical therapist would not result in a functional advantage for patients undergoing TKA when compared with NMES and an unsupervised at-home range of motion exercise program and that patient satisfaction would not differ between the 2 groups. Seventy patients were randomized into a postoperative protocol of conventional physical therapy with a licensed therapist, including range of motion exercises and strengthening exercises, or into a program of NMES and range of motion exercises performed at home without therapist supervision. Noninferiority of the NMES program was obtained 6 weeks postoperatively (Knee Society pain/function scores, Western Ontario and McMaster Universities Osteoarthritis Index, flexion). Noninferiority was shown 6 months postoperatively for all parameters. The results suggest that rehabilitation managed by a physical therapist results in no functional advantage or difference in patient satisfaction when compared with NMES and an unsupervised at-home range of motion program. Neuromuscular electrical stimulation and unsupervised at-home range of motion exercises may provide an option for reducing the cost of the postoperative TKA recovery process without compromising quadriceps strength or patient satisfaction. Copyright 2013, SLACK Incorporated.

Receptor imaging of schizophrenic patients under treatment with typical and atypical neuroleptics; Nuklearmedizinische Rezeptordiagnostik bei schizophrenen Patienten unter Therapie mit typischen und atypischen Neuroleptika

Energy Technology Data Exchange (ETDEWEB)

Dresel, S.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin der Ludwig-Maximilians-Univ. Muenchen (Germany); Meisenzahl, E. [Psychiatrische Klinik der Ludwig-Maximilians-Univ. Muenchen (Germany); Scherer, J. [Bezirkskrankenhaus Haar (Germany)

2002-09-01

-motorische Nebenwirkungen hervorzurufen. Die Besetzung postsynaptischer Dopamin-D2-Rezeptoren wird als ein wesentlicher Aspekt der antipsychotischen Wirksamkeit der Neuroleptika angesehen. Diese koennen nuklearmedizinisch durch [I-123]IBZM-SPECT dargestellt werden. Fuer das typische Neuroleptikum Haloperidol wurde eine dosisabhaengige, exponentielle Besetzung der Dopamin-D2-Rezeptoren nachgewiesen. Ab einem Schwellenwert des spezifischen Bindungsindex von 0,4 (Norm: >0,95) zeigten mit einer Ausnahme alle untersuchten Patienten extrapyramidal-motorische Nebenwirkungen. Auch unter Therapie mit dem atypischen Neuroleptikum Clozapin ergab sich eine exponentielle Dosis-Wirkungsbeziehung mit jedoch einem deutlich flacheren Kurvenverlauf im Vergleich zu Haloperidol. Extrapyramidalmotorische Nebenwirkungen traten bei diesen Patienten nicht auf. Neuere, als atypisch eingestufte Neuroleptika wie Risperidon und Olanzapin zeigten ebenfalls eine exponenzielle Dosis-Wirkungsbeziehung, wobei deren Kurvenverlaeufe zwischen denen von Haloperidol und Clozapin lagen. Extrapyramidal-motorische Nebenwirkungen traten bei den letzteren Neuroleptika seltener als bei Haloperidol, bei Olanzapin nur bei einem Patienten in unserem eigenen Patientengut auf. Das pharmakologische Profil atypischer Neuroleptika zeichnet sich neben der Bindung an die postsynaptischen Dopamin-D2-Rezeptoren auch durch Bindung an Rezeptoren diverser anderer Neurotransmittersysteme, insbesondere des serotonergen Systems, aus. Somit ist wahrscheinlich, dass die niedrigere Inzidenz fuer extrapyramidal-motorische Nebenwirkungen bei atypischen Neuroleptika durch (orig.)

Therapeutische Überlegungen bei sensomotorischer diabetischer Neuropathie

Directory of Open Access Journals (Sweden)

Bührlen M

2013-01-01

Full Text Available Der Begriff der sensomotorischen diabetischen Neuropathie beschreibt einen heterogenen Beschwerdekomplex, der auf einer diabetesbedingten Schädigung des peripheren Nervensystems beruht. Bis zu 50 % der Menschen mit Diabetes mellitus leiden im Verlauf ihrer Erkrankung an Symptomen einer sensomotorischen Neuropathie. Chronische Schmerzen, Dysund Parästhesien sowie die Komplikation des diabetischen Fußsyndroms stellen für die Betroffenen gravierende Folgen dar. Die Optimierung der metabolischen Kontrolle stellt eine wichtige Basismaßnahme dar. Andere, zweifelsfrei gesicherte Möglichkeiten der Prävention oder kausalen Therapie sind nicht bekannt. Bei Auftreten einer schmerzhaften Neuropathie sollte eine gezielte analgetische Therapie möglichst früh begonnen werden. Mit den trizyklischen Antidepressiva, Duloxetin, Gabapentin und Pregabalin stehen Wirkstoffe zur Verfügung, die eine spezifische Therapie neuropathischer Schmerzen ermöglichen. Dabei ist zu beachten, dass in der Regel keine Schmerzfreiheit erreicht werden kann. Entscheidend ist das Erreichen eines für den Patienten tolerablen Schmerzniveaus unter Minimierung medikamentenassoziierter Nebenwirkungen. Das individuelle Ansprechen auf ein Medikament und die optimale Dosis können nicht vorhergesagt, sondern müssen individuell erprobt werden. Bei leichten Schmerzen können die Nicht-Opioid- Analgetika Paracetamol und Metamizol eingesetzt werden. Fehlen Therapiealternativen, dann stellen Opioide eine weitere Möglichkeit der Therapie starker Schmerzen dar. Aufgrund einer zusätzlichen Monoamin-Wiederaufnahmehemmerwirkung nehmen Tramadol und Tapentadol in dieser Gruppe eine Sonderstellung ein. In der Risiko- Nutzen-Abwägung darf das Nebenwirkungs- und Abhängigkeitspotenzial der Opioide in der Langzeittherapie nicht unterschätzt werden. Für andere medikamentöse Therapien oder alternative Therapiemethoden liegt keine ausreichende wissenschaftliche Evidenz vor. Sie können aber im

Cognitive and affective benefits of combination therapy with galantamine plus cognitive rehabilitation for Alzheimer's disease.

Science.gov (United States)

Tokuchi, Ryo; Hishikawa, Nozomi; Matsuzono, Kosuke; Takao, Yoshiki; Wakutani, Yosuke; Sato, Kota; Kono, Syoichiro; Ohta, Yasuyuki; Deguchi, Kentaro; Yamashita, Toru; Abe, Koji

2016-04-01

The aim of the present study was to compare the effects of a galantamine only therapy and a combination therapy with galantamine plus ambulatory cognitive rehabilitation for Alzheimer's disease patients. For this retrospective cohort study, we enrolled 86 patients with Alzheimer's disease, dividing them into two groups - a galantamine only group (group G, n = 45) and a combination with galantamine plus ambulatory rehabilitation group (group G + R, n = 41). The present cognitive rehabilitation included a set of physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. We compared the Mini-Mental State Examination and Frontal Assessment Battery for cognitive assessment, and Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia score for affective assessment in two groups over 6 months. The baseline Mini-Mental State Examination score was 20.2 and 18.7 in groups G and G + R, respectively. Other baseline data (Frontal Assessment Battery, Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia) were not different between the two groups. Although group G kept all the scores stable until 6 months of the treatment, the Apathy Scale score showed a significant improvement in group G + R as early as 3 months, followed by the Mini-Mental State Examination and Frontal Assessment Battery improvements at 6 months (*P = 0.04 and *P = 0.02, respectively). The Geriatric Depression Scale and Abe's Behavioral and Psychological Symptoms of Dementia did not show any changes. The combination therapy of galantamine plus ambulatory cognitive rehabilitation showed a superior benefit both on cognitive and affective functions than galantamine only therapy in Alzheimer's disease patients. © 2015 Japan Geriatrics Society.

Merging pathways: music therapy in neurosurgical rehabilitation.

Science.gov (United States)

Gilbertson, S; Ischebeck, W

2002-01-01

Relatively few departments of Music Therapy are found within neurosurgical rehabilitation clinics. In institutions where these departments exist, music therapy has become an integral part of multi-professional treatment and research activities (Gilbertson 1999). The diverse intervention strategies in Music Therapy focus upon auditory, motor, visual, cognitive and affective processing which are all involved in receptive and expressive musical behaviour and which affect related non-musical behaviour. A clear differentiation is made between primary and adjunct therapy roles. The related fields of neuromusicology, neuroanatomy, neuropsychology, music psychology and humanistic psychology are primary sources in the development of models of clinical application (Hodges 1996). Our main interests are focussed on the following issues and areas of clinical application: The initialisation of contact with patients in vegetative status Communicative interaction with patients who can not (initially) use verbal communication (aphasic disorders) Temporal motor organisation with patients with sensomotor disorders Cognitive organisation and mnemonic framework with patients with neuropsychological functional disorders (concentration, memory, perception) Treatment of spatial perception disorders (neglect) Enhancing personal and social integration following individual isolation, social withdrawal. These topics will be discussed and highlighted with clinical examples.

Rehabilitation of Aphasia: application of the Melodic-Rhythmic Therapy to the Italian Language

Directory of Open Access Journals (Sweden)

Maria Daniela eCortese

2015-09-01

Full Text Available Aphasia is a complex disorder, frequent after stroke (~38%, with a detailed pathophysiological characterization. Proper approaches are mandatory to devise an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, among these with neurobehavioral ratio, the Melodic Intonation Therapy (MIT .Van Eeckhout’s adaptation to the French language (Melodic-Rhythmic Therapy: MRT has implemented the training strategy by adding a rhythmic structure reproducing the French prosody.Purposes of this study were to adapt the MRT rehabilitation procedures to the Italian language and to verify its efficacy in a group of 6 chronic patients (5 males with severe non-fluent aphasia and without specific aphasic treatments at least from 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min. They were assessed 6 months after the end of the treatment (follow-up. The patients showed a significant improvement at the Aachener Aphasie Test in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.

Facilitation of research-based evidence within occupational therapy in stroke rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Borg, T.; Hounsgaard, Lise

2011-01-01

Purpose: This study investigated the facilitation of evidence-based practice with the use of everyday life occupations and client-centred practice within occupational therapy in three settings of stroke rehabilitation. Method: The study was based on a phenomenological hermeneutical research...

The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

Science.gov (United States)

Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon

2014-12-01

To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

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

Botulinumtoxin-A in der Behandlung neurogener Blasenfunktionsstörungen bei Kindern: Funktionelle und histomorphologische Langzeitergebnisse

Directory of Open Access Journals (Sweden)

Schulte-Baukloh H

2004-01-01

Full Text Available Die etablierte Therapie der neurogenen Detrusorhyperaktivität bei Kindern besteht in der Gabe von Anticholinergika und begleitendem intermittierendem Einmalkatheterismus. Eine hohe Nebenwirkungsrate der Anticholinergika oder eine nicht ausreichende Dämpfung der Detrusoraktivität limitiert jedoch die Anwendung und zwingt nicht selten zu einem operativen Vorgehen. Wir untersuchten deshalb die Wirksamkeit von Botulinumtoxin-A (BTX-A auf die neurogene Detrusorhyperaktivität bei Kindern mit neurogener Blasenfunktionsstörung. Hierzu wurden 24 Kinder (11 Mädchen, 13 Jungen; 2,5–20 (Ø 11,9 Jahre mit maximalem Detrusordruck 40 cm H2O trotz anticholinerger Medikation in die Studie eingeschlossen. Nach urodynamischer Evaluierung wurden gewichtsadaptiert 85–300 U BTX-A (Botox(R zystoskopisch an 30–40 Stellen in den M. detrusor injiziert. Urodynamische Kontrollen erfolgten nach 1, 3 und 6 Monaten. Urodynamisch fand sich ein erhöhtes Reflexvolumen nach 1 Monat um +84 %, nach 3 Monaten um +68 % und nach 6 Monaten um +23 %. Entsprechend verhielten sich die Maximalkapazitäten: +35 % (nach 1 Monat, +23 % (nach 3 Monaten und +36 % (nach 6 Monaten. Die Maximaldrücke veränderten sich im o.g. Zeitraum um –41 %, –22 % bzw. +4 %. Die korrespondierenden Veränderungen der Inkontinenzrate betrug –46 %, –15 % bzw. –13 %. Bei 5 Kindern konnte jedoch auch mit dieser Therapie keine zufriedenstellende Drucksituation sichergestellt werden; nach der daraufhin durchgeführten Blasenaugmentation fanden sich in den Blasenresektaten histomorphologisch typische BTX-A bedingte Veränderungen, die jedoch in ihrer Ausprägung keinen signifikanten Gradienten aufwiesen. Zusammenfassend läßt sich festhalten, daß es nach Botulinumtoxin-A-Injektion in den Detrusormuskel bei der Mehrzahl der Patienten zu einer ausgeprägten und therapeutisch relevanten Verbesserung sämtlicher urodynamischer Parameter bei sehr guter Verträglichkeit des Medikamentes kommt

Precise Point Positioning with the BeiDou Navigation Satellite System

Directory of Open Access Journals (Sweden)

Min Li

2014-01-01

Full Text Available By the end of 2012, China had launched 16 BeiDou-2 navigation satellites that include six GEOs, five IGSOs and five MEOs. This has provided initial navigation and precise pointing services ability in the Asia-Pacific regions. In order to assess the navigation and positioning performance of the BeiDou-2 system, Wuhan University has built up a network of BeiDou Experimental Tracking Stations (BETS around the World. The Position and Navigation Data Analyst (PANDA software was modified to determine the orbits of BeiDou satellites and provide precise orbit and satellite clock bias products from the BeiDou satellite system for user applications. This article uses the BeiDou/GPS observations of the BeiDou Experimental Tracking Stations to realize the BeiDou and BeiDou/GPS static and kinematic precise point positioning (PPP. The result indicates that the precision of BeiDou static and kinematic PPP reaches centimeter level. The precision of BeiDou/GPS kinematic PPP solutions is improved significantly compared to that of BeiDou-only or GPS-only kinematic PPP solutions. The PPP convergence time also decreases with the use of combined BeiDou/GPS systems.

Precise point positioning with the BeiDou navigation satellite system.

Science.gov (United States)

Li, Min; Qu, Lizhong; Zhao, Qile; Guo, Jing; Su, Xing; Li, Xiaotao

2014-01-08

By the end of 2012, China had launched 16 BeiDou-2 navigation satellites that include six GEOs, five IGSOs and five MEOs. This has provided initial navigation and precise pointing services ability in the Asia-Pacific regions. In order to assess the navigation and positioning performance of the BeiDou-2 system, Wuhan University has built up a network of BeiDou Experimental Tracking Stations (BETS) around the World. The Position and Navigation Data Analyst (PANDA) software was modified to determine the orbits of BeiDou satellites and provide precise orbit and satellite clock bias products from the BeiDou satellite system for user applications. This article uses the BeiDou/GPS observations of the BeiDou Experimental Tracking Stations to realize the BeiDou and BeiDou/GPS static and kinematic precise point positioning (PPP). The result indicates that the precision of BeiDou static and kinematic PPP reaches centimeter level. The precision of BeiDou/GPS kinematic PPP solutions is improved significantly compared to that of BeiDou-only or GPS-only kinematic PPP solutions. The PPP convergence time also decreases with the use of combined BeiDou/GPS systems.

Adherence of physical therapy with clinical practice guidelines for the rehabilitation of stroke in an active inpatient setting.

Science.gov (United States)

M S, Ajimsha; Kooven, Smithesh; Al-Mudahka, Noora

2018-03-09

Clinical guidelines are systematically developed statements designed to help practitioners and patients to make decisions about appropriate health care. Clinical practice guideline adherence analysis is the best way to fine tune the best practices in a health care industry with international benchmarks. To assess the physical therapist's adherence to structured stroke clinical practice guidelines in an active inpatient rehabilitation center in Qatar. Department of Physical therapy in the stroke rehabilitation tertiary referral hospital in Qatar. A retrospective chart audit was performed on the clinical records of 216 stroke patients discharged from the active inpatient stroke rehabilitation unit with a diagnosis of stroke in 2016. The audit check list was structured to record the adherence of the assessment, goal settings and the management domains as per the "Physical Therapy After Acute Stroke" (PAAS) guideline. Of the 216 case files identified during the initial search, 127 files were ultimately included in the audit. Overall adherence to the clinical practice guideline was 71%, a comparable rate with the studies analyzing the same in various international health care facilities. Domains which were shared by interdisciplinary teams than managed by physical therapy alone and treatments utilizing sophisticated technology had lower adherence with the guideline. A detailed strength and weakness breakdown were then conducted. This audit provides an initial picture of the current adherence of physical therapy assessment and management with the stroke physical therapy guideline at a tertiary rehabilitation hospital in the state of Qatar. An evaluation of the guideline adherence and practice variations helps to fine tune the physical therapy care to a highest possible standard of practice. Implications for Rehabilitation  • An evaluation of the guideline adherence and practice variations helps to fine tune the rehabilitation care to the highest possible standard

Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym.

Science.gov (United States)

Bustamante Valles, Karla; Montes, Sandra; Madrigal, Maria de Jesus; Burciaga, Adan; Martínez, María Elena; Johnson, Michelle J

2016-09-15

Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the

Group Reality Therapy in Addicts Rehabilitation Process to Reduce Depression, Anxiety and Stress

Directory of Open Access Journals (Sweden)

Omid Massah

2015-03-01

Full Text Available Objectives: Substance abuse is one of the most outstanding socio-psychological hazards that can easily wreck one’s personal, family and social life. Reality Therapy is a type of Cognitive rehabilitation (known as psychosocial rehabilitation, and the application of this method in the treatment of different disorders has recently been the topic of research. The objective of this study was to examine the effectiveness of group reality therapy on the reduction of stress, anxiety and depression in addicts. Methods: A quasi-experimental study of pretest-posttest design, with a control group was conducted. The study population consisted of all addicts attending Tehran’s ‘Neda’ Rehab Clinic. First, the DASS-21 questionnaire was administered and then 40 people were selected from those who had scored average and higher. They were then randomly assigned to two test and control groups of 20 each. Analysis of co-variance was used to analyze the data, with which pretest scores were controlled, and the effect of the independent variable on posttest scores was evaluated. Results: Following the intervention, there were significant decreases in the mean scores of all three variables, i.e. stress, anxiety and depression in the test group (P<0.05. Discussion: Psychosocial rehabilitation based on reality therapy can be considered as an effective method for reducing stress, anxiety and depression in addicts and also as an adjunctive therapy in treating other ailments.

Mehrfacheffekt-Feuchtluftdestillation bei Umgebungsdruck

OpenAIRE

Müller-Holst, Hendrik

2007-01-01

Ein neuartiges Verfahren zur Feuchtluftdestillation mittels Verdunstung und Kondensation in einer einzigen Kammer wurde im Rahmen der Arbeit umfassend analysiert. Das Verfahren arbeitet bei Umgebungsdruck; der dadurch bei Temperaturen unter dem Siedepunkt verringerte Stoffübergang wird durch große Austauschflächen mit hoher Packungsdichte kompensiert. Der Transport der im Verdunster beladenen Feuchtluft zum Kondensator erfolgt innerhalb einer optimierten geometrischen Anordnung der Baueinheit...

Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions.

Science.gov (United States)

Silver, Julie K; Gilchrist, Laura S

2011-05-01

Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in physical and occupational therapy. Patients may need physical and occupational therapy services for a variety of cancer-related or cancer-treatment-related problems, including pain, fatigue, deconditioning, and difficulty with gait. They may also have problems resuming their previous level of function, which can impact on activities of daily living, instrumental activities of daily living, return to previous home and community activity levels, and return to work. This review discusses the role of physical and occupational therapy in helping cancer patients improve pain and musculoskeletal issues, deconditioning and endurance effects, fatigue, balance and falls, and lymphedema and psychosocial problems.

Effectiveness of music therapy in state-trait anxiety rate of addicts in drug-free rehabilitation stage

Directory of Open Access Journals (Sweden)

E Soleimani

2016-02-01

Full Text Available Objective: This study was an attempt to investigate the effect of music therapy on addicts’ state-trait anxiety rate in the stage of drug-free rehabilitation. Method: A quasi-experimental research design, along with pretest-posttest and control group was employed for the conduct of this study. The statistical population of the study included the addicts in the rehabilitation stage who had referred to the clean collaborators rehabilitation camp in Ardebil province in November 2014. From this population, the number of 32 addicts in 16-50-year-old age range was selected as the participants of the study by convenience sampling method. State-Trait Anxiety Inventory was used for data collection. Results: The results of multivariate covariant analysis showed that there is a significant difference between control and experimental groups in state and trait anxiety. In other words, the state and trait anxiety of addicts in the experimental group had been reduced after music therapy. Conclusion: Considering the obtained results, it can be concluded that music therapy alone or along other psychological interventions can be an effective method for reducing addicts’ anxiety in drug-free rehabilitation stage.

Group Therapy Use and Its Impact on the Outcomes of Inpatient Rehabilitation After Traumatic Brain Injury: Data From Traumatic Brain Injury-Practice Based Evidence Project.

Science.gov (United States)

Hammond, Flora M; Barrett, Ryan; Dijkers, Marcel P; Zanca, Jeanne M; Horn, Susan D; Smout, Randall J; Guerrier, Tami; Hauser, Elizabeth; Dunning, Megan R

2015-08-01

To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes. Prospective observational cohort. Inpatient rehabilitation. Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011. Not applicable. Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge. Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups. Copyright © 2015 American Congress

Systemic cancer multistep therapy; Systemische Krebs-Mehrschritt-Therapie

Energy Technology Data Exchange (ETDEWEB)

Weigang-Koehler, K. [Medizinische Klinik 5, Arbeitsgruppe Biologische Krebstherapie, Staedtisches Klinikum Nuernberg (Germany); Kaiser, G. [Medizinische Klinik 5, Arbeitsgruppe Biologische Krebstherapie, Staedtisches Klinikum Nuernberg (Germany); Gallmeier, W.M. [Medizinische Klinik 5, Arbeitsgruppe Biologische Krebstherapie, Staedtisches Klinikum Nuernberg (Germany)

1997-04-11

To get an insight into the claimed efficacy of `systemic cancer multistep therapy` (sKMT) with hyperglycemia, whole-body hyperthermia and hyperoxemia, we conducted a best case analysis with 20 patients who had received sKMT alone (9 patients) or in combination with chemo- or radiotherapy (11 patients). There was no complete remission or an unquestionable partial remission when sKMT was used alone. When sKMT was combined with classical effective therapies like chemo- and radiotherapy, 1 patient had questionable complete remission and 3 patients had partial remission. In these three patients sKMT had been combined with a newly applied chemotherapy: Therefore, it remains unclear which method was effective in causing the remission. (orig.) [Deutsch] Um eine Ueberblick ueber die behauptete Wirksamkeit der systemischen Krebs-Mehrschritt-Therapie (sKMT) nach von Ardenne zu erlangen, fuehrten wir eine Best-case-Analyse bei 20 Patienten durch, die die sKMT ohne Chemotherapie (9 Patienten) und in Kombination mit Chemo- bzw. Strahlentherapie (11 Patienten) erhalten hatten. sKMT allein hatte zu keiner kompletten Remission oder sicheren partiellen Remission gefuehrt. Bei der Kombination von sKMT mit klassischen Therapieverfahren wie Chemotherapie und Bestrahlung trat bei einem Patienten eine fragliche komplette Remission ein sowie bei 3 Patienten eine partielle Remission. Im letzteren Fall war jeweils eine fuer den Patienten neue Chemotherapie mit der sKMT kombiniert worden, so dass unklar bleibt, was die Verbesserung herbeifuehrte. (orig.)

A Comparison of Aphasia Therapy Outcomes before and after a Very Early Rehabilitation Programme Following Stroke

Science.gov (United States)

Godecke, Erin; Ciccone, Natalie A.; Granger, Andrew S.; Rai, Tapan; West, Deborah; Cream, Angela; Cartwright, Jade; Hankey, Graeme J.

2014-01-01

Background: Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims: To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4-5 weeks post-stroke)…

Progress of BeiDou time transfer at NTSC

Science.gov (United States)

Guang, Wei; Dong, Shaowu; Wu, Wenjun; Zhang, Jihai; Yuan, Haibo; Zhang, Shougang

2018-04-01

Time transfer using global navigation satellite system (GNSS) is a primary method of remote atomic clock comparisons. As of today, there are four operational GNSS systems, namely GPS, GLONASS, Galileo and BeiDou Navigation Satellite System (BDS or BeiDou). All of them can continuously provide position, navigation and time services. This paper mainly focuses on the progress of BeiDou time transfer at the National Time Service Center, Chinese Academy of Sciences (NTSC). In order to realize the BeiDou common view (CV) time comparison, we developed the Rinex2CGGTTS software according to the guidelines of the Common GNSS Generic Time Transfer Standard, Version 2E (CGGTTS V2E). By comparing the solutions of the Rinex2CGGTTS software to the solutions of the sbf2cggtts software provided by the manufacturer of our multi-GNSS receiver, we found the sbf2cggtts (version 1.0.5) solutions contained biases in measurements to different BeiDou satellites. The biases are most likely caused by sbf2cggtts’ timing group delay corrections in data processing. The noise of the observation data is analyzed by code multipath and common clock difference. Finally, the BeiDou CV results are compared to the GPS/GLONASS/Galileo CV results between NTSC and three European UTC(k) laboratories, including Royal Observatory of Belgium (ORB), Real Institute y Observatory de la Armada (ROA), Research Institutes of Sweden (RISE or SP). For the comparisons of each baseline, we aligned the BeiDou/Galileo/GLONASS links to the calibrated GPS link with the double-difference method. The results show that the performance of BeiDou CV is correlated to the number of BeiDou satellites available in common view. With the current BeiDou constellation, the standard deviation of the differences between all BeiDou CV satellites averaging result and the GPS PPP result is 2.03 ns, 2.90 ns and 4.06 ns for ORB-NTSC, SP-NTSC and ROA-NTSC links respectively.

HRCT of the lung in collagen vascular diseases; HRCT der Lunge bei Kollagenosen

Energy Technology Data Exchange (ETDEWEB)

Diederich, S. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany); Roos, N. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany); Schmitz-Linneweber, B. [Medizinische Klinik B, Westfaelische Wilhelms-Univ., Muenster (Germany); Gaubitz, M. [Medizinische Klinik B, Westfaelische Wilhelms-Univ., Muenster (Germany); Peters, P.E. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany)

1996-07-01

Collagen vascular diseases, representing systemic soft tissue disorders, may cause a broad spectrum of pathologic changes of the respiratory tract. The type and extent of manifestations can vary considerably among individuals and entities. This survey describes the chest radiographic and, in particular, high-resolution computed tomographic and, in particular, high-resolution computed tomographic (HRCT) findings of individual lesions of the respiratory tract. It includes fibrosing alveolitis (alveolitis, interstitial pneumonia, pulmonary fibrosis) and bronchial (bronchitis/bronchiolitis, bronchiectasis), pleural and vascular manifestations, as well as lymphadenopathy and abnormalities related to therapy. We present typical patterns of changes in progressive systemic sclerosis (PSS, scleroderma), systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD, Sharp syndrome), Sjoegren syndrome, overlap syndrome and rheumatoid arthritis (RA). Furthermore, we describe findings which are specific for individual entities such as esophageal involvement in PSS, acute pneumonitis and pulmonary hemorrhage in SLE, lymphoproliferative disease in Sjoegren syndrome and necrobiotic nodules in RA. (orig.) [Deutsch] Die Kollagenosen koennen als systemische Bindegewebserkrankungen auch zu einem breiten Spektrum pathologischer Veraenderungen am Respirationstrakt fuehren, wobei sich Art und Ausmass der Manifestationen innerhalb einzelner Entitaeten und zwischen verschiedenen Krankheitsbildern erheblich unterscheiden koennen. In der vorliegenden Uebersicht werden die entsprechenden Befunde von Thoraxuebersichtsaufnahme und insbesondere hochaufloesender Computertomographie (HRCT) beschrieben. Beruecksichtigt werden dabei die fibrosierende Alveolitis (Alveolitis, interstitielle Pneumonie, Lungenfibrose), bronchiale (Bronchitis/Bronchiolitis, Bronchiektasen), pleurale und vaskulaere Manifestationen sowie Lymphadenopathie und therapie-induzierte Befunde. Typische Befundmuster

The effect of vitamin D auxiliary rehabilitation therapy in children with cerebral palsy and language dysfunction.

Science.gov (United States)

Zhu, X; Jiao, R; Tu, M; Wang, W; Wen, X; Song, B

2015-09-11

To observe the clinical efficacy of vitamin D auxiliary rehabilitation therapy in children with cerebral palsy and language dysfunction. Eighty-two cases of children with cerebral palsy and language dysfunction in our hospital from March 2011 to June 2014 were selected for this study. They were divided into two groups: the rehabilitation treatment group (simple group, 39 cases) and the vitamin D auxiliary rehabilitation therapy group (combination group, 43 cases). After three months of treatment, language development, Gesell Child Development Scale, Bayley Infant Development Scale score and vitamin D and calcium levels were compared. The language development, Gesell Child Development Scale, Bayley Infant Development Scale score and vitamin D and calcium levels for two of the groups, after treatment, are improved compared to before treatment. The difference was statistically significant (P language development in the combination group was obviously higher than the simple group. The difference was significant (95.3% vs. 74.4%, X2 = 2.486, P = 0.032). The Gesell Child Development Scale improved in the combination group compared to the simple group. The difference was statistically significant [(70.4 ± 11.3) vs (53.3 ±10.5), t = 3.127, P = 0.026]. The proportion of normal children was significantly higher than the rehabilitation treatment group, and the difference was statistically significant (30.2% vs. 20.5%, X2 = 3.016, P = 0.029). In the combination group, the vitamin D and calcium levels were statistically increased compared to the rehabilitation treatment group. It had statistical differences between the two groups (Pauxiliary rehabilitation therapy could improve the language function and the language development status in children with cerebral palsy and language dysfunction.

Penile angiography and superselective embolization therapy in arterial priapism; Penisangiographie und superselektive Embolisationstherapie bei high-flow Priapismus

Energy Technology Data Exchange (ETDEWEB)

Dinkel, H.P.; Triller, J. [Inst. fuer Diagnostische Radiologie, Inselspital, Univ. Bern (Switzerland); Hochreiter, W. [Urologische Klinik, Inselspital, Univ. Bern (Switzerland)

2003-08-01

Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.) [German] Ziel: Untersuchung der Interventionsmoeglichkeiten bei arteriellem (high-flow) Priapismus durch endovaskulaere superselektive Embolisation der Penisarterien. Methode: Alle innerhalb eines Vierjahreszeitraums (1/99-5/2002) wegen Priapismus zur Angiographie

Treatment of malignant biliary obstructions via the percutaneous approach; Interventionen bei malignen Gallenwegstenosen

Energy Technology Data Exchange (ETDEWEB)

Radeleff, B.A.; Lopez-Benitez, R.; Hallscheidt, P.; Grenacher, L.; Libicher, M.; Richter, G.M.; Kauffmann, G.W. [Radiologische Klinik der Ruprecht-Karls-Universitaet Heidelberg (Germany). Abteilung fuer Radiodiagnostik

2005-11-01

This paper gives an overview of experience and success of percutaneous transhepatic interventions in malignant biliary obstruction. Even after exhaustion of surgical and endoscopic therapy options, the percutaneously inserted stents provide effective palliation. The palliative treatment of malignant jaundice using a stent is an established procedure in clinical practice, particularly whenever the endoscopic, transpapillary approach is not possible due to high obstructions or previous surgery. The technical success rate is very high (about 95-100%), and the complication rate is about 10-30%. Since the patency rate of stents is higher than that of plastic endoprostheses, their primary use is justified despite higher costs, provided the patients are adequately selected. (orig.) [German] Vorgelegt wird eine Uebersicht ueber den gegenwaertigen Stellenwert radiologischer Interventionen bei malignen Gallenwegstenosen, die nur bei 10-20% der Patienten heilbar sind. Wenn ein endoskopisch transpapillaerer Zugang nicht moeglich ist, z. B. bei hohen Obstruktionen oder nach frueheren Eingriffen, ermoeglichen die perkutane transhepatische Punktion und Implantation von Metallendoprothesen eine gute Palliation. Die perkutane Gallengangdrainage und Stentplatzierung sind fuer den erfahrenen, interventionell taetigen Radiologen wenig kompliziert und mit einer Erfolgsrate von 95-100% dem endoskopischen Vorgehen deutlich ueberlegen. Morbiditaet und Mortalitaet der endoskopischen Verfahren waren in aelteren Arbeiten noch geringer als die der perkutanen Methoden. Aktuellen Studien zufolge sind beide Verfahren gleichwertig, wahrscheinlich aufgrund technischer Verbesserungen der perkutanen Interventionen. Die technische Erfolgsrate bei der Stentapplikation liegt ueber 95%. Mittels perkutaner transhepatischer biliaerer Drainageneinlage (PTCD) eingelegte Metallstents bleiben haeufiger und laenger offen als Plastikstents. Bei entsprechender Lebenserwartung des Patienten ist ihr Einsatz daher

Gesture Therapy: A Vision-Based System for Arm Rehabilitation after Stroke

Science.gov (United States)

Sucar, L. Enrique; Azcárate, Gildardo; Leder, Ron S.; Reinkensmeyer, David; Hernández, Jorge; Sanchez, Israel; Saucedo, Pedro

Each year millions of people in the world survive a stroke, in the U.S. alone the figure is over 600,000 people per year. Movement impairments after stroke are typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. However, due to economic pressures, stroke patients are receiving less therapy and going home sooner, so the potential benefit of the therapy is not completely realized. Thus, it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. Current solutions are too expensive, as they require a robotic system for rehabilitation. We have developed a low-cost, computer vision system that allows individuals with stroke to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a web based virtual environment for facilitating repetitive movement training, with state-of-the art computer vision algorithms that track the hand of a patient and obtain its 3-D coordinates, using two inexpensive cameras and a conventional personal computer. An initial prototype of the system has been evaluated in a pilot clinical study with promising results.

A randomized prospective study of rehabilitation therapy in the treatment of radiation-induced dysphagia and trismus

Energy Technology Data Exchange (ETDEWEB)

Tang, Y.; Shen, Q.; Lu, K.; Peng, Y. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Neurology; Wang, Y. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Internal Medicine; Wang, Y. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Neurosurgery

2011-01-15

Purpose: To evaluate the therapeutic effect of rehabilitation therapy on radiation-induced dysphagia and trismus in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Patients and Methods: 43 NPC patients after radiotherapy were included. Patients were randomly assigned to either the rehabilitation group or a control group. Both groups were subjected to routine treatment, while the rehabilitation group also received rehabilitation therapy for 3 months. The severity of dysphagia was assessed using the water swallow test, while trismus was evaluated with the LENT/SOMA score and the interincisor distance (IID). The water swallow test, the LENT/SOMA score, as well as IID for both groups before and after treatment were analyzed and compared. Results: After treatment, the rehabilitation group displayed a significant improvement in swallowing function, while the control group did not. The efficacy rate (percentage of patients with excellent or effective results) of rehabilitation group was higher than that of control group (77% vs. 43%), and the difference was statistically significant ({chi}{sup 2} = 5.32, p = 0.02). IID pretreatment and posttreatment did not show much difference in the rehabilitation group, while in the control group IID significantly decreased posttreatment (1.1 {+-} 0.36 cm vs.1.8 {+-} 0.56 cm, p = 0.001). Although the mean IID in patients of both groups decreased after the 3 month follow-up, the decrease in the rehabilitation group was less than that of the control group (0.19 {+-} 0.5 cm vs. 0.69 {+-} 0.56 cm, p = 0.004). The efficacy rate of trismus in the rehabilitation group was significantly higher than that of the control group (64% vs. 28%, {chi}{sup 2} = 5.31, p = 0.02). Conclusions: Rehabilitation training can improve swallow function and slow down the progress of trismus in NPC patients following radiotherapy. (orig.)

A randomized prospective study of rehabilitation therapy in the treatment of radiation-induced dysphagia and trismus

International Nuclear Information System (INIS)

Tang, Y.; Shen, Q.; Lu, K.; Peng, Y.; Wang, Y.; Wang, Y.

2011-01-01

Purpose: To evaluate the therapeutic effect of rehabilitation therapy on radiation-induced dysphagia and trismus in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Patients and Methods: 43 NPC patients after radiotherapy were included. Patients were randomly assigned to either the rehabilitation group or a control group. Both groups were subjected to routine treatment, while the rehabilitation group also received rehabilitation therapy for 3 months. The severity of dysphagia was assessed using the water swallow test, while trismus was evaluated with the LENT/SOMA score and the interincisor distance (IID). The water swallow test, the LENT/SOMA score, as well as IID for both groups before and after treatment were analyzed and compared. Results: After treatment, the rehabilitation group displayed a significant improvement in swallowing function, while the control group did not. The efficacy rate (percentage of patients with excellent or effective results) of rehabilitation group was higher than that of control group (77% vs. 43%), and the difference was statistically significant (χ 2 = 5.32, p = 0.02). IID pretreatment and posttreatment did not show much difference in the rehabilitation group, while in the control group IID significantly decreased posttreatment (1.1 ± 0.36 cm vs.1.8 ± 0.56 cm, p = 0.001). Although the mean IID in patients of both groups decreased after the 3 month follow-up, the decrease in the rehabilitation group was less than that of the control group (0.19 ± 0.5 cm vs. 0.69 ± 0.56 cm, p = 0.004). The efficacy rate of trismus in the rehabilitation group was significantly higher than that of the control group (64% vs. 28%, χ 2 = 5.31, p = 0.02). Conclusions: Rehabilitation training can improve swallow function and slow down the progress of trismus in NPC patients following radiotherapy. (orig.)

EXERCISE THERAPY ON UNSTABLE SUPPORT AND HYDROKINETIC THERAPY IN THE REHABILITATION OF PATIENTS WITH BACK PAIN

Directory of Open Access Journals (Sweden)

E. V. Filatova

2017-01-01

Full Text Available Purpose. A comparative analysis of the efficiency of different procedures of exercise therapy is carried out: hydrokinesitherapy and therapeutic gymnastics with the use of exercise on an unstable support (stabiloplatform depending on the sex of patients.Materials and methods. Under our observation there were 72 patients undergoing rehabilitation on the basis of SBOH CC No. 201 DHM Zelenograd, an equal number of women and men and 36 people with back pain of vertebrogenic genesis. All patients repeatedly received standard medical therapy, physiotherapy (magnetotherapy, laser therapy and a massage therapist. At the end of the physiotherapy treatment was assigned a set of physical therapy: group 1 included men and women, 36 — classes on stabiloplatform, a course of 10 treatments; Group 2 consisted of men and women, 36 — hydrokinesitherapy in the pool, a course of 10 treatments. The effectiveness of therapy was assessed: on a scale (VAS, mm, Schober’s test, test Tomiura test Ott summary index of health status (Oswestry questionnaire.Results. The intensity of the pain syndrome according to the VAS score in the compared groups before the rehabilitation did not differ (on average 5.8 in men and 6.15 in women, after the completion of the course of treatment it statistically significantly decreased in both groups. Significantly, the best indicators were determined in the group of men when practicing on the stable platform (1.4 vs. 3.8 in women, and in women with physical therapy in the pool (1.6 vs. 2.9 in men. Effectiveness of changes in the test values of the mobility assessment of different parts of the spine, depending on the method of rehabilitation performed: men were more efficiently restored on the stabiloblatform, women in the pool classes. The indicators of the Tomayer test (inclination forward significantly changed in both groups: in men on the stabiloplatform from 28.3 ± 0.05 to 13.8 ± 0.1 (p <0.05; for those engaged in the basin from

Effects of iodine and thyroid hormones in inducing and treating Hashimoto's thyroiditis; Effekte von Iodid und Schilddruesenhormonen bei der Induktion und Therapie einer Thyreoiditis Hashimoto

Energy Technology Data Exchange (ETDEWEB)

Rink, T.; Schroth, H.J.; Holle, L.H.; Garth, H. [Stadtkrankenhaus Hanau (Germany). Abt. fuer Nuklearmedizin

1999-07-01

. der Verlauf der Thyreoglobulin- (Tg-) und Peroxidase-(TPO)-Antikoerper bei bestehender Thyreoiditis Hashimoto unter verschiedenen Therapieformen. Methode: Eine Gruppe von 375 Personen mit weitgehend unauffaelliger Schilddruese erhielt taeglich 200 {mu}g Iod, woechentlich einmalig 1,53 mg Iod oder keine Medikation. In einem zweiten Kollektiv von 377 Patienten mit Thyreoiditis Hashimoto erfolgte eine nichtsuppressive Hormonmedikation, eine suppressive Hormonmedikation, die kombinierte Gabe einer nichtsuppressiven Hormondosis mit Iod (50-150 {mu}g/d), eine reine Iodmedikation mit taeglich 200 {mu}g bzw. keine Therapie. Die mittlere Beobachtungszeit dieser beiden Gruppen lag bei 860 bzw. 848 Tagen. Ergebnisse: Im ersten Kollektiv zeigte sich weder unter Medikation mit taeglich 200 {mu}g Iod noch bei den unbehandelten Patienten ein klarer Anstieg der Antikoerpertiter. Unter Prophylaxe mit woechentlich 1,53 mg Iod fand sich hingegen eine signifikante Erhoehung sowohl der Tg- als auch der TPO-AK-Spiegel, und die Inzidenz einer Thyreoiditis Hashimoto war vierfach hoeher als in den beiden anderen Untergruppen. Die Patienten des zweiten Kollektivs zeigten einen signifikanten Abfall der Tg-AK unter taeglicher Medikation mit bis zu 200 {mu}g Iod, waehrend der Rueckgang der TPO-AK vom TSH-Titer abhing und in der supprimierten Gruppe am ausgepraegtesten war (p<0,0001). Schlussfolgerung: Zur Verringerung der Inzidenz einer Autoimmunthyreopathie ist bei disponierten Patienten eine taeglich zugefuehrte Iodprophylaxe ggf. guenstiger als hochdosierte woechentliche Applikationen. Diese Medikation in Kombination mit einer Hormontherapie kann selbst bei einer bestehenden Thyreoiditis Hashimoto sowohl die Tg- als auch die TPO-AK signifikant senken. (orig.)

Working memory in volunteers and schizophrenics using BOLD fMRI; Das Arbeitsgedaechtnis bei Gesunden und bei Schizophrenen: Untersuchungen mit BOLD-fMRT

Energy Technology Data Exchange (ETDEWEB)

Giesel, F.L. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (Germany); Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Hohmann, N. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (Germany); Psychiatrische Universitaetsklinik Heidelberg, Sektion Gerontopsychiatrie (Germany); Seidl, U.; Kress, K.R.; Schoenknecht, P.; Schroeder, J. [Psychiatrische Universitaetsklinik Heidelberg, Sektion Gerontopsychiatrie (Germany); Kauczor, H.-U.; Essig, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (Germany)

2005-02-01

Functional magnetic resonance imaging uses the blood oxygen level-dependent effect (BOLD MRI) for noninvasive display of cerebral correlatives of cognitive function. The importance for the understanding of physiological and pathological processes is demonstrated by investigations of working memory in schizophrenics and healthy controls. Working memory is involved in processing rather than storage of information and therefore is linked to complex processes such as learning and problem solving. In schizophrenic psychosis, these functions are clearly restricted. Training effects in the working memory task follow an inverse U-shape function, suggesting that cerebral activation reaches a peak before economics of the brain find a more efficient method and activation decreases. (orig.) [German] Die funktionelle Magnetresonanztomographie (fMRT) nutzt den ''blood oxygen level dependent effect'' (BOLD-Effekt) zur nichtinvasiven Darstellung zerebraler Korrelate kognitiver Funktionen. Die Bedeutung dieses Verfahrens fuer das Verstaendnis physiologischer und pathologischer Prozesse wird anhand von Untersuchungen zum Arbeitsgedaechtnis bei Schizophrenen und gesunden Kontrollpersonen verdeutlicht. Das Arbeitsgedaechtnis dient weniger der Speicherung, sondern vielmehr der Verarbeitung von Informationen und ist deshalb in komplexe Prozesse wie Lernen und Problemloesen eingebunden. Im Rahmen schizophrener Psychosen kommt es zu einer deutlichen Einschraenkung dieser Funktionen. Erwartungsgemaess zeigen sich unter Durchfuehrung eines Arbeitsgedaechtnisparadigmas Unterschiede in der zerebralen Aktivitaet, die jedoch bei den Erkrankten unter Therapie prinzipiell reversibel sind. Von Interesse sind auch Trainingseffekte bei Gesunden, wobei eine verminderte Aktivierung nach Training auf eine ''Oekonomisierung'' schliessen laesst. (orig.)

Phase II Pragmatic Randomized Controlled Trial of Patient-Led Therapies (Mirror Therapy and Lower-Limb Exercises) During Inpatient Stroke Rehabilitation.

Science.gov (United States)

Tyson, Sarah; Wilkinson, Jack; Thomas, Nessa; Selles, Ruud; McCabe, Candy; Tyrrell, Pippa; Vail, Andy

2015-10-01

Patient-led therapy has the potential to increase the amount of therapy patients undertake during stroke rehabilitation and to enhance recovery. Our objective was to assess the feasibility and acceptability of 2 patient-led therapies during the acute stages of stroke care: mirror therapy for the upper limb and lower-limb exercises for the lower limb. This was a blind assessed, multicenter, pragmatic randomized controlled trial of patient-led upper-limb mirror therapy and patient-led lower leg exercises. Stroke survivors with upper and lower limb limitations, undergoing inpatient rehabilitation and able to consent were recruited at least 1 week poststroke. Both interventions proved feasible, with >90% retention. No serious adverse events were reported. Both groups did less therapy than recommended; typically 5 to 15 minutes for 7 days or less. Participants receiving mirror therapy (n = 63) tended to do less practice than those doing lower-limb exercises (n = 31). Those with neglect did 69% less mirror therapy than those without (P = .02), which was not observed in the exercise group. Observed between-group differences were modest but neglect, upper-limb strength, and dexterity showed some improvement in the mirror therapy group. No changes were seen in the lower-limb group. Both patient-led mirror therapy and lower-limb exercises during inpatient stroke care are safe, feasible, and acceptable and warrant further investigation. Practice for 5 to 15 minutes for 7 days is a realistic prescription unless strategies to enhance adherence are included. © The Author(s) 2015.

Verlauf der zellulären Immunantwort bei Lebendnierenempfängern - Messung von IFN-γ und IL-17 im Elispot-Assay

OpenAIRE

Grehn, Conrad

2015-01-01

Die Nierentransplantation ermöglicht Patienten die Wiederherstellung der Nierenfunktion. Aufgrund der begrenzten Verfügbarkeit an Organen nimmt dabei die Zahl der Transplantationen von einem lebenden Spender stetig zu. Zudem ermöglichen die präzisen und genauen Vorbereitungen und Abläufe bei Lebendnierenspenden eine bessere 5-Jahres-Überlebensrate als bei Kadaverspenden. Die genetische Verschiedenheit zwischen Spender und Empfänger bedingt jedoch eine lebenslange immunsuppressive Therapie, um...

Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture.

Science.gov (United States)

Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D

2010-07-01

To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

Update on rehabilitation in multiple sclerosis.

Science.gov (United States)

Donzé, Cécile

2015-04-01

Given that mobility impairment is a hallmark of multiple sclerosis, people with this disease are likely to benefit from rehabilitation therapy throughout the course of their illness. The review provides an update on rehabilitation focused on balance and walking impairment. Classical rehabilitation focusing on muscle rehabilitation, neurotherapeutic facilitation is effective and recommended. Other techniques did not prove their superiority: transcutaneal neurostimulation, repetitive magnetic stimulation, electromagnetic therapy, whole body vibration and robot-assisted gait rehabilitation and need more studies to conclude. Cooling therapy, hydrotherapy, orthoses and textured insoles could represent a complementary service to other techniques in specific conditions. Multidisciplinary rehabilitation program provides positive effects and high satisfaction for patients with multiple sclerosis but needs more evaluation. New technologies using serious game and telerehabilitation seem to be an interesting technique to promote physical activity, self-management and quality of life. Rehabilitation like other therapy needs regular clinical evaluation to adapt the program and propose appropriate techniques. Moreover, the objective of rehabilitation needs to be decided with the patient with realistic expectation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

PET activation in basal ganglia disorders: Parkinson`s disease and dystonia; PET-Aktivierungsstudien bei Basalganglienerkrankungen: Morbus Parkinson und Dystonien

Energy Technology Data Exchange (ETDEWEB)

Ceballos-Baumann, A.O. [Neurologische Klinik, Technische Univ. Muenchen (Germany); Boecker, H. [Neurologische Klinik, Technische Univ. Muenchen (Germany); Conrad, B. [Neurologische Klinik, Technische Univ. Muenchen (Germany)

1997-03-01

This article reviews PET activation studies with performance of different motor paradigms (joy-stick movements, imagination of movement, writing) in patients with movement disorders. The focus will be on Parkinson`s disease (PD) and dystonia. PET findings will be related to clinical and electrophysiological observations. PET activation studies before and after therapeutic interventions such as pallidotomy in Parkinson`s disease and botulinum toxin in writer`s cramp are described. The contribution of PET activation studies to the understanding of the pathophysiology of dystonia and PD is discussed. (orig.) [Deutsch] Der Beitrag beschreibt verschiedene PET-Aktivierungsstudien mit motorischen Paradigmen (`joystick`-Bewegungen, Vorstellung von Bewegung, Schreiben) bei Bewegungsstoerungen, im wesentlichen bei Patienten mit Dystonie, einer Hyperkinese, und Morbus Parkinson als Hypokinese. Die experimentellen Befunde werden mit der Klinik in Bezug gebracht. Neue Untersuchungen vor und nach therapeutischen Interventionen, wie die stereotaktische Pallidotomie bei Parkinson und die Botulinum-Toxin-Therapie bei Schreibkrampf, werden beschrieben. Der Beitrag von PET-Aktivierungsstudien zum Verstaendnis der Pathophysiologie von Bewegungsstoerungen wird diskutiert. (orig.)

The knowledge and attitudes of occupational therapy, physiotherapy and speech-language therapy students, regarding the speech-language therapist's role in the hospital stroke rehabilitation team.

Science.gov (United States)

Felsher, L; Ross, E

1994-01-01

The purpose of the present study was to survey and compare the knowledge and attitudes of final year occupational therapy, physiotherapy and speech-language therapy students, concerning the role of the speech-language therapist as a member of the stroke rehabilitation team in the hospital setting. In order to achieve this aim, a questionnaire was administered to final year students in these three disciplines, and included questions on most areas of stroke rehabilitation with which the speech-language therapist might be involved, as well as the concepts of rehabilitation and teamwork in relation to stroke rehabilitation. Results suggested a fairly good understanding of the concepts of rehabilitation and teamwork. Students appeared to have a greater understanding of those disorders following a stroke, with which the speech-language therapist is commonly involved, such as Aphasia, Dysarthria, Verbal Apraxia and Dysphagia. However, students appeared to show less understanding of those disorders post-stroke, for which the speech-language therapist's role is less well defined, such as Agraphia, Alexia and Amnesia. In addition, a high percentage of role duplication/overlapping in several aspects of stroke rehabilitation, such as family and social support, was found. Several implications for facilitating communication, collaboration and understanding between paramedical professions, as well as for further research are also provided.

Observation of the effect of physical rehabilitation therapy combined with the medication on pelvic floor dysfunction.

Science.gov (United States)

Han, Wei; Wang, Yongmei; Qi, Shengbo; Li, Tingting; Cao, Jiang; Zheng, Tinghua; Su, Yan

2018-02-01

We observed the effects of physical rehabilitation therapy combined with medication on pelvic floor dysfunction (PFD). We collected the medical records of 84 maternal patients with PFD who received treatment at the Affiliated Hospital of Hebei University between May 2015 and October 2016. These patients were randomly divided into two groups, the control group (n=42) and observation group (n=42). In the control group, patients received conventional physical rehabilitation therapy while in observation group, patients received the shixiao powder combined with siwu decoction in addition to the physical rehabilitation. The therapeutic effects were compared between the two groups. The total effective rate of the observation group was 97.6%, which was significantly higher than 78.6% in the control group (Ppelvic floor function under rest state, such as electromyo-graphy amplitude, contraction force, coordinate strength and urine flow rate, were significantly higher than those in control group (P0.05). In observation group, after treatment, the rehabilitation effects of urinary incontinence and sexual life quality at 3 months post-delivery were significantly better than those in control group (P0.05), however, after treatment, the levels of CRP and IL-10 of patients in observation group were significantly lower than those in control group (Pphysical rehabilitation therapy combined with the shixiao powder and siwu decoction exhibits significant efficacy in the treatment of PFD by effectively improving the pelvic floor functions, increasing perineal muscle strength, and decreasing expression levels of inflammatory factors, which can significantly ameliorate life quality and reduce the incidence rate of complications. Thus, this treatment method shows great application value in clinical practice.

Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

Directory of Open Access Journals (Sweden)

Ana Paula Cunha Loureiro

Full Text Available INTRODUCTION: Among Parkinson's disease (PD motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale, were recruited for this study. Patients (65 ± 13 years old participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464, Berg Functional Balance Scale (p = 0.0277, lateral functional reach to the right (p = 0.0431* and lateral functional reach to the left (p = 0.0277. CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.

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.

Anticholinerge Therapie der OAB

Directory of Open Access Journals (Sweden)

Hampel C

2007-01-01

Full Text Available Kenntnisse über Differentialdiagnostik und Pathophysiologie des Blasenüberaktivitäts-Syndroms sind essentiell für eine erfolgreiche Therapie. Obwohl Verhaltenstraining und Elektrostimulation ihre Wirksamkeit bei OAB bewiesen haben, ist die Therapie der ersten Wahl nach wie vor die anticholinerge Behandlung. Dessen ungeachtet ist die Einnahmetreue der Patienten unbefriedigend, was in der letzten Zeit zu verschiedenen Medikamentenneuentwicklungen mit verbesserter Verträglichkeit bei gleichbleibend hoher Effektivität geführt hat. Retard-Formulierungen, extraenterale Applikationswege und Rezeptor-Subselektivität sind hierbei die Prinzipien, welche die Behandlungsakzeptanz und Patientenzufriedenheit steigern sollen.

Osteoporose bei Spondylitis ankylosans - Einfluß von Lebensgewohnheiten

Directory of Open Access Journals (Sweden)

Aglas F

2004-01-01

Full Text Available Krankheitsbedingte Artefakte können bei der SpA (Spondylitis ankylosans; Mb. Bechterew die Sensitivität einer Knochendichtemessung im Lumbalbereich beeinträchtigen. Das bei dieser rheumatischen Erkrankung bekannte Osteoporoserisiko ist neben genetischen Faktoren und Entzündungsmechanismen auch von verschiedenen exogenen Einflüssen abhängig. An 47 SpA-Patienten wurde mittels DEXA eine vergleichende Knochendichtemessung (BMD an der Hüfte (Schenkelhals und Ward'sches Dreieck sowie im Bereich der Wirbelsäule (L1-L4 vorgenommen. Zusätzlich erfolgte eine Erhebung der Lebens-Ernährungsgewohnheiten der SpA-Patienten in bezug auf die BMD, um exogene Einflüsse erfassen zu können. Die Knochendichtemessungen ergaben an der LWS wesentlich häufiger eine BMD im Normbereich als am proximalen Femur. Besonders deutliche Unterschiede traten im höheren Lebensalter auf, bei dem aufgrund von Kalzifizierungsvorgängen und Syndesmophyten an der LWS fälschlicherweise eine Dichtezunahme vorgetäuscht wird. Es kann daher bei SpA empfohlen werden, die wesentlich sensitivere Dichtemessung am Schenkelhals durchzuführen. Die über einen Zeitraum von 3 Jahren beobachteten, signifikant erhöhten, medianen CRP-Spiegel zeigen, daß eine permanente Aktivierung von Entzündungsprozessen bei SpA auch einen negativen Faktor betreffend des Knochenmasseverlustes darstellt. Die Analyse der Lebensgewohnheiten ergab, daß SpA-Patienten mit normaler BMD ausnahmslos regelmäßig kalziumreiche Nahrungsmittel zu sich nehmen; bei verminderter BMD wurde in der Mehrheit ein fehlender Konsum an Milchprodukten beobachtet. Leider war auch mit abnehmender BMD eine Verminderung der bei SpA empfohlenen Bewegungsübungen festzustellen. Aufgrund der Resultate ergibt sich eine generelle Empfehlung zu regelmäßigen Bewegungsübungen plus Osteoporosediät bei allen Bechterew-Patienten.

Overcoming the Challenges of BeiDou Receiver Implementation

Directory of Open Access Journals (Sweden)

Mohammad Zahidul H. Bhuiyan

2014-11-01

Full Text Available Global Navigation Satellite System (GNSS-based positioning is experiencing rapid changes. The existing GPS and the GLONASS systems are being modernized to better serve the current challenging applications under harsh signal conditions. These modernizations include increasing the number of transmission frequencies and changes to the signal components. In addition, the Chinese BeiDou Navigation Satellite system (BDS and the European Galileo are currently under development for global operation. Therefore, in view of these new upcoming systems the research and development of GNSS receivers has been experiencing a new upsurge. In this article, the authors discuss the main functionalities of a GNSS receiver in view of BDS. While describing the main functionalities of a software-defined BeiDou receiver, the authors also highlight the similarities and differences between the signal characteristics of the BeiDou B1 open service signal and the legacy GPS L1 C/A signal, as in general they both exhibit similar characteristics. In addition, the authors implement a novel acquisition technique for long coherent integration in the presence of NH code modulation in BeiDou D1 signal. Furthermore, a simple phase-preserved coherent integration based acquisition scheme is implemented for BeiDou GEO satellite acquisition. Apart from the above BeiDou-specific implementations, a novel Carrier-to-Noise-density ratio estimation technique is also implemented in the software receiver, which does not necessarily require bit synchronization prior to estimation. Finally, the authors present a BeiDou-only position fix with the implemented software-defined BeiDou receiver considering all three satellite constellations from BDS. In addition, a true multi-GNSS position fix with GPS and BDS systems is also presented while comparing their performances for a static stand-alone code phase-based positioning.

BEI Resource Repository

Data.gov (United States)

U.S. Department of Health & Human Services — BEI Resources provides reagents, tools and information for studying Category A, B, and C priority pathogens, emerging infectious disease agents, non-pathogenic...

Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis.

Science.gov (United States)

Peng, Le; Zhang, Chao; Zhou, Lan; Zuo, Hong-Xia; He, Xiao-Kuo; Niu, Yu-Ming

2018-04-01

To investigate the effectiveness of traditional manual acupuncture combined with rehabilitation therapy versus rehabilitation therapy alone for shoulder hand syndrome after stroke. PubMed, EMBASE, the Cochrane Library, Chinese Biomedicine Database, China National Knowledge Infrastructure, VIP Information Database, Wan Fang Database and reference lists of the eligible studies were searched up to July 2017 for relevant studies. Randomized controlled trials that compared the combined effects of traditional manual acupuncture and rehabilitation therapy to rehabilitation therapy alone for shoulder hand syndrome after stroke were included. Two reviewers independently screened the searched records, extracted the data and assessed risk of bias of the included studies. The treatment effect sizes were pooled in a meta-analysis using RevMan 5.3 software. A total of 20 studies involving 1918 participants were included in this study. Compared to rehabilitation therapy alone, the combined therapy significantly reduced pain on the visual analogue scale and improved limb movement on the Fugl-Meyer Assessment scale and the performance of activities of daily living (ADL) on the Barthel Index scale or Modified Barthel Index scale. Of these, the visual analogue scale score changes were significantly higher (mean difference = 1.49, 95% confidence interval = 1.15-1.82, P < 0.00001) favoring the combined therapy after treatment, with severe heterogeneity ( I 2  = 71%, P = 0.0005). Current evidence suggests that traditional manual acupuncture integrated with rehabilitation therapy is more effective in alleviating pain, improving limb movement and ADL. However, considering the relatively low quality of available evidence, further rigorously designed and large-scale randomized controlled trials are needed to confirm the results.

{sup 1}H-MR spectroscopy in anorexia nervosa. Reversible cerebral metabolic changes; {sup 1}H-MR-Spektroskopie bei Anorexia nervosa: Reversible zerebrale Metabolitenaenderungen

Energy Technology Data Exchange (ETDEWEB)

Moeckel, R.; Schlemmer, H.P.; Becker, G.; Koepke, J.; Georgi, M. [Heidelberg Univ. (Germany). Inst. fuer Klinische Radiologie; Gueckel, C.; Goepel, C.; Schmidt, M. [Zentralinstitut fuer Seelische Gesundheit, Mannheim (Germany). Klinik fuer Kinder- und Jugendpsychiatrie; Hentschel, F. [Zentralinstitut fuer Seelische Gesundheit, Mannheim (Germany). Neuroradiologie

1999-04-01

Purpose: By using localized {sup 1}H-MR spectroscopy in the brain of patients with anorexia nervosa we wanted to verify our preliminary results and to look for a reversibility of the metabolic changes under therapy. Methods: In 22 patients and 17 healthy volunteers (11 follow-up examinations) single voxel {sup 1}H-MR spectroscopy (TE=50 ms, TM=30 ms, TR=1500 ms, voxel (2 cm){sup 3}, acq.: 256) was used in two different localizations (thalamus and parieto-occipital region). The first examination of the patients was performed before therapy, the follow-up examination at the end of therapy. Results: In both regions of the brain we found a statistically significant elevation of the Cho/Cr-ratio in comparison to normal controls. The follow-up examinations revealed reversibility of the metabolic changes under successful therapy. Conclusion: {sup 1}H-MR spectroscopy reveals metabolic changes in the brain of patients with anorexia nervosa, which are reversible under successful therapy. These metabolic changes can be conclusively explained using a biochemical model. (orig.) [Deutsch] Ziel: Im Rahmen dieser weiterfuehrenden Studie sollten die bisherigen Ergebnisse der lokalisierten {sup 1}H-MR-Spektroskopie des Gehirns an Patienten mit Anorexia nervosa verifiziert werden. Weiter sollte ueberprueft werden, ob die von uns nachgewiesenen metabolischen Veraenderungen unter Therapie reversibel sind. Methode: Die {sup 1}H-MR-Spektren wurden bei 22 Patientinnen und 17 Probanden (11 Verlaufskontrollen) in Einzelvolumentechnik (TE=50 ms, TM=30 ms, TR=1500 ms, Voxel: (2 cm){sup 3}, Acq.: 256) in zwei unterschiedlichen Hirnregionen (Thalamus, parieto-okzipitale Region) durchgefuehrt. Die erste Untersuchung der Patienten erfolgte bei Aufnahme und die Verlaufskontrolle zum Abschluss der stationaeren Behandlung. Ergebnisse: Bei den Patienten wurde in beiden Hirnregionen ein statistisch signifikant erhoehter Wert fuer das Cho/Cr-Verhaeltnis im Vergleich zu dem Normalkollektiv nachgewiesen

Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Mohammad Ali Ahmadi-Pajouh

2017-02-01

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

Actual approaches in diagnosis and therapy of malignant lymphoma; Staging und Therapiekontrolle bei Lymphomen

Energy Technology Data Exchange (ETDEWEB)

Moog, F. [LMU, Muenchen (Germany). Klinik fuer Nuklearmedizin; Roemer, W. [Technische Univ. Muenchen (Germany). Klinik fuer Nuklearmedizin

1998-07-01

Actual molecular strategies in therapy of lymphoma attempt to utilize the immune system to target and eliminate residual lymphoma cells after first line therapy. Therefore lymphoma-specific vaccines are used. Therapy was already successful in vitro, in vivo studies are planned for the near future. In the past two decades, prognosis of lymphoma patients has improved due to advances in staging as well as in therapy control. The introduction of duplex sonography allows the decision on dignity of suspicious lymph nodes not only by size criteria but also by different perfusion pattern. Similar advances have been made in cross sectional imaging like computed tomography and magnetic resonance imaging. The development of lymph node specific contrast agents present new tools for further investigation. In nuclear medicine, functional imaging using positron-emission tomography presents new perspectives especially in diagnosis and treatment control of malignant lymphoma. The visualization of the glucose metabolism using the radiolabeled glucose analogue fluorodeoxyglucose (FDG) allows the detection of involved lymph nodes independent of arbitrary criteria such as lesion diameter. First studies on the use of FDG-PET in staging and restaging of lymphoma patients show promising results. (orig.) [Deutsch] Das 2. Muenchner Nuklearmedizin-Symposium hatte unter anderem das Staging und die Therapiekontrolle bei malignen Lymphomen zum Thema. Neben molekular- und zellbiologischen Ansaetzen zur Lymphomvakzinierung wurde der aktuelle Stand der Moeglichkeiten beim Staging und der Therapiekontrolle aus der Sicht des Radiologen und des Nuklearmediziners vorgetragen. Moderne molekularbiologische Strategien basieren auf einer Modifikation der Immunantwort mit dem Ziel, minimale Tumorreste nach einer konventionellen Therapie zu eleminieren. Dabei kommt in erster Linie das Prinzip der `Tumorimpfung` zum Einsatz. Tumorzellen werden spezifisch ueber einen virusassoziierten Gentransfer oder einen

Balneotherapy in Psoriasis Rehabilitation.

Science.gov (United States)

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

2017-01-01

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

Music-supported therapy in the rehabilitation of subacute stroke patients: a randomized controlled trial.

Science.gov (United States)

Grau-Sánchez, Jennifer; Duarte, Esther; Ramos-Escobar, Neus; Sierpowska, Joanna; Rueda, Nohora; Redón, Susana; Veciana de Las Heras, Misericordia; Pedro, Jordi; Särkämö, Teppo; Rodríguez-Fornells, Antoni

2018-04-01

The effect of music-supported therapy (MST) as a tool to restore hemiparesis of the upper extremity after a stroke has not been appropriately contrasted with conventional therapy. The aim of this trial was to test the effectiveness of adding MST to a standard rehabilitation program in subacute stroke patients. A randomized controlled trial was conducted in which patients were randomized to MST or conventional therapy in addition to the rehabilitation program. The intensity and duration of the interventions were equated in both groups. Before and after 4 weeks of treatment, motor and cognitive functions, mood, and quality of life (QoL) of participants were evaluated. A follow-up at 3 months was conducted to examine the retention of motor gains. Both groups significantly improved their motor function, and no differences between groups were found. The only difference between groups was observed in the language domain for QoL. Importantly, an association was encountered between the capacity to experience pleasure from music activities and the motor improvement in the MST group. MST as an add-on treatment showed no superiority to conventional therapies for motor recovery. Importantly, patient's intrinsic motivation to engage in musical activities was associated with better motor improvement. © 2018 New York Academy of Sciences.

Efficacy of vacuum-assisted closure therapy on rehabilitation during the treatment for surgical site infection after cardiovascular surgery.

Science.gov (United States)

Yoshimoto, Akihiro; Inoue, Takafumi; Fujisaki, Masayuki; Morizumi, Sei; Suematsu, Yoshihiro

2016-08-01

Surgical site infection (SSI) after cardiovascular procedures is a severe complication, potentially leading to high morbidity and mortality. In addition, during the treatment of SSI, rehabilitation is delayed, which can severely impair postoperative recovery. The aim of this study was to assess the effect of vacuum-assisted closure (VAC) therapy on rehabilitation during the treatment of SSI after cardiovascular surgery. From January 2008 to March 2015, 10 patients underwent VAC therapy for SSI after cardiovascular operations. The patient characteristics, duration of VAC therapy, time interval from the implementation of VAC to physical therapy (PT) (T1), ambulation (T2) and walking (T3), functional independent measure (FIM), and maximum consecutive walking capacity (MCWC) were retrospectively analyzed. Nine patients underwent mid-sternal incision and one patient underwent thoraco-abdominal incision. The mean time interval from the beginning of VAC therapy to PT, ambulation, and walking was 0.38 ± 0.50, 0.63 ± 0.71, and 1.38 ± 1.86 days, respectively. The average FIM was 84.5 ± 14.0 at the beginning of VAC therapy and 106.7 ± 18.5 at the end of VAC therapy (P = 0.000494). On average, MCWC was 52.3 ± 54.6 m at the installation of VAC therapy and 189.7 ± 152.8 m at the completion of VAC therapy (P = 0.0169). FIM and MCWC improvement rate was better in VAC group than non-VAC group although these data are not suitable for statistical analysis because of a small sample size. Although further studies are warranted, VAC therapy may have a role in facilitating rehabilitation and improving the prognosis of SSI cases after major cardiovascular operations.

Examination of the somatostatin receptor status in non-medullary thyroid cancer; Untersuchungen zum Somatostatinrezeptor-Status bei nicht-medullaeren Schilddruesenkarzinomen

Energy Technology Data Exchange (ETDEWEB)

Goerges, R.; Brandt-Mainz, K.; Bockisch, A. [Essen Univ. (Gesamthochschule) (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Kahaly, G. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Medizin - Endokrinologie und Stoffwechselerkrankungen; Mueller-Brand, J.; Maecke, H. [Kantonsspital Basel (Switzerland). Inst. fuer Nuklearmedizin; Walgenbach, S. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Allgemein- und Abdominalchirurgie; Bruns, C. [Praeklinische Forschung Novartis, Basel (Switzerland); Andreas, J. [Universitaetsklinik Mainz (Germany). Klinik und Poliklinik fuer Nuklearmedizin

1999-06-01

Aim: Recent in-vitro and in-vivo studies demonstrated a somatostatin receptor expression in some non-medullary thyroid carcinomas. In this study we investigated the somatostatin receptor status for this particular tumor entity in a larger patient group. Subject and methods: We compared 131-iodine with 111-In-pentetreotide scans in 24 patients with metastasizing, non-medullary thyroid cancer. The findings were correlated with other imaging modalities. Additionally, we performed receptor autoradiography in one patient, octreotide therapy in another patient and administration of 90-Y- and 111-In-DOTATOC in 2 consecutive patients. Results: In the 15 patients with papillary or follicular carcinoma, 111-In-pentetreotide was inferior to 131-I in 8/15, equal in 1/15, and superior in 6/15 patients. In 8/9 of the patients with Huerthle cell cacinoma, metastases showed a 111-In-pentetreotide accumulation of various intensity, while 131-iodine scans were negative except for one patient. 111-In-pentetreotide was equal or superior compared to 201-Tl or 99m-Tc-sestamibi, but for the most part inferior in comparison with 18-F-FDG-PET. The findings of 111-In-pentetreotide scintigraphy correlated well with the receptor autoradiography and the accumulation of DOTATOC, but not with the therapeutic effect of `cold` octreotide on the thyroid cancer metastases. Conclusions: Several metastases of papillary and follicular carcinoma, and the majority of Huerthle cell cancer metastases can express somatostatin receptors. 111-In-pentetreotide scintigraphy is a promising tool for localization of metastases especially in Huerthle cell cancer or if PET is not available, and may be useful for selection of possible candidates, if therapeutic effective {beta}-emitting somatostatin analogues will be available for routine application. (orig.) [Deutsch] Ziel: in aktuellen In-vitro und In-vivo-Untersuchungen wurde eine Somatostatinrezeptor-Expression bei einigen nicht

Radionuclide therapy of endocrine-related cancer; Nuklearmedizinische Therapie endokriner Tumoren

Energy Technology Data Exchange (ETDEWEB)

Kratochwil, C.; Giesel, F.L. [Universitaetsklinikum Heidelberg, Abteilung Nuklearmedizin, Heidelberg (Germany)

2014-10-15

(sub)totale Remissionen moeglich, die 15-Jahres-Ueberlebensrate liegt fuer diese Patienten um die 90 %. Auch die Metaiodbenzylguanidin(MIBG)-Therapie hat in Europa Marktzulassung und kann nach aktueller Literatur bei der Behandlung inoperabler Neuroblastome und maligner Phaeochromozytome bzw. Paragangliome bei gut 30 % der Patienten eine signifikante Tumorverkleinerung, bei knapp 80 % ein sekretorisches Ansprechen bzw. eine Symptomverbesserung bewirken. Nach vielversprechenden Phase-2-Daten zur Therapie neuroendokriner Tumoren mit radioaktiven Somatostatinanaloga wie DOTATATE oder DOTATOC, bei denen sich jeweils 24 bis 36 Monate progressionsfreies Ueberleben unter Therapie gezeigt haben, rekrutiert aktuell eine erste Phase-3-Zulassungsstudie fuer intestinale Karzinoide. Mit radioaktiven Konjugaten auf Basis der Peptidhormone GLP1 und Minigastrin sind zielgerichtete Tracer fuer Insulinome und medullaere Schilddruesenkarzinome in der fruehen klinischen Erprobung. Vor der zielgerichteten Therapie mit dichtionisierend strahlenden Radionukliden erfolgt in der Regel eine Bildgebung mit Gammastrahlen emittierenden, diagnostischen Analogsubstanzen, um somit eine auf dem Tumorphaenotyp basierende Patientenstratifizierung zu ermoeglichen. (orig.)

A Method for Estimating BeiDou Inter-frequency Satellite Clock Bias

Directory of Open Access Journals (Sweden)

LI Haojun

2016-02-01

Full Text Available A new method for estimating the BeiDou inter-frequency satellite clock bias is proposed, considering the shortage of the current methods. The constant and variable parts of the inter-frequency satellite clock bias are considered in the new method. The data from 10 observation stations are processed to validate the new method. The characterizations of the BeiDou inter-frequency satellite clock bias are also analyzed using the computed results. The results of the BeiDou inter-frequency satellite clock bias indicate that it is stable in the short term. The estimated BeiDou inter-frequency satellite clock bias results are molded. The model results show that the 10 parameters of model for each satellite can express the BeiDou inter-frequency satellite clock bias well and the accuracy reaches cm level. When the model parameters of the first day are used to compute the BeiDou inter-frequency satellite clock bias of the second day, the accuracy also reaches cm level. Based on the stability and modeling, a strategy for the BeiDou satellite clock service is presented to provide the reference of our BeiDou.

Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

Science.gov (United States)

Hirata, Gisela Carmona; Santos, Rosane Sampaio

2012-01-01

Summary Introduction: There are an estimated 30,000–40,000 new cases of cerebral palsy per year in Brazil. Motor disorders caused by cerebral palsy can lead to dysphagia as they may alter the preparatory, oral, pharyngeal, and esophageal phases. Aim: To identify existing rehabilitation methods of swallowing disorders in cerebral palsy, with emphasis on the pursuit of research using the Bobath concept, the Castillo Morales concept, oral sensorimotor therapy, and continuing education. Summary of the findings: We performed a systematic review of the medical and speech therapy literature on the rehabilitation of oropharyngeal dysphagia in children with cerebral palsy spanning 1977–2010 and from all languages and nations. Among the 310 articles retrieved, only 22 (7.09%) addressed therapeutic rehabilitation of oropharyngeal dysphagia in children with cerebral palsy. Of the 22 reports, 12 (54.5%) were from Canada, 3 (13.6%) were from Japan, 2 (9%) were from Brazil, 2 (9%) were from Germany, 1 (4.5%) was from the USA, 1 (4.5%) was from the United Kingdom, and 1 (4.5%) was from Poland. Of these reports, 63.6% used oral sensorimotor therapy as a therapeutic method, 36.3% reported continuing education as a therapeutic approach, and only 18.1% and 9% used the Bobath concept and Castillo Morales concept, respectively. Conclusion: Even with a constantly increasing cerebral palsy population, few studies include (re)habilitation in the treatment of oropharyngeal dysphagia in these children. PMID:25991964

Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

Directory of Open Access Journals (Sweden)

Hirata, Gisela Carmona

2012-01-01

Full Text Available Introduction: There are an estimated 30,000-40,000 new cases of cerebral palsy per year in Brazil. Motor disorders caused by cerebral palsy can lead to dysphagia as they may alter the preparatory, oral, pharyngeal, and esophageal phases. Aim: To identify existing rehabilitation methods of swallowing disorders in cerebral palsy, with emphasis on the pursuit of research using the Bobath concept, the Castillo Morales concept, oral sensorimotor therapy, and continuing education. Summary of the findings: We performed a systematic review of the medical and speech therapy literature on the rehabilitation of oropharyngeal dysphagia in children with cerebral palsy spanning 1977-2010 and from all languages and nations. Among the 310 articles retrieved, only 22 (7.09% addressed therapeutic rehabilitation of oropharyngeal dysphagia in children with cerebral palsy. Of the 22 reports, 12 (54.5% were from Canada, 3 (13.6% were from Japan, 2 (9% were from Brazil, 2 (9% were from Germany, 1 (4.5% was from the USA, 1 (4.5% was from the United Kingdom, and 1 (4.5% was from Poland. Of these reports, 63.6% used oral sensorimotor therapy as a therapeutic method, 36.3% reported continuing education as a therapeutic approach, and only 18.1% and 9% used the Bobath concept and Castillo Morales concept, respectively. Conclusion: Even with a constantly increasing cerebral palsy population, few studies include (rehabilitation in the treatment of oropharyngeal dysphagia in these children.

Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of First Stroke Attack in Ibadan, Nigeria.

Science.gov (United States)

Olukolade, Olugbemi; Osinowo, Helen O

2017-01-01

Poststroke depression (PSD) is a common complication after stroke. There is no adequate treatment for PSD. This study examined efficacy of cognitive rehabilitation therapy (CRT) in the treatment of PSD among stroke survivors. An experimental design, 30 participants with poststroke depression were randomly assigned into 3 groups of cognitive rehabilitation therapy (CRT), psychoeducation (PE), and the control group (CG). CRT consisted of nine sessions with three-phased sessions focusing on activity stimulation, negative thoughts, and people contacts, PE consisted of nine sessions focusing on knowledge on stroke and poststroke depression, and the CG group was on the waiting list. The BDI scale was used for assessing PSD at posttest. There was a significant difference in the efficacy of CRT, PE, and the CG on PSD, with CRT-CG mean difference of -9.4 ± 3.11 and PE-CG 1.0 ± 3.83. Furthermore, stress was not a confounding variable on the efficacy of CRT. The type of therapy significantly influenced PSD at posttest, with the CRT having greater mean reduction to CG (-11.1 ± 3.1) than PE to the CG (3.0 ± 3.8). Cognitive rehabilitation therapy significantly reduced poststroke depression. Hence, it should be integrated as an adjunct treatment of poststroke depression.

Changes in functional brain organization and behavioral correlations after rehabilitative therapy using a brain-computer interface

Directory of Open Access Journals (Sweden)

Brittany Mei Young

2014-07-01

Full Text Available This study aims to examine the changes in task-related brain activity induced by rehabilitative therapy using brain-computer interface (BCI technologies and whether these changes are relevant to functional gains achieved through the use of these therapies. Stroke patients with persistent upper-extremity motor deficits received interventional rehabilitation therapy using a closed-loop neurofeedback BCI device (n=8 or no therapy (n=6. Behavioral assessments using the Stroke Impact Scale, the Action Research Arm Test, and the Nine-Hole Peg Test as well as task-based fMRI scans were conducted before, during, after, and one month after therapy administration or at analogous intervals in the absence of therapy. Laterality Index (LI during finger tapping of each hand were calculated for each time point and assessed for correlation with behavioral outcomes. Brain activity during finger tapping of each hand shifted over the course of BCI therapy but not in the absence of therapy to greater involvement of the non-lesioned hemisphere (and lesser involvement of the stroke-lesioned hemisphere as measured by LI. Moreover, changes from baseline LI values during finger tapping of the impaired hand were correlated with gains in both objective and subjective behavioral measures. These findings suggest that the administration of interventional BCI therapy can induce differential changes in brain activity patterns between the lesioned and nonlesioned hemisphere and that these brain changes are associated with changes in specific motor functions.

[Rehabilitation evaluation on post-stroke abnormal movement pattern prevented and treated with acupuncture and rehabilitation].

Science.gov (United States)

Zhang, Hui-min; Tang, Qiang

2011-06-01

To explore the impacts of acupuncture and rehabilitation on post-stroke abnormal patterns of limb movement and evaluate them via rehabilitation method. Ninety cases of post-stroke movement disorder were randomly divided into an acupuncture-rehabilitation group, a body acupuncture group and a medication group, 30 cases in each group. In medication group, the conventional medication in neurological department was administered. In acupuncture-rehabilitation group and body acupuncture group, on the basis of the therapy as medication group, scalp acupuncture (such as parietal area and anterior parietal area, etc.), rehabilitation training and traditional body acupuncture [such as Jianyu (LI 15) and Fengshi (GB 31),etc.] were supplemented. The continuous electric stimulation was applied in body acupuncture group. The treatment lasted for 8 weeks. The assessment of clinical efficacy, Fugl-Meyer score, Modified Ashworth scale (MAS), range of motion (ROM) and shoulder pain score were taken as observation indices for rehabilitation evaluation before and after treatment in each group. The effective rate was 93.1% (27/29) in acupuncture-rehabilitation group, which was superior to 66.7% (20/30) in body acupuncture group and 57.1% (16/28) in control group (both Prehabilitation group were significantly superior to those in body acupuncture group and medication group (Prehabilitation therapy and traditional body acupuncture remarkably improve in post-stroke movement disorder. But acupuncture and rehabilitation therapy is apparently superior to traditional body acupuncture. This therapy can effectively prevent and treat post-stroke abnormal patterns and it is greatly significant in the improvement of survival quality for the patients.

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...

Maxillofacial prosthodontic rehabilitation of a patient with oral complications during and after multimodality therapy for the management of oral squamous cell carcinoma.

Science.gov (United States)

Acharya, Varun; Chambers, Mark S

2015-06-01

Multimodality cancer therapy involving surgical resection, chemotherapy, and radiation therapy is frequently employed in the management of head and neck cancer. Patients who have undergone such therapy face substantial challenges during and after treatment. Prosthodontic rehabilitation is essential during and after tumor ablation to restore function, esthetics, and minimize interruption in daily routine. This clinical report describes the challenges faced by a patient undergoing multimodality therapy for a squamous cell carcinoma of the maxillary sinus and the stages involved in prosthodontic rehabilitation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Pulmonary manifestations in collagen vascular diseases; Pulmonale Manifestationen bei Kollagenosen

Energy Technology Data Exchange (ETDEWEB)

Vogel, M.N.A. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kreuter, M. [Thoraxklinik, Universitaetsklinikum Heidelberg, Zentrum fuer interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kauczor, H.U. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Heussel, C.P. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany)

2016-10-15

Pulmonary complications are frequent in patients with collagen vascular diseases (CVD). Frequent causes are a direct manifestation of the underlying disease, side effects of specific medications and lung infections. The standard radiological procedure for the work-up of pulmonary pathologies in patients with CVD is multidetector computed tomography (MDCT) with thin-slice high-resolution reconstruction. The accuracy of thin-slice CT for the identification of particular disease patterns is very high. The pattern of usual interstitial pneumonia (UIP) representing the direct pulmonary manifestation of rheumatoid arthritis (RA) can be identified with a sensitivity of 45 % and a specificity of 96 %. Both direct pulmonary manifestations, drug-induced toxicity and certain infections can have a similar appearance in thin-slice MDCT in various forms of CVD. Knowledge of the patterns and causes contributes to the diagnostic certainty. At first diagnosis of a CVD and associated pulmonary symptoms thin-slice MDCT is recommended. Clinical, lung function and imaging follow-up examinations should be performed every 6-12 months depending on the results of the MDCT. In every case the individual CT morphological patterns of pulmonary involvement must be identified. The combination of information on the anamnesis, clinical and imaging results is a prerequisite for an appropriate disease management. (orig.) [German] Pulmonale Komplikationen sind bei Patienten mit Kollagenosen keine Seltenheit. Haeufig sind eine direkte Manifestation der Grunderkrankung, eine Nebenwirkung der medikamentoesen Therapie oder eine Lungeninfektion die Ursachen. Das radiologische Standardverfahren zur Klaerung pulmonaler Pathologien bei Patienten mit Kollagenosen ist die Multidetektorcomputertomographie mit duennschichtigen Rekonstruktionen (Duennschicht-MDCT). Die Treffsicherheit der Duennschicht-MDCT ist fuer die Identifikation eines Erkrankungsmusters sehr hoch. So kann beispielsweise das Muster einer

Umgang mit Antithrombotika bei Operationen an der Haut vor und nach Publikation der entsprechenden S3-Leitlinie.

Science.gov (United States)

Gaskins, Matthew; Dittmann, Martin; Eisert, Lisa; Werner, Ricardo Niklas; Dressler, Corinna; Löser, Christoph; Nast, Alexander

2018-03-01

Laut einer Befragung im Jahre 2012 war der Umgang mit Antithrombotika bei dermatochirurgischen Eingriffen in Deutschland sehr heterogen. 2014 wurde erstmals eine evidenzbasierte Leitlinie zu diesem Thema veröffentlicht. Es wurde eine anonyme Befragung derselben Stichprobe zum Umgang mit Antithrombotika sowie zu Kenntnissen der Leitlinie durchgeführt. Die Ergebnisse wurden als relative Häufigkeiten berichtet und denen aus 2012 gegenübergestellt. 208 Antwortbögen wurden ausgewertet (Rücklaufquote: 36,6 %). Die große Mehrheit der Dermatologen erklärte, kleinere Eingriffe unter Fortführung der Therapie mit Phenprocoumon, niedrig dosierter Acetylsalicylsäure (≤ 100 mg) und Clopidogrel sowie mit direkten oralen Antikoagulanzien durchzuführen. Bei größeren Eingriffen war der Umgang hingegen weiterhin heterogen, insbesondere unter niedergelassenen Dermatologen. Der Anteil der Dermatologen, die Phenprocoumon, Acetylsalicylsäure und Clopidogrel leitlinienkonform verwendeten, hat sich insgesamt vergrößert. Führten 2012 beispielsweise 53,8 % der Klinikärzte bzw. 36,3 % der niedergelassenen Dermatologen eine große Exzision unter Fortführung der Therapie mit niedrig dosierter Acetylsalicylsäure durch, taten dies 2017 90,2 % bzw. 57,8 % (Phenprocoumon: 33,8 % bzw. 11,9 % auf 63,9 % bzw. 29,9 %; Clopidogrel: 36,9 % bzw. 23,2 % auf 63,9 % bzw. 30,6 %). Unter den Klinikärzten war ein hoher Anteil mit der Leitlinie vertraut und fand diese hilfreich. Eine Zunahme des leitlinienkonformen Verhaltens war bei allen Eingriffen zu verzeichnen. Bei größeren Eingriffen zeigte sich trotz deutlicher Verbesserung die Notwendigkeit verstärkter Anstrengungen zur Leitlinienumsetzung bzw. zur Identifizierung von Implementierungsbarrieren. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Association between the volume of inpatient rehabilitation therapy and the risk of all-cause and cardiovascular mortality in patients with ischemic stroke.

Science.gov (United States)

Hu, Gwo-Chi; Hsu, Chia-Yu; Yu, Hui-Kung; Chen, Jiann-Perng; Chang, Yu-Ju; Chien, Kuo-Liong

2014-02-01

To investigate the relationship between the volume of inpatient rehabilitation therapy and mortality among patients with acute ischemic stroke, as well as to assess whether the association varies with respect to stroke severity. A retrospective study with a cohort of consecutive patients who had acute ischemic stroke between January 1, 2008, and June 30, 2009. Referral medical center. Adults with acute ischemic stroke (N=1277) who were admitted to a tertiary hospital. Not applicable. Stroke-related mortality. During the median follow-up period of 12.3 months (ranging from January 1, 2008, to December 31, 2009), 163 deaths occurred. Greater volume of rehabilitation therapy was associated with a reduced risk of all-cause and cardiovascular mortality (P for trend rehabilitation volume was associated with a 55% lower risk of all-cause mortality (hazard ratio [HR]=.45; 95% confidence interval [CI], .30-.65) and a 50% lower risk of cardiovascular mortality (HR=.50; 95% CI, .31-.82). The association did not vary with respect to stroke severity (P for interaction = .45 and .73 for all-cause and cardiovascular mortality, respectively). The volume of inpatient rehabilitation therapy and mortality were significantly inversely related in the patients with ischemic stroke. Thus, further programs aimed at promoting greater use of rehabilitation services are warranted. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The implementation of the ICF among Israeli rehabilitation centers--the case of physical therapy.

Science.gov (United States)

Jacob, Tamar

2013-10-01

The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.

Grasps Recognition and Evaluation of Stroke Patients for Supporting Rehabilitation Therapy

Directory of Open Access Journals (Sweden)

Beatriz Leon

2014-01-01

Full Text Available Stroke survivors often suffer impairments on their wrist and hand. Robot-mediated rehabilitation techniques have been proposed as a way to enhance conventional therapy, based on intensive repeated movements. Amongst the set of activities of daily living, grasping is one of the most recurrent. Our aim is to incorporate the detection of grasps in the machine-mediated rehabilitation framework so that they can be incorporated into interactive therapeutic games. In this study, we developed and tested a method based on support vector machines for recognizing various grasp postures wearing a passive exoskeleton for hand and wrist rehabilitation after stroke. The experiment was conducted with ten healthy subjects and eight stroke patients performing the grasping gestures. The method was tested in terms of accuracy and robustness with respect to intersubjects’ variability and differences between different grasps. Our results show reliable recognition while also indicating that the recognition accuracy can be used to assess the patients’ ability to consistently repeat the gestures. Additionally, a grasp quality measure was proposed to measure the capabilities of the stroke patients to perform grasp postures in a similar way than healthy people. These two measures can be potentially used as complementary measures to other upper limb motion tests.

Innovative Development and Forecast of BeiDou System

Directory of Open Access Journals (Sweden)

TAN Shusen

2017-10-01

Full Text Available Due to the strong demand for satellite applications and rapid development of new space technology,the cross-integration of space-based radio systems has become a trend.BeiDou system started from two satellites to build China's first generation satellite navigation and positioning system with the features of fast location reporting(RDSSand short message communication(MSSservice.Then BeiDou technology frame combined with RNSS continuous navigation and RDSS location report,was constructed in eight years,and the coverage in Asia-Pacific was completed.Through effective satellite radio frequency compatible design and international coordination,BeiDou system is the first radio satellite system which includes RNSS,RDSS,MSS three major services,approved by International Telecommunication Union(ITUin the world.This paper expounds the development process,technical frame,main features and prospect of BeiDou system with three major services and four key functions,in the concept of innovation and transcendence.

Positron emission tomography in urological cancer; Positronenemissionstomographie bei urologischen Tumoren

Energy Technology Data Exchange (ETDEWEB)

Wit, M. de [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Onkologie/Haematologie, Medizinische Klinik; Kotzerke, J. [Universitaetsklinikum Ulm (DE). Radiologie III (Nuklearmedizin)

2000-09-01

In staging cancer of the urinary bladder, the kidneys and the prostate and of testicular cancer there is a need for detecting tumor involvement of the lymph nodes to avoid surgical exploration. Positron emission tomography (PET) using fluorodeoxyglucose (FDG) can detect tumorous lymph nodes (sensitivity: 70%, specificity: 85%) which is helpful for several patients. In carcinoma of the prostate, other radiotracers than FDG (e.g. C-11-choline) might be more sensitive to detect tumorous lymph nodes. Up to now no diagnostical benefit of PET in germ cell tumors could be demonstrated in the published small series. In principle FDG-PET is useful in diagnosis of recurrence. In germ cell cancer FDG-PET seems to identify effectively persistent vital tumor tissue after chemotherapy. A multicenter study was initiated to demonstrate the potential of FDG-PET in a sufficient number of patients with germ cell tumor. (orig.) [German] Bei Harnblasen-, Nieren-, Prostata- und Hodenkarzinomen besteht aus klinischer Sicht ein Bedarf an verbessertem Lymphknoten-Staging, um die operative Evaluation zu vermeiden. Die Positronenemissionstomographie (PET) mit Fluordeoxyglukose (FDG) kann daher im Einzelfall bei Harnblasen- und Nierenkarzinomen hilfreich sein (bei Sensitivitaet um 70% und Spezifitaet um 85%). Beim Prostatakarzinom koennten sich andere Radiotracer (z.B. C-11-Cholin) bei der Detektion von tumoroesen Lymphknoten ueberlegen erweisen. Bei Keimzelltumoren konnte ein Nutzen der PET im primaeren Staging bei den bisher publizierten kleinen Studien nicht nachgewiesen werden. Fuer die Rezidivdiagnostik ist bei den genannten Tumoren aus grundsaetzlicher Ueberlegung der Einsatz von DFG-PET sinnvoll. Die Erkennung von vitalem malignen Tumorgewebe nach Chemotherapie erscheint bei Keimzelltumoren mit FDG-PET weitgehend sicher zu gelingen. Eine multizentrische Studie wurde begonnen, die hierueber Aufschluss geben wird. (orig.)

Therapie des Harnleitersteins - extrakorporale Stoßwellenlithotripsie und Ureteroskopie im Vergleich

Directory of Open Access Journals (Sweden)

Strohmaier WL

1999-01-01

Full Text Available In einer prospektiven Studie wurden 146 Patienten mit nicht spontan abgehenden Harnleitersteinen behandelt. Sie wurden über Vor- und Nachteile der ESWL bzw. URS aufgeklärt. Die primäre Therapie erfolgte nach Wunsch des Patienten. 97 Patienten entschieden sich für eine primäre ESWL. Zweimal erfolgte sie sekundär. Wir führten 128 Behandlungen durch: Bei 71 Patienten eine, bei 21 zwei und bei 5 drei Sitzungen. Danach wurden 70 % der Patienten steinfrei, bei 30 % versagte die ESWL. Die Versagerrate war mit 41 % bei den distalen Steinen am höchsten. Bei den distalen Steinen waren nicht erfolgreich behandelte signifikant größer als erfolgreich therapierte. Bei 26 Therapieversagern lag eine Steinanalyse vor: 23 Patienten litten an einem Whewellitstein. Relevante Komplikationen nach ESWL beobachteten wir nicht. Die Therapieversager wurden sekundär der URS zugeführt. 49 Patienten entschieden sich primär für die URS. Sekundär wurde sie bei 29 Patienten eingesetzt. In 75 Fällen erfolgte die URS in einer Sitzung, dreimal in zwei Sitzungen. Danach waren 95 % der Patienten steinfrei. Distale Steine wiesen die höchste Erfolgsrate auf (97,5 %. Als Sekundärbehandlung war einmal eine ESWL und zweimal eine Ureterolithotomie erforderlich. Eine operationsbedürftige Komplikation beobachteten wir nur in einem Fall. Die URS wurde bei allen Patienten in Analgosedierung oder Spinalanästhesie durchgeführt. 75 % der ESWL-Behandlungen mußten in Analgosedierung erfolgen. Unsere Ergebnisse zeigen, daß die URS ein effektives und sicheres Verfahren mit niedriger Komplikationsrate ist. Größte Vorteile zeigt sie bei distalen Harnleitersteinen. Die ESWL zeigt eine geringere Steinfreiheitsrate mit höherer Anzahl von Wiederholungsbehandlungen auf. Whewellitsteine sind für die ESWL problematisch. Daher sollte die URS bei distalen Harnleitersteinen primär als Therapiealternative zur ESWL angeboten werden. Bei Whewellitsteinen ist die URS die Therapie der

Physikalische Therapie der Beckenbodeninsuffizienz - Methodenvergleich

Directory of Open Access Journals (Sweden)

Bocker B

2002-01-01

Full Text Available Harninkontinenz wird von der Internationalen Gesellschaft für Kontinenz als soziales und hygienisches Problem durch unwillkürlichen Harnverlust definiert [1]. Um Aussagen über die Wirksamkeit einzelner Therapieformen in der Behandlung dieser Erkrankung treffen zu können, untersuchten wir 24 Patientinnen mit neuromuskulärer Beckenbodenschwäche sowie 24 männliche Patienten nach Prostatektomie. In einer kontrollierten, prospektiven Längsschnittstudie erhielten je 8 Patienten jeder Diagnosegruppe nach randomisierter Zuordnung eine Serie Elektrostimulation der Beckenbodenmuskulatur (ES, Biofeedbacktherapie (BF und EMG-getriggerte Elektrostimulation (EMG-ES in Kombination mit einer standardisierten Krankengymnastik (KG. Hauptzielparameter ist der Harninkontinenzgrad, Nebenzielparameter die Häufigkeit der Inkontinenzepisoden und Beckenbodenspannung, gemessen über den Oberflächen-EMG-Bereich. In bezug auf den Harninkontinenzgrad sind die Ergebnisse am Studienende bei Einsatz der Feedbackverfahren signifikant besser als nach isolierter Elektrostimulation. Durch BF sank der Harninkontinenzgrad nach Ingelmann-Sundberg im Mittelwert von Therapiebeginn bis zum Ende des Follow-up um 1,2; nach EMG-ES um 1,05. Passive ES führte zu einer Harninkontinenzreduktion um 0,36. In der Beeinflussung der Inkontinenzepisoden ist die bessere Wirkung der Biofeedbackverfahren im Follow-up gesichert (Häufigkeit / d von 2,5 auf 0,75 gegenüber einer Abnahme von 2,6 auf 1,9 infolge ES. Bezüglich des EMG-Bereiches zeigt die reine Elektrostimulation im Gegensatz zu den Feedback-gekoppelten Verfahren (Zunahme der Aktivität um 13,6 bzw. 12 µV keine Wirkung auf die Muskelaktivität. Bei isolierter Betrachtung der Diagnosegruppen führt reine Biofeedbackbehandlung bei den prostatektomierten Patienten zur Abnahme der Harninkontinenz über das Therapieende hinaus: MV = 2,0 bei SD = 0,17 zu Beginn auf MV = 0,7 bei SD = 0,14 zwölf Wochen nach Therapie. Dagegen hat EMG

Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

NARCIS (Netherlands)

Li, C.; Rusak, Z.; Horvath, I.; Ji, L.; Hou, Y.

2014-01-01

In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be

[Computer-assisted therapy and video games in psychosocial rehabilitation for schizophrenia patients].

Science.gov (United States)

Brun, G; Verdoux, H; Couhet, G; Quiles, C

2018-02-28

Video games and virtual reality have recently become used by clinicians for training or information media or as therapeutic tools. The purpose is to review the use of these technologies for therapy destined for schizophrenia patients. We conducted a review in October 2016 using Pubmed, Scopus and PsychInfo using the following Medical Subject Headings (MESH): "video games", "virtual reality" and "therapy, computer-assisted/methods", each associated with "schizophrenia". Papers were included in the review if: (a) they were published in an English, Spanish or French-language peer-reviewed journal, (b) the study enrolled patients with schizophrenia or schizo-affective disorder, (c) the patients used a therapeutic video game or therapeutic virtual reality device. Eighteen publications were included. The devices studied are mainly therapeutic software developed specifically for therapeutic care. They can be classified according to their therapeutic objectives. These targets corresponded to objectives of psychosocial rehabilitation: improvement of residual symptomatology, cognitive remediation, remediation of cognition and social skills, improvement of everyday life activities, support for occupational integration. Very different devices were proposed. Some researchers analysed programs developed specifically for patients with schizophrenia, while others were interested in the impact of commercial games. Most of the studies were recent, preliminary and European. The impact of these devices was globally positive, particularly concerning cognitive functions. Computer-assisted therapy, video games and virtual reality cannot replace usual care but could be used as adjunctive therapy. However, recommending their use seems premature because of the recent and preliminary character of most studies. Moreover, a link is still lacking between this field of research in psychiatry and other fields of research, particularly game studies. Finally, it might be interesting to analyse more

Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial.

Science.gov (United States)

Kongkasuwan, Ratcharin; Voraakhom, Kotchakorn; Pisolayabutra, Prim; Maneechai, Pichai; Boonin, Jiraporn; Kuptniratsaikul, Vilai

2016-10-01

To examine the efficacy of creative art therapy plus conventional physical therapy, compared with physical therapy only, in increasing cognitive ability, physical functions, psychological status and quality of life of stroke patients. Randomized controlled trial with blinded assessor. An in-patient setting PARTICIPANTS: One hundred and eighteen stroke patients aged ⩾50 years who could communicate verbally. All participants received conventional physical therapy five days per week. An intervention group received additional creative art therapy, twice a week for four weeks, in a rehabilitation ward. Cognitive function, anxiety and depression, physical performance and quality of life were measured with the Abbreviated Mental Test, the Hospital Anxiety and Depression Scale, the modified Barthel Index scale and the pictorial Thai Quality of Life questionnaire, respectively. Mean differences for the intervention group were significantly greater than the control group for depression (-4.5, 95% CI -6.5, -2.5, part therapy and most reported improved concentration (68.5%), emotion (79.6%), self-confidence (72.2%) and motivation (74.1%). Creative art therapy combined with conventional physical therapy can significantly decrease depression, improve physical functions and increase quality of life compared with physical therapy alone. © The Author(s) 2015.

Seasonal Admission Rates of Geriatric Patients with Musculoskeletal Problems to Physical Therapy and Rehabilitation Clinics

OpenAIRE

Sari, Zubeyir; Yurdalan, Saadet Ufuk; Polat, Mine Gulden; Ozgul, Bahar; Kanberoglu, Ayfer; Onel, Selma

2013-01-01

Seasonal variations in the admission rates of geriatric patients with musculoskeletal problems to physical therapy and rehabilitation clinics were examined in this study. Totally 2257 patients (1802, 79.84% female; 455, 20.16% male) over the age of 65 years (mean age 72.32±5.67years) who were admitted to Duygu Private Hospital and Burcu Private Physical Therapy Branch Center in Istanbul were included. Monthly admissions and seasonal distribution were retrospectively calculated for 2 years. Ad...

Beckenbodenbeschwerden bei Fahrradfahrerinnen und mögliche Therapieansätze

Directory of Open Access Journals (Sweden)

Lyatoshinsky P

2016-01-01

Full Text Available Einleitung und Hypothese: Fahrradfahren ist nicht nur ein immer beliebter werdender Freizeitsport, sondern auch ein immer intensiver genutztes Fortbewegungsmittel. Somit ist es mittlerweile von großer Bedeutung, herauszufinden, welchen negativen Einfluss das Fahrradfahren auf den menschlichen Körper hat. Dieser Review fasst die aktuelle Evidenz zur Epidemiologie, Therapie und Prävention der Genital- und Beckenbodenbeschwerden bei weiblichen Fahrradfahrerinnen zusammen.brMethoden: Zwei Metadatenbanken, OvidSP und Deutsches Institut für Medizinische Dokumentation und Information (DIMDI, wurden auf Studien durchsucht, die über Genital- und Beckenbodenbeschwerden bei weiblichen Fahrradfahrerinnen berichteten und mögliche Therapie- oder Prophylaxeansätze untersuchten. Für die Literaturrecherche wurden folgende Schlagwörter verwendet: „female“, „bicycling“, „pelvic floor“, „lower urinary tract symptoms“ und „vulvar diseases“.brErgebnis: Die Suche ergab 1219 Artikel. Nach Entfernen der Duplikate aus dem Ergebnispool wurden 763 Publikationen nach relevanten Titeln untersucht. Letztendlich konnten 12 Fachartikel für unser Review herangezogen werden. 10 Studien waren Beobachtungsstudien und 2 experimentell. Symptome, die hierbei mit Fahrradfahren assoziiert wurden, waren: Schmerz und Neuropathien in der Beckenbodenregion sowie urologische Dysfunktionen und Hautverletzungen. Breitere und konventionelle Sättel führten zu einer geringeren Symptomatik als Sättel mit einer Lochung sowie schmälere Sportsättel.brZusammenfassung: Die Qualität der gegenwärtigen Studien war im Allgemeinen niedrig. Dennoch gibt es Evidenz dafür, dass Radfahrerinnen unter sehr ähnlichen Symptomen leiden wie Radfahrer: von kleineren Hautläsionen bis hin zu neurologischen Beschwerden.

Towards incorporating affective computing to virtual rehabilitation; surrogating attributed attention from posture for boosting therapy adaptation

Science.gov (United States)

Rivas, Jesús J.; Heyer, Patrick; Orihuela-Espina, Felipe; Sucar, Luis Enrique

2015-01-01

Virtual rehabilitation (VR) is a novel motor rehabilitation therapy in which the rehabilitation exercises occurs through interaction with bespoken virtual environments. These virtual environments dynamically adapt their activity to match the therapy progress. Adaptation should be guided by the cognitive and emotional state of the patient, none of which are directly observable. Here, we present our first steps towards inferring non-observable attentional state from unobtrusively observable seated posture, so that this knowledge can later be exploited by a VR platform to modulate its behaviour. The space of seated postures was discretized and 648 pictures of acted representations were exposed to crowd-evaluation to determine attributed state of attention. A semi-supervised classifier based on Na¨ıve Bayes with structural improvement was learnt to unfold a predictive relation between posture and attributed attention. Internal validity was established following a 2×5 cross-fold strategy. Following 4959 votes from crowd, classification accuracy reached a promissory 96.29% (µ±σ = 87.59±6.59) and F-measure reached 82.35% (µ ± σ = 69.72 ± 10.50). With the afforded rate of classification, we believe it is safe to claim posture as a reliable proxy for attributed attentional state. It follows that unobtrusively monitoring posture can be exploited for guiding an intelligent adaptation in a virtual rehabilitation platform. This study further helps to identify critical aspects of posture permitting inference of attention.

Initial assessment of the COMPASS/BeiDou-3: new-generation navigation signals

Science.gov (United States)

Zhang, Xiaohong; Wu, Mingkui; Liu, Wanke; Li, Xingxing; Yu, Shun; Lu, Cuixian; Wickert, Jens

2017-10-01

The successful launch of five new-generation experimental satellites of the China's BeiDou Navigation Satellite System, namely BeiDou I1-S, I2-S, M1-S, M2-S, and M3-S, marks a significant step in expanding BeiDou into a navigation system with global coverage. In addition to B1I (1561.098 MHz) and B3I (1269.520 MHz) signals, the new-generation BeiDou-3 experimental satellites are also capable of transmitting several new navigation signals in space, namely B1C at 1575.42 MHz, B2a at 1176.45 MHz, and B2b at 1207.14 MHz. For the first time, we present an initial characterization and performance assessment for these new-generation BeiDou-3 satellites and their signals. The L1/L2/L5 signals from GPS Block IIF satellites, E1/E5a/E5b signals from Galileo satellites, and B1I/B2I/B3I signals from BeiDou-2 satellites are also evaluated for comparison. The characteristics of the B1C, B1I, B2a, B2b, and B3I signals are evaluated in terms of observed carrier-to-noise density ratio, pseudorange multipath and noise, triple-frequency carrier-phase ionosphere-free and geometry-free combination, and double-differenced carrier-phase and code residuals. The results demonstrate that the observational quality of the new-generation BeiDou-3 signals is comparable to that of GPS L1/L2/L5 and Galileo E1/E5a/E5b signals. However, the analysis of code multipath shows that the elevation-dependent code biases, which have been previously identified to exist in the code observations of the BeiDou-2 satellites, seem to be not obvious for all the available signals of the new-generation BeiDou-3 satellites. This will significantly benefit precise applications that resolve wide-lane ambiguity based on Hatch-Melbourne-Wübbena linear combinations and other applications such as single-frequency precise point positioning (PPP) based on the ionosphere-free code-carrier combinations. Furthermore, with regard to the triple-frequency carrier-phase ionosphere-free and geometry-free combination, it is found

MRI for therapy planning in patients with atrial septum defects; MRT zur Therapieplanung bei Patienten mit Vorhofseptumdefekt

Energy Technology Data Exchange (ETDEWEB)

Huber, A.; Rummeny, E. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institut fuer Radiologie, Muenchen (Germany); Prompona, M.; Reiser, M.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Kozlik-Feldmann, R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Kinderkardiologie, Muenchen (Germany); Muehling, O. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik I, Muenchen (Germany)

2011-01-15

The aim of this study was to determine the value of a combined magnetic resonance imaging (MRI) protocol including steady-state free precession (SSFP) imaging, phase-contrast measurements and contrast-enhanced MR angiography (CE-MRA) for presurgical or preinterventional diagnostic imaging in patients with suspected atrial septum defects. Out of 65 MRI studies of patients with suspected atrial septum defects, 56 patients were included in the study. The atrial septum defects were identified on cine images. Velocity encoded flow measurements were used to determine shunt volumes, which were compared with invasive oxymetry in 24 patients. Contrast-enhanced MRI was used to assess the thoracic vessels in order to detect vascular anomalies. The findings were compared with the intraoperative results. A total of 24 patients with high shunt volumes were treated either surgically (16 patients) or interventionally (8 patients) and 32 patients with low shunt volumes did not require surgical or interventional treatment. The vascular anomaly, which in all cases was anomalous pulmonary venous return, was confirmed by the intraoperative findings. The type and location of atrial septal defects which required treatment, were confirmed intraoperatively or during the intervention. The results of shunt quantification by MRI showed a good correlation with the results of invasive oximetry (r=0.91, p <0.0001). A combined MRI protocol including cine SSFP images, velocity-encoded flow measurements and CE-MRA is an accurate method for preoperative and preinterventional evaluation of atrial septum defects. (orig.) [German] Ziel war es, die Wertigkeit eines kombinierten MRT-Protokolls aus Funktionsuntersuchung, Flussmessung und MR-Angiographie zur praeoperativen oder -interventionellen Abklaerung bei Patienten mit Vorhofseptumdefekt zu evaluieren. Ingesamt wurden 56 Patienten mit Vorhofseptumdefekt aus einem Kollektiv von 65 Patienten mit Verdacht auf Vorhofseptumdefekt, die im MRT untersucht

Wirksamkeit der Hypnose auf Schmerzen bei Erwachsenen: systematische Literaturreview

OpenAIRE

Pfaffen, Céline; Z`Brun-Schnyder, Silvia

2018-01-01

Das Ziel dieser systematischen Literaturreview ist es, die Wirksamkeit der Hypnose auf Schmerzen bei Erwachsenen zu überprüfen. Daraus ergibt sich folgende Forschungsfrage: "Wie wird die Wirksamkeit der Hypnose auf Schmerzen bei Erwachsenen in der wissenschaftlichen Literatur beschrieben?"

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.

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

Directory of Open Access Journals (Sweden)

Wei Zhang

2016-12-01

Full Text Available Objective: To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia. Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state. Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05. The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05. After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05. Conclusions: The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

Institute of Scientific and Technical Information of China (English)

Wei Zhang; Na Li; Ying-Ting Li; Shu-Qing Dong; Li-Mei Feng

2016-01-01

Objective:To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia.Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state.Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05). The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05). After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05).Conclusions:The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

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.

Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions.

Science.gov (United States)

Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Musculoskeletal complaints among physiotherapy and occupational therapy rehabilitation professionals in Bangladesh.

Science.gov (United States)

Islam, Md Shofiqul; Habib, Md Monjurul; Hafez, Md Abdul; Nahar, Nazmun; Lindstrom-Hazel, Debra; Rahman, Mohammad Khalilur

2015-01-01

Physiotherapy and occupational therapy professionals are at high risk of developing occupational musculoskeletal injuries globally. Musculoskeletal pain is the most common problem. To determine the extent of discomfort that physiotherapy and occupational therapy health professionals report while working at a physical rehabilitation centre. Physiotherapy and occupational therapy professionals which include both graduate and diploma physiotherapists and occupational therapists as well as physiotherapy and occupational therapy assistants. A self administered questionnaire (survey) was conducted on a convenient sample of 101 physiotherapy and occupational therapy personnel. The mean age of the 101 participants was 27.8 (± 4.5) years and most of the participants (62%) had less than 5 years of work experience. Ninety-five percent of the participants complained of work related pain. Most of the participants reported pain in the lower back (n=84) followed by upper back (n=71) and neck (n=66). Significant associations were found for pain in ankles/feet with age (p=0.05) and pain in neck with gender (p=0.01). Physiotherapy and occupational therapy professionals suffer from pain in relation to the work they do as therapists which may be due to non-practice of appropriate body mechanics. Mechanism to assess level of practice during dealing with patients may be introduced to enable corrective measures. Incentives should be considered for appropriate practice.

[The potential of general magnetic therapy for the treatment and rehabilitation (a review)].

Science.gov (United States)

Kulikov, A G; Voronina, D D

2016-01-01

This paper was designed to describe the main characteristics of general magnetic therapy and the mechanisms underlying its biological and therapeutic action. Special attention is given to the extensive application of this method in the routine clinical practice. The publications in the current scientific literature are reviewed in order to evaluate the potential of general magnetic therapy as a component of the combined treatment of various somatic pathologies, rehabilitation of the patients after surgical intervention with special reference to the management of the patients presenting with the oncological problems. The data suggesting good tolerability and high therapeutic effectiveness of the physiotherapeutic method under consideration.

The Integration of Cognitive Remediation Therapy into the Whole Psychosocial Rehabilitation Process: An Evidence-Based and Person-Centered Approach

Directory of Open Access Journals (Sweden)

Rafael Penadés

2012-01-01

Full Text Available Cognitive remediation therapies seem to ameliorate cognitive impairments in patients with schizophrenia. Interestingly, some improvement in daily functioning can also be expected as a result. However, to achieve these results it is necessary that cognitive remediation is carried out in the context of broader psychosocial rehabilitation involving the learning of other communication, social, and self-control skills. Unfortunately, little is known about how to integrate these different rehabilitation tools in broader rehabilitation programs. Based on both the neurocognitive behavioral approach and the action theory framework, a hierarchical flowchart is represented in this paper to integrate CRT with other evidence-based psychological therapies in outpatient settings. Finally, some evidence is provided in which cognitive abilities need to be targeted in remediation programs to improve functioning. In summary, to improve daily functioning, according to these studies, cognitive remediation needs to include the teaching of some cognitive strategies that target executive skills.

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

Science.gov (United States)

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

2018-01-01

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

[Osteopathie bei gastroösophagealem Reflux mit Hiatushernie: Ein Fallbericht gemäß der CARE-Leitlinie].

Science.gov (United States)

Rotter, Gabriele; Brinkhaus, Benno

2017-01-01

Hintergrund: Das Vorhandensein einer Hiatushernie kann das Auftreten einer gastroösophagealen Refluxerkrankung (GERD) als Komplikation bedingen. Konventionelle medizinische Therapiemaßnahmen können zu unerwünschten Ereignissen und Rezidiven führen. Bisher sind die Effekte von osteopathischen Behandlungen bei Hiatushernie und GERD nicht bekannt. Fallbericht: Eine 59-jährige Patientin mit endoskopisch diagnostizierter chronischer Gastritis, GERD und Hiatushernie beklagte einen persistierenden gastroösophagealen Reflux trotz konventionell-medizinischer konservativer Therapie. Die osteopathische Diagnostik ergab eine funktionelle Störung im Bereich des Magens und der Kardia mit einer Beteiligung zugehöriger Reflexzonen. Nach einer osteopathischen Behandlung als individuelle, befundorientierte Therapie ließen die Beschwerden erheblich nach. Die Hiatushernie war nach einer dieser Behandlung endoskopisch nicht mehr nachweisbar. Schlussfolgerungen: Dieser Fallbericht schildert die Symptomreduktion einer GERD nach osteopathischer Behandlung. In der endoskopischen Folgeuntersuchung fand sich die initial diagnostizierte Hiatushernie nicht mehr, diese Befund änderung könnte jedoch auf die unterschiedlichen Untersucher zurückgeführt werden. Prospektive kontrollierte klinische Studien sind notwendig, um den Stellenwert von osteopathischen Behandlungen bei GERD mit Hiatushernie zu untersuchen. © 2017 The Author(s). Published by S. Karger GmbH, Freiburg.

Wirksamkeit und Verträglichkeit von Mepartricin (Iperplasin® bei benigner Prostatahyperplasie: Ergebnisse eine Anwendungsbeobachtung

Directory of Open Access Journals (Sweden)

Madersbacher H

2000-01-01

Full Text Available Ziel der Studie: Das Ziel dieser Anwendungsbeobachtung war es, Wirksamkeit und Verträglichkeit von Mepartricin-Filmtabletten (Iperplasin® bei der Behandlung von Patienten mit benigner Prostatahyperplasie (BPH bzw. Prostatavergrößerung (BPE zu untersuchen. Patienten und Methoden: Im Rahmen einer österreichweiten Anwendungsbeobachtung wurden Patienten mit unterer Harntraktsymptomatik (LUTS, verursacht durch eine BPH/BPE, untersucht. Die wichtigsten Einschlußkriterien waren eine reduzierte maximale Harnflußrate (Qmax von 6-15 ml/sec und ein Restharn 100 ml. Als Studienmedikation erhielten die Patienten 3 x 1 Tbl. Iperplasin®. Ein, drei und sechs Monate nach Studienbeginn wurden die Patienten nachkontrolliert. Die wichtigsten Zielparameter waren eine Verbesserung des Internationalen Prostata Symptomen Scores (IPSS, der Lebensqualitätsfrage des IPSS (IPSS-Ql sowie des Qmax. Ein Einfluß auf die Sexualität wurde anhand des GRISS-Scores erhoben. Ergebnisse: Insgesamt wurden 130 Patienten (67,4 ± 8,4 Jahre; Durchschnitt ± Standardabweichung in diese Studie aufgenommen. Der IPSS sank von 16,4 ± 5,0 zu Studienbeginn auf 9,4 ± 6,0 (-41 %; p 0,0001 nach 6 Monaten Therapie, der IPSS-Ql von 3,3 ± 0,8 auf 2,0 ± 1,1 (-39 %; p 0,0001. Im gleichen Zeitraum stieg der Qmax von 11,3 ± 6,0 auf 12,5 ± 6,4 ml/sec (+11 %; p 0,0001, der Restharn sank von 49 ± 36 ml auf 33 ± 35 ml (-33 %; p 0,0001. Insgesamt war die Therapie mit Iperplasin® gut verträglich, bei 10 % traten im Rahmen der Studie unerwünschte Ereignisse oder interkurrente Erkrankungen auf, bei zwei Patienten mußte eine TURP durchgeführt werden. Der GRISS-Score blieb über den gesamten Studienzeitraum konstant. Schlußfolgerung: Diese Anwendungsbeobachtung belegt die Sicherheit von Iperplasin® bei Patienten mit LUTS und BPH/BPE, vor allem kommt zu keiner Beeinträchtigung der Vita sexualis. Obwohl eine signifikante Verbesserung von subjektiven und objektiven Parametern in dieser

Entwicklungstrends bei landwirtschaftlichen Applikationen - ein Zwischenfazit

Directory of Open Access Journals (Sweden)

Christa Hoffmann

2014-10-01

Full Text Available Globalisierung, volatile Märkte und der vermehrte Rückzug der Agrarpolitik aus der Marktregulierung sorgen dafür, dass die Entscheidungsfindungsprozesse auf landwirtschaftlichen Betrieben an Komplexität zunehmen. Applikationen bieten durch ihre Mobilität und individuellen Ausgestaltungsmöglichkeiten Optionen, um den Landwirt bei seiner täglichen Arbeit zu unterstützen. In diesem Kontext nimmt diese Arbeit eine Bestandsaufnahme und Kategorisierung nativer Applikationen mit landwirtschaftlichem Bezug vor. Die Ergebnisse zeigen unter anderem einen Angebotsschwerpunkt im Produktionszweig Pflanzenbau und bei den Funktionen bestimmte häufig auftretende bedarfsbedingte Kombinationen (z. B. Planung und Analyse.

Knochenstoffwechsel bei malignen Erkrankungen

Directory of Open Access Journals (Sweden)

Keck A-V

2003-01-01

Full Text Available Bei malignen Erkrankungen, wie dem Mammakarzinom, dem Prostatakarzinom, dem Bronchialkarzinom oder dem multiplen Myelom ist der Knochen eines der am häufigsten von Metastasen betroffenen Organe. Das klinische Beschwerdebild ist durch das Auftreten pathologischer Frakturen, Schmerzen und Hyperkalzämien gekennzeichnet. Eine erhöhte Knochenresorptionsrate und Verlust an Knochenmasse im Sinne von osteoporoseartigen Veränderungen bedingt durch eine inadäquat überschießende Osteoklastendifferenzierung und -aktivierung sind ursächlich dafür verantwortlich. Durch jüngst publizierte Ergebnisse diverser Studien und Untersuchungen konnten die genauen Mechanismen der Rekrutierung und Aktivierung von Osteoklasten weiter aufgeklärt werden. Receptor activator of nuclear factor-kappa-B ligand (RANKL, ein Mitglied der Tumor necrosis factor (TNF Superfamilie konnte als entscheidender Faktor in der Osteoklastengenese identifiziert werden. Die Interaktion von RANKL mit seinem Rezeptor RANK (receptor activator of nuclear factor-kappa-B induziert die Entwicklung der osteoklastären Reihe aus dem hämatopoetischen Kompartment und fördert weiters die Differenzierung zu Osteoklastenvorstufen und die Aktivierung reifer Osteoklasten, ebenso wird eine verzögert einsetzende Apoptose bewirkt. Neben RANK und RANKL ist Osteoprotegerin (OPG als dritte Komponente in der Regulation der Knochenresorption involviert. Als Mitglied der TNF-Superfamilie bindet OPG an RANKL und blockiert somit alle stimulierenden Effekte von RANK auf die Osteoklastenentwicklung und neutralisiert so alle biologischen Effekte von RANKL. Diverse Hormone und Zytokine üben durch die Modifikation der Ratio von RANKL zu OPG einen regulatorischen Effekt auf die Knochenresorption aus. Diese ist bei osteolytischen Knochenmetastasen, beim multiplen Myelom und bei der malignen Hyperkalzämie erhöht. Das Gleichgewicht knochenaufbauender wie -abbauender Mechanismen scheint somit durch die Ratio von

KRITIK SOSIAL DALAM KOMIK STRIP PAK BEI

Directory of Open Access Journals (Sweden)

Yudhi Novriansyah

2016-08-01

Full Text Available This research aimed to do interpret the marking which flange social criticism and know laboring ideology in story of Comic Strip Pak Bei. Research based on theory of structural semiotic according to Ferdinand De Saussure. Using analysis of Syntagmatic as first level of meaning to the text network and also picture, and analysis of Paradigmatic as second level of meaning or implicit meaning (connota-tion, myth, ideology Analysis done to six Comic choice edition of Strip Pak Bei period of November 2004 - Februari 2005 which tend to flange social criticism. At band of syntagmatic, result of research indicate that story theme lifted from social problems that happened in major society. The fact clear progressively when connected by Intertextual with information and texts which have preexisted. At band of Paradigmatic, social criticism tend to emerge dimly, is not transparent. Because of Comic Strip Pak Bei expand in the middle of Java cultural domination that developing myth of criticize as action menacing compatibility and orderliness of society. Story of Comic Strip Pak Bei also confirm dominant ideology in Java society culture, namely ideology of Patriarkhi and Feudalism which still go into effect until now. This prove ideology idea according to Louis Althusser which not again opposition between class, but have been owned and practiced by all social class.

Group therapy task training versus individual task training during inpatient stroke rehabilitation: a randomised controlled trial.

Science.gov (United States)

Renner, Caroline Ie; Outermans, Jacqueline; Ludwig, Ricarda; Brendel, Christiane; Kwakkel, Gert; Hummelsheim, Horst

2016-07-01

To compare the efficacy of intensive daily applied progressive group therapy task training with equally dosed individual progressive task training on self-reported mobility for patients with moderate to severe stroke during inpatient rehabilitation. Randomized controlled clinical trial. In-patient rehabilitation center. A total of 73 subacute patients with stroke who were not able to walk without physical assistance at randomisation. Patients were allocated to group therapy task training (GT) or individual task training (IT). Both interventions were intended to improve walking competency and comprised 30 sessions of 90 minutes over six weeks. Primary outcome was the mobility domain of the Stroke Impact Scale (SIS-3.0). Secondary outcomes were the other domains of SIS-3.0, standing balance, gait speed, walking distance, stair climbing, fatigue, anxiety and depression. No adverse events were reported in either arm of the trial. There were no significant differences between groups for the SIS mobility domain at the end of the intervention (Z= -0.26, P = 0.79). No significant differences between groups were found in gait speed improvements (GT:0.38 ±0.23; IT:0.26±0.35), any other gait related parameters, or in non-physical outcomes such as depression and fatigue. Inpatient group therapy task training for patients with moderate to severe stroke is safe and equally effective as a dose-matched individual task training therapy. Group therapy task training may be delivered as an alternative to individual therapy or as valuable adjunct to increase time spent in gait-related activities. © The Author(s) 2015.

[Evaluation on efficacy of Jin's "Sanzhen" therapy combined with rehabilitation training for hemiplegia of stroke patients by Fugl-Meyer scale].

Science.gov (United States)

Han, De-Xiong; Zhuang, Li-Xing; Zhang, Ying

2011-06-01

To assess the therapeutic effect of Jin's "Sanzhen" therapy combined with rehabilitation training on limb-motor function of stroke patients by using Fugl-Meyer scale. A total of 254 hemiplegic stroke outpatients and inpatients from 7 hospitals were randomly divided into Jin's "Sanzhen" (JSZ) group (n = 83), rehabilitation group (n = 84) and combination group (n = 87). Acupuncture was applied to acupoints of Jin's "Sanzhen" including Quchi (LI 11), Waiguan (SJ 5) and Hegu (LI 4); Futu (ST 32). Zusanli (ST 36) and Sanyinjiao (SP 6); etc. The acupuncture needles were retained for 30 min after "Deqi". Rehabilitation training included passive joint movement, standing-sitting training, tapping-pressing stimulation, walking training, etc. The treatment was conducted once daily, 5 sessions a week and for 4 weeks. Fugl-Meyer scale composed of 100-point motor domain of the upper- and lower-extremity sections was used to assess the patients' motor function. On day 28 after the treatment, of the 83.84 and 87 hemiplegic stroke patients in the JSZ, rehabilitation and combination groups, 48 (57.8%), 31 (36.9%) and 50 (57.5%) experienced marked improvement in their clinical symptoms and signs, 26 (31.3%), 44 (52.4%) and 31(35.6%) had an improvement, and 9 (10.8%), 9 (10.7%) and 6 (6.9%) failed in the treatment, with the total effective rates being 89.2%, 89.3% and 93.1%, respectively. The neurological deficit score (NDS) of the combination group was significantly lower than that of the rehabilitation group (P rehabilitation groups (P rehabilitation groups in both NDS and FMAS (P > 0.05). Jin's "Sanzhen" therapy combined with rehabilitation training can significantly improve the limb motor function of hemiplegic stroke patients, and has a good synergistic effect.

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

Science.gov (United States)

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

2018-04-03

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

Anwendung des Traumatherapieverfahrens -Narrative Expositionstherapie- bei komplex traumatisierten Patienten unter besonderer Berücksichtigung des Schlafes

OpenAIRE

Scharff, Anna-Lena

2016-01-01

Die Studie sollte aufgrund der häufigen Komorbidität einer Posttraumatischen Belastungsstörung mit der Borderline Persönlichkeitsstörung die Frage untersuchen, ob die Narrative Expositionstherapie einen Therapieerfolg bei komplex traumatisierten Patienten hat. Desweiteren sollte der Effekt der Therapie auf den Schlaf untersucht werden und eventuell prädiktive Zusammenhänge zwischen Schlafqualität und Therapieerfolg herausgestellt werden.

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

Directory of Open Access Journals (Sweden)

Tian Renton

Full Text Available Neurofeedback therapy (NFT has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i identifying how NFT is utilized to treat cognitive deficits following stroke, ii examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT and iii providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i were specific to a stroke population, ii delivered CRT via a NFT protocol, iii included participants who were affected by a cognitive deficit(s following stroke (i.e. memory loss, loss of executive function, speech impairment etc.. NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

Science.gov (United States)

Renton, Tian; Tibbles, Alana; Topolovec-Vranic, Jane

2017-01-01

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large

Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction.

Science.gov (United States)

Verdecchia, Daniel H; Mendoza, Marcela; Sanguineti, Florencia; Binetti, Ana C

2014-01-01

Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Krafttraining bei älteren "frail" Personen

Directory of Open Access Journals (Sweden)

Kapan A

2013-01-01

Full Text Available Aufgrund der demographischen Entwicklung in den westlichen Industrieländern kann bei einem Ausbleiben adäquater Präventionsmaßnahmen davon ausgegangen werden, dass in Österreich im Jahr 2050 356.000 gebrechliche („frail“ und 1,5 Millionen Personen mit Vorstufen erwartet werden können. Im Alter von 50–70 Jahren kann auch bei gesunder Ernährung und körperlicher Aktivität die Muskelkraft um bis zu 30 % nachlassen. Für den Erhalt der Mobilität und um dem Muskelabbau entgegenzuwirken nimmt das körperliche Training, vor allem das Krafttraining, einen wichtigen Stellenwert ein.

Manual for Training Leprosy Rehabilitation Workers.

Science.gov (United States)

Itoh, Masayoshi; Eason, Alice L.

The purpose of this manual is to introduce the general concepts and techniques in leprosy rehabilitation to physical therapy aides. Because of the lack of well-trained, qualified, physical therapists, the committee on leprosy rehabilitation considers it necessary to publish a teaching manual outlining leprosy rehabilitation for those who work with…

Stroke patients' experiences with Wii Sports® during inpatient rehabilitation

DEFF Research Database (Denmark)

Celinder, Dora; Peoples, Hanne

2012-01-01

INTRODUCTION: Commercial virtual reality games have been used as adjunct therapy for stroke rehabilitation, mainly after patients have been discharged. The aim of this study was to explore stroke patients' experiences with Wii Sports® as a supplement to conventional occupational therapy in a cont......INTRODUCTION: Commercial virtual reality games have been used as adjunct therapy for stroke rehabilitation, mainly after patients have been discharged. The aim of this study was to explore stroke patients' experiences with Wii Sports® as a supplement to conventional occupational therapy...... therapy services may benefit patient rehabilitation directly or provide motivation for alternative leisure activities....

Physical rehabilitation in complex therapy of the ureter stones patients in the Truskavets health resort area

Directory of Open Access Journals (Sweden)

Shologon R.P.

2010-05-01

Full Text Available Efficiency of rehabilitation measures is considered in complex therapy with the use of differentiated methods of medical physical education for patients with stones of ureter. Under a supervision there was 143 patients. 93 patients were made basic group, 50 patients - control. From them 51 (56 % are men and 42 (54% are women. Age of patients made from 20 to 60 years. A sanatorium-resort rehabilitation is recommended with the use of the differentiated methods of medical gymnastics. Application of method improved the indexes of the functional state of buds and overhead urinary ways. Frequency of advancement and output of concrements is also megascopic.

Temporary balloon occlusion as therapy for uncontrollable arterial hemorrhage in multiply injured patients; Temporaere Ballonokklusion als Therapie unkontrollierbarer arterieller Blutungen bei Polytraumapatienten

Energy Technology Data Exchange (ETDEWEB)

Rieger, J.; Linsenmaier, U.; Rock, C.; Pfeifer, K.J. [Abt. fuer Radiologie, Klinikum Innenstadt, Ludwig-Maximilian-Univ., Muenchen (Germany); Euler, E. [Chirurgische Klinik und Poliklinik, Klinikum Innenstadt, Ludwig-Maximilian-Univ., Muenchen (Germany)

1999-01-01

Purpose: Presentation of temporary balloon occlusion as an interventional radiological method for managing hemorrhage in multiply injured patients with uncontrollable loss of blood. Method: Temporary, non-selective arterial occlusion by introduction of a balloon catheter contralaterally to the source of bleeding has been performed since 1992 on 7 patients with multiple injuries, hemorrhagic shock requiring reanimation, and angiographic demonstration of an arterial hemorrhage in the supply region of the internal iliac artery with complex pelvic fracture. In each case a PTA balloon catheter was introduced transfemorally, non-selectively positioned proximal to the bleeding source, and left in place for 24-48 h under manometric control. Control angiographies were performed prior to catheter removal. Results: The bleeding was stopped immediately in all 7 patients. The hemodynamic stability made transport and thus further surgical management and/or a short-term treatment in the intensive-care station possible. Control angiographies confirmed that the bleeding had stopped in all patients. Conclusions: We recommend temporary balloon occlusion as a rapid and effective method for the management of bleeding in otherwise uncontrollable traumatic hemorrhages in the supply region of the internal iliac artery. (orig.) [Deutsch] Ziel: Vorstellung der temporaeren Ballonokklusion als interventionell-radiologischer Methode zur Blutungskontrolle bei Polytraumapatienten mit unkontrollierbarem Blutverlust. Methode: Temporaerer, nicht-selektiver arterieller Gefaessverschluss mit kontralateral der Blutungsquellen eingefuehrten PTA-Ballonkathetern bei seit 1992 insgesamt 7 Patienten mit Polytrauma, reanimationspflichtigem haemorrhagischem Schock und angiographischem Nachweis einer arteriellen Blutung im Versorgungsgebiet der A. iliaca interna im Rahmen einer komplexen Beckenfraktur. Transfemoral wurde jeweils ein PTA-Ballonkatheter eingefuehrt, nicht selektiv proximal der Blutungsquelle

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

Energy Technology Data Exchange (ETDEWEB)

Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany); Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Gruenwald, F. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Frankfurt (Germany); Leisner, B. [Abt. fuer Nuklearmedizin des Allg. Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Muenster (Germany)

2004-12-01

The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3{sup rd} version. (orig.) [German] Die Version 3 der Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen stellt im Wesentlichen eine redaktionelle Ueberarbeitung der Version 2 dar. Im Kapitel Indikation und Empfehlungen fuer eine Radioiodtherapie, eine Operation oder eine thyreostatische Therapie bei gutartigen Schilddruesenerkrankungen basiert die Leitlinie auf einem interdisziplinaer abgestimmten Konzept. Die Entscheidungskriterien sind multifaktoriell und beruecksichtigen die Art der Schilddruesenerkrankung (Autonomie, Morbus Basedow, Struma, Rezidivstruma

UMA PROSPOSTA DEDUTIVISTA PARA PRINCÍPIOS CONTÁBEIS

Directory of Open Access Journals (Sweden)

Paulo Schmidt

2009-09-01

Full Text Available A proposta deste estudo a apresentar um breve relato sobre a evolução do pensamento cientifico ocorrida na física com a substituição dos princípios contábeis e filosófico, desde a Antiguidade grega ate os dias de hoje, como forma de fundamentar o posicionamento contrario ao raciocínio indutivo para o estabelecimento de uma estrutura conceitual para a contabilidade e para o desenvolvimento dos princípios contábeis. Apos essa incursão pelo campo filosófico, será aduzido um dos trabalhos de D. R. Scott, ex-professor da Universidade de Michigan, que já na década de 1930 defendia o processo de raciocínio dedutivo e a necessidade de coerência e unidade para o estabelecimento dos princípios contábeis. Este estudo justifica-se, principalmente, porque ainda existem pesquisadores da área contábil que defendem o método indutivo com único procedimento cientifico capaz de levar a certeza, Como defendia Descartes. Alem disso, mesmo apos a revolução cientifica princípios teóricos de Newton, pelos princípios da teoria da relatividade de Einstein, alguns pesquisadores defendem a imutabilidade dos princípios contábeis, como sendo verdades indubitáveis, não aceitando o permanente desenvolvimento da teoria contábil e sua continua adaptabilidade a nova realidade ambiental. A contabilidade, assim como toda disciplina do conhecimento humano que postula um patamar cientifico, deve estruturar-se com base em um conjunto de princípios racionalmente dispostos. Diante desse panorama, faz-se mister inquirir se os princípios contábeis podem ser oniscientes e impassíveis as mudanças do mundo?

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.

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury.

Science.gov (United States)

Cuthbert, Jeffrey P; Staniszewski, Kristi; Hays, Kaitlin; Gerber, Don; Natale, Audrey; O'Dell, Denise

2014-01-01

To evaluate the feasibility and safety of utilizing a commercially available virtual reality gaming system as a treatment intervention for balance training. A randomized controlled trial in which assessment and analysis were blinded. An inpatient rehabilitation facility. Interventions included balance-based physical therapy using a Nintendo Wii, as monitored by a physical therapist, and receipt of one-on-one balance-based physical therapy using standard physical therapy modalities available for use in the therapy gym. Participants in the standard physical therapy group were found to have slightly higher enjoyment at mid-intervention, while those receiving the virtual reality-based balance intervention were found to have higher enjoyment at study completion. Both groups demonstrated improved static and dynamic balance over the course of the study, with no significant differences between groups. Correlational analyses suggest a relationship exists between Wii balance board game scores and BBS scores for measures taken beyond the baseline assessment. This study provides a modest level of evidence to support using commercially available VR gaming systems for the treatment of balance deficits in patients with a primary diagnosis of TBI receiving inpatient rehabilitation. Additional research of these types of interventions for the treatment of balance deficits is warranted.

The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review.

Science.gov (United States)

Madera, Marcella; Brady, Jeremy; Deily, Sylvia; McGinty, Trent; Moroz, Lee; Singh, Devender; Tipton, George; Truumees, Eeric

2017-06-01

OBJECTIVE The purpose of this study was to provide a systematic and comprehensive review of the existing literature regarding postfusion rehabilitation. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors conducted an exhaustive review of multiple electronic databases. Potential articles were screened using inclusion/exclusion criteria. Two authors independently analyzed these studies using predefined data fields, including study quality indicators such as level of evidence and availability of accepted patient-reported outcomes measures. These findings were synthesized in a narrative format. A third author resolved disagreements regarding the inclusion of a study. RESULTS Twenty-one articles with I or II levels of evidence were included in the review. The authors divided the findings of the literature review into several groups: rehabilitation terminology, timing and duration of postfusion rehabilitation, the need for rehabilitation relative to surgery-related morbidity, rehabilitation's relationship to outcomes, and cognitive and psychosocial aspects of postsurgical rehabilitation. Current evidence generally supports formal rehabilitation after lumbar fusion surgery. Starting physical therapy at the 12-week postoperative mark results in better outcomes at lower cost than an earlier, 6-week start. Where available, psychosocial support improves outcomes. However, a number of the questions could not be answered with high-grade evidence. In these cases, the authors used "best evidence available" to make recommendations. There are many cases in which different types of caregivers use clinical terminology differently. The data supporting an optimal protocol for postfusion rehabilitation remains elusive but, using the data available, the authors have crafted recommendations and a model protocol, which is currently undergoing prospective study. CONCLUSIONS Rehabilitation has long been a common feature in

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.

[The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

Science.gov (United States)

Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

2003-01-01

The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the

[The application of laser therapy for the medical rehabilitation of the children presenting with chronic osteomyelitis].

Science.gov (United States)

Trunova, O V; Mashkov, A E; Khan, M A; Prikuls, V F; Nazarenko, N N; Supova, M V; Smirnova, S N; Larionov, K S

2015-01-01

The objective of the present study was to develop a scientifically sound rationale for the application of infrared laser radiation (IRLR) either separately or in the combination with fluctuation magnetic therapy in the medical rehabilitation of the children presenting with chronic hematogenous osteomyelitis. Another objective was to evaluate the clinical effectiveness of this therapeutic modality. Two achieve these goals, the clinical observations and special research studies were conducted in two directions with the participation of 95 patients at the age varying from 1 to 15 years. The study has demonstrated the effectiveness of the inclusion of IRLR in the medical rehabilitation program for the children with chronic hematogenous osteomyelitis in different periods of the disease. It was shown that the transcutaneous infrared irradiation of the affected area during the exacerbation of chronic osteomyelitis had a well apparent immunostimulatory effect and reduced the activity of the inflammatory process. The application of IRLR in combination with fluctuation magnetic therapy during the period of partial remission, had a more pronounced influence on the microcirculation and stimulated the regenerative and trophic processes.

Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke: protocol of the CIRCIT trial.

Science.gov (United States)

Hillier, Susan; English, Coralie; Crotty, Maria; Segal, Leonie; Bernhardt, Julie; Esterman, Adrian

2011-12-01

There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown. To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-days per week therapy services or group circuit class therapy over five-days a week) to usual care for people receiving inpatient rehabilitation after stroke. Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes. A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure (FIM) score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions: • usual care therapy over five-days a week • standard care therapy over seven-days a week, or • group circuit class therapy over five-days a week. Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat. The primary outcome measure is walking ability (six-minute walk test) at four-week postintervention with three- and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Wii-based interactive video games as a supplement to conventional therapy for rehabilitation of children with cerebral palsy: A pilot, randomized controlled trial.

Science.gov (United States)

Sajan, Jane Elizabeth; John, Judy Ann; Grace, Pearlin; Sabu, Sneha Sara; Tharion, George

2017-08-01

To assess the effect of interactive video gaming (IVG) with Nintendo Wii (Wii) supplemented to conventional therapy in rehabilitation of children with cerebral palsy (CP). Randomized, controlled, assessor-blinded study. Children with CP; 10 children each in the control and intervention groups. IVG using Wii, given as a supplement to conventional therapy, for 45 min per day, 6 days a week for 3 weeks. The children in the control group received conventional therapy alone. Posture control and balance, upper limb function, visual-perceptual skills, and functional mobility. Significant improvement in upper limb functions was seen in the intervention group but not in the control group. Improvements in balance, visual perception, and functional mobility were not significantly different between control and intervention groups. Wii-based IVG may be offered as an effective supplement to conventional therapy in the rehabilitation of children with CP.

Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: focused review and results of new randomized controlled trial.

Science.gov (United States)

Masiero, Stefano; Armani, Mario; Rosati, Giulio

2011-01-01

The successful motor rehabilitation of stroke patients requires early intensive and task-specific therapy. A recent Cochrane Review, although based on a limited number of randomized controlled trials (RCTs), showed that early robotic training of the upper limb (i.e., during acute or subacute phase) can enhance motor learning and improve functional abilities more than chronic-phase training. In this article, a new subacute-phase RCT with the Neuro-Rehabilitation-roBot (NeReBot) is presented. While in our first study we used the NeReBot in addition to conventional therapy, in this new trial we used the same device in substitution of standard proximal upper-limb rehabilitation. With this protocol, robot patients achieved similar reductions in motor impairment and enhancements in paretic upper-limb function to those gained by patients in a control group. By analyzing these results and those of previous studies, we hypothesize a new robotic protocol for acute and subacute stroke patients based on both treatment modalities (in addition and in substitution).

[Possibilities of transcranial magnetic therapy and color and rhythm therapy in rehabilitation of ischemic stroke].

Science.gov (United States)

Sholomov, I I; Cherevashchenko, L A; Suprunov, O V; Raĭgorondskiĭ, Iu M

2009-01-01

One hundred and sixteen post-stroke patients were studied in the early rehabilitation period. All patients were divided into 4 groups: 3 main and 1 control groups. Three main groups (87 patients) received transcranial magnetic therapy (TMT) and/or color and rhythm therapy (CRT) along with traditional treatment and the control group (29 patients) received only basic therapy. TMT was conducted using bitemporal technique, running regime with modulation frequency 1-10 Hz. In CRT, the alternating stimulation of the right and left eye with green and/or blue color with a period of 2-4 s and duration of luminescence 1s was applied. Each of 3 main groups received 2 treatment sessions with an interval of 1,5 month (1st - TMT, 2nd - CRT, 3rd - TMT + CRT). After the treatment, the marked positive changes were seen in all main groups, in particular in group 3. The improvement of neurologic symptoms on the B. Lindmark scale was higher by 9,5% in group 3 compared to the control one, on the Barthel index - by 8,8%, on MMSE and A. Luria and Schulte test - by 5,4 and 14,3%, respectively. Rheographic and encephalographic study revealed the significant improvement of hemodynamics and alpha-rhythm differentiation, decrease of patients with dysrhythmia by 14,6% in group 3 as compared to the control group. The best results were seen in the combination of TMT and CRT, TMT exerted a higher effect on the hemodynamics and CRT - on the psychoemotional state. Both therapies were well tolerated and had no side-effects.

Early Rehabilitation After Stroke: a Narrative Review.

Science.gov (United States)

Coleman, Elisheva R; Moudgal, Rohitha; Lang, Kathryn; Hyacinth, Hyacinth I; Awosika, Oluwole O; Kissela, Brett M; Feng, Wuwei

2017-11-07

Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain's dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits. Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge. The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

Application of hyperbaric oxygen therapy in the rehabilitation of patients after surgical correction of the penile urethral strictures

Directory of Open Access Journals (Sweden)

Kotenko К.V.

2013-12-01

Full Text Available The aim of the article is to examine the impact and justify the use of hyperbaric oxygenation in the complex rehabilitation of patients after surgery for penile urethral strictures. Material and Methods. A group of 37 patients were examined who underwent various reconstructive operations on the urethra, 16 of which in the postoperative period in addition to conventional therapy conducted hyperbaric oxygenation. Results. It is shown that the use of hyperbaric oxygenation in the early postoperative period in patients undergoing replacement plastic of urethra can reduce the incidence of postoperative complications, and reduced the time of urethral drainage. Conclusion. An integrated approach with the use of hyperbaric oxygen therapy in the rehabilitation of patients undergoing extended replacement plastic of penile urethral strictures, reduces the amount of potential effect-dependent postoperative complications, which generally leads to shorter hospital stay after surgical treatment.

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

Science.gov (United States)

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

2015-01-01

To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

[Cognitive rehabilitation of amusia].

Science.gov (United States)

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

2008-06-01

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

Cryotherapy in rheumatic disorders; Kryotherapie bei rheumatischen Erkrankungen

Energy Technology Data Exchange (ETDEWEB)

Soerensen, H. [Rheumaklinik Immanuel-Krankenhaus, Berlin (Germany). Innere Rheumatologische Abt.

1994-12-31

When applied locally, cold therapy (cryotherapy) has the effect of inhibiting inflammation, occluding blood vessels, and stopping bleeding. Active rheumatic inflammation, activated arthrosis, and swelling after injury can be alleviated by local cold application, while heat application would worsen the situation. In whole-body cryotherapy the whole patient, wearing only a bathing suit, is exposed to a temperature of -100 C. The present paper descrcribes the cold room of the Immanuel Hospital in Berlin-Wannsee. (BWI) [Deutsch] Kaeltetherapie (Kryotherapie) wirkt lokal angewendet entzuendungshemmend, blutgefaessabdichtend und blutstillend. Eine aktive rheumatische Entzuendung, aktivierte Arthrose und Schwellungsreaktionen bei Verletzungen werden durch lokale Kaelteanwendungen gedaempft, wogegen Waerme den akuten Zustand verschlimmern wuerde. In der Ganzkoerperkaeltetherapie wird der ganze Mensch in Badebekleidung einer realen Temperatur von -100 C ausgesetzt. Der vorliegende Beitrag beschreibt die Kaeltekammer des Immanuel Krankenhauses in Berlin Wannsee. (BWI)

Impact of pretreatment variables on the outcome of {sup 131}I therapy with a standardized dose of 150 Gray in Graves` disease; Einfluss praetherapeutischer Variablen auf die Wirkung einer standardisierten {sup 131}J-Therapie mit 150 Gray beim Morbus Basedow

Energy Technology Data Exchange (ETDEWEB)

Pfeilschifter, J. [Heidelberg Univ., Radiologische Klinik (Germany). Abt. fuer Nuklearmedizin; Elser, H. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I; Haufe, S. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I; Ziegler, R. [Heidelberg Univ., Radiologische Klinik (Germany). Abt. fuer Nuklearmedizin; Georgi, P. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I

1997-04-01

Aim: We examined the impact of several pretreatment variables on thyroid size and function in 61 patients with Graves` disease one year after a standardized [131]I treatment with 150 Gray. Methods: FT3, FT4, and TSH serum concentrations were determined before and 1.5, 3, 6, and 12 months after therapy. Thyroid size was measured by ultrasound and scintigraphy before and one year after therapy. Results: One year after therapy, 30% of the patients had latent or manifest hyperthyroidism, 24% were euthyroid, and 46% had developed latent or manifest hypothyroidism. Age and initial thyroid volume were major predictors of posttherapeutical thyroid function. Thus, persistent hyperthyroidism was observed in 70% of the patients age 50 years and older with a thyroid size of more than 50 ml. With few exception, thyroid size markedly decreased after therapy. Initial thyroid size and age were also major predictors of posttherapeutical thyroid volume. Thyroid size normalized in all patients younger than 50 years of age, independent from initial thyroid size. Conclusion: Radioiodine treatment with 150 Gray causes a considerable decrease in thyroid size in most patients with Graves` disease. Age and initial thyroid volume are important determinants of thyroid function and size after therapy and should be considered in dose calculation. (orig.) [Deutsch] Ziel: Bei 61 Patienten mit einem Morbus Basedow haben wir den Einfluss praetherapeutischer Variablen auf die Funktion und das Volumen der Schilddruese ein Jahr nach einer {sup 131}J-Therapie mit 150 Gray untersucht. Methoden: FT3, FT4, und TSH wurden vor Therapie und eineinhalb, 3, 6 und 12 Monate nach Therapie gemessen. Das Schilddruesenvolumen wurde vor Therapie und ein Jahr nach Therapie sonographisch und szintigraphisch bestimmt. Ergebnisse: Ein Jahr nach Therapie waren 30% der Patienten latent oder manifest hyperthyreot, 24% euthyreot, und 46% latent oder manifest hypothyreot. Lebensalter und Ausgangsvolumen der Schilddruese

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

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Stabile KHK und Hypertonie: Diagnostik, medikamentöse Therapie und Revaskularisierungsstrategien

OpenAIRE

Elsner D

2008-01-01

Nicht nur eine koronare Herzerkrankung (KHK) sondern auch Mikrozirkulationsstörungen führen bei Hypertonikern häufig zum Symptom der Angina pectoris. Grundpfeiler in der Diagnostik der KHK sind die entsprechenden Belastungstests. Allerdings ist die Aussagekraft bei Hypertonikern, insbesondere von Belastungs- EKG und Myokardszintigramm, eingeschränkt. Goldstandard bleibt daher die Koronarangiographie. Basis der Therapie der KHK ist die Modifikation des Lebensstils und Ausschaltung bz...

PET in cerebrovascular disease; PET bei zerebrovaskulaeren Erkrankungen

Energy Technology Data Exchange (ETDEWEB)

Herholz, K. [Neurologische Universitaetsklinik der Univ. Koeln (Germany)]|[Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

1997-03-01

Tissue viability is of particular interest in acute cerebral ischemia because it may be preserved if reperfusion can be achieved rapidly, e.g. by acute thrombolysis. Measurements of regional cerebral blood flow (CBF) and oxygen consumption by PET can assess tissue viability, and they have substantially increased our knowledge of th pathophysiology of ischemic stroke and the associated penumbra. Widerspread clinical application in acute stroke, however, is unlikely because of the large logistic and personnel resources required. In chronic cerebrovascular disease, measurement of regional CBF and glucose metabolism, which is usually coupled, provide detailed insights in disturbance of cortical function, e.g. due to deafferentiation, and contribute to differentiation of dementia types. Chronic misery perfusion, i.e. reduced perfusion that does not match the metabolic demand of the tissue, can be demonstrated by PET. It may be found in some patients with high-grade arterial stenoses. Less severe impairment of brain perfusion can be demonstrated by measurement of the cerebrovascular reserve capacity. The most frequent clinical situations can be assessed by less demanding procedures, e.g. by SPECT. In conclusion, PET has its role in cerebrovascular disease primarily within scientific studies, where high resolution and absolute quantitation of physiological variables are essential. (orig.). 65 refs. [Deutsch] Beim akuten ischaemischen Insult ist die Vitalitaet des Gewebes von besonderem Interesse, da sie durch rasche Reperfusion, z.B. durch Thrombolyse, erhalten bleiben kann. Messungen der zerebralen Durchblutung und des Sauerstoffumsatzes mittels PET geben darueber wesentliche Aufschluesse, und sie sind wichtig fuer das Verstaendnis der Pathophysiologie ischaemischer Infarkte und der Penumbra mit kritischer Perfusion beim Menschen. Ihre breitere Anwendung in der klinischen Patientenversorgung kommt allerdings wegen des hohen Aufwandes derzeit kaum in Betracht. Bei

Massage therapy in post-operative rehabilitation of children and adolescents with cerebral palsy - a pilot study.

Science.gov (United States)

Nilsson, Stefan; Johansson, Gunilla; Enskär, Karin; Himmelmann, Kate

2011-08-01

The purpose of this pilot study was to explore the use of massage therapy in children with cerebral palsy undergoing post-operative rehabilitation. Three participants were randomized to massage therapy and another three participants to rest. All children had undergone surgery in one or two lower limbs. Pain, wellbeing, sleep quality, heart rate and qualitative data were collected for each child. The scores of pain intensity and discomfort were low in all participants. Heart rate decreased in participants who were randomized to rest, but no change was found in the massage therapy group. The lack of decrease in heart rate in the study group of massage therapy may imply an increased sensitivity to touch in the post-operative setting. Further research with larger study populations are needed to evaluate how and when massage therapy is useful for children with cerebral palsy. Copyright © 2010 Elsevier Ltd. All rights reserved.

The effects of repeated rehabilitation “Tune-Ups” on functional recovery after stroke

DEFF Research Database (Denmark)

Clarke, Jared; Mala, Hana; Windle, Victoria

2008-01-01

and rehabilitative reaching (i.e. “enriched/rehab”). Following 9 weeks of treatment, all animals were placed in standard housing for 5 weeks, after which they received 2 weeks of intensive therapy consisting of enhanced enriched environments and structured sensorimotor/cognitive rehabilitative activities (i.e. “Tune......Objectives: For the vast majority of stroke survivors, rehabilitation (i.e. physiotherapy and occupational therapy) is the only treatment option available. Following an initial phase of rehabilitation, many patients are sent home and return periodically for brief periods of therapy … often lasting...... just days. It is unclear what, if any, benefit this periodic return to therapy has for functional recovery, and if the type and intensity of therapy is optimal for maintaining or further enhancing functional gains. While the beneficial effects of early rehabilitation on neuroplasticity and functional...

Development and Evaluation of the Biogenic Emissions Inventory System (BEIS) Model v3.6

Science.gov (United States)

We have developed new canopy emission algorithms and land use data for BEIS v3.6. Simulations with BEIS v3.4 and BEIS v3.6 in CMAQ v5.0.2 are compared these changes to the Model of Emissions of Gases and Aerosols from Nature (MEGAN) and evaluated the simulations against observati...

Rehabilitation robotics.

Science.gov (United States)

Krebs, H I; Volpe, B T

2013-01-01

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

Motivational Rehabilitation using Serious Games

Directory of Open Access Journals (Sweden)

Antoni Jaume i Capó

2013-11-01

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

Adaptive rehabilitation gaming system: on-line individualization of stroke rehabilitation.

Science.gov (United States)

Nirme, Jens; Duff, Armin; Verschure, Paul F M J

2011-01-01

The effects of stroke differ considerably in degree and symptoms for different patients. It has been shown that specific, individualized and varied therapy favors recovery. The Rehabilitation Gaming System (RGS) is a Virtual Reality (VR) based rehabilitation system designed following these principles. We have developed two algorithms to control the level of task difficulty that a user of the RGS is exposed to, as well as providing controlled variation in the therapy. In this paper, we compare the two algorithms by running numerical simulations and a study with healthy subjects. We show that both algorithms allow for individualization of the challenge level of the task. Further, the results reveal that the algorithm that iteratively learns a user model for each subject also allows a high variation of the task.

Interdisciplinary Cognitive-Behavioral Therapy as Part of Lumbar Spinal Fusion Surgery Rehabilitation: Experience of Patients With Chronic Low Back Pain.

Science.gov (United States)

Lindgreen, Pil; Rolving, Nanna; Nielsen, Claus Vinther; Lomborg, Kirsten

2016-01-01

Patients receiving lumbar spinal fusion surgery often have persisting postoperative pain negatively affecting their daily life. These patients may be helped by interdisciplinary cognitive-behavioral therapy which is recognized as an effective intervention for improving beneficial pain coping behavior, thereby facilitating the rehabilitation process of patients with chronic pain. The purpose of this study was to describe the lived experience of patients recovering from lumbar spinal fusion surgery and to explore potential similarities and disparities in pain coping behavior between receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. We conducted semistructured interviews with 10 patients; 5 receiving cognitive-behavioral therapy in connection with their lumbar spinal fusion surgery and 5 receiving usual care. We conducted a phenomenological analysis to reach our first aim and then conducted a comparative content analysis to reach our second aim. Patients' postoperative experience was characterized by the need to adapt to the limitations imposed by back discomfort (coexisting with the back), need for recognition and support from others regarding their pain, a relatively long rehabilitation period during which they "awaited the result of surgery", and ambivalence toward analgesics. The patients in both groups had similar negative perception of analgesics and tended to abstain from them to avoid addiction. Coping behavior apparently differed among receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. Receivers prevented or minimized pain by resting before pain onset, whereas nonreceivers awaited pain onset before resting. The postoperative experience entailed ambivalence, causing uncertainty, worry and insecurity. This ambivalence was relieved when others recognized the patient's pain and offered support. Cognitive-behavioral therapy as part of rehabilitation may have encouraged beneficial pain coping

A treatment for a chronic stroke patient with a plegic hand combining CI therapy with conventional rehabilitation procedures: case report.

Science.gov (United States)

Bowman, Mary H; Taub, Edward; Uswatte, Gitendra; Delgado, Adriana; Bryson, Camille; Morris, David M; McKay, Staci; Mark, Victor W

2006-01-01

Constraint-Induced Movement therapy (CI therapy) is a recognized rehabilitation approach for persons having stroke with mild to moderately severe motor upper extremity deficits. To date, no rehabilitation treatment protocol has been proven effective that addresses both motor performance and spontaneous upper extremity use in the life situation for chronic stroke participants having severe upper extremity impairment with no active finger extension or thumb abduction. This case report describes treatment of a chronic stroke participant with a plegic hand using a CI therapy protocol that combines CI therapy with selected occupational and physical therapy techniques. Treatment consisted of six sessions of adaptive equipment and upper extremity orthotics training followed by a three-week, six-hour daily intervention of CI therapy plus neurodevelopmental treatment. Outcome measures included the Motor Activity Log for very low functioning patients (Grade 5 MAL), upper extremity portion of the Fugl-Meyer Motor Assessment, Graded Wolf Motor Function Test - for very low functioning patients (gWMFT- Grade 5), and Modified Ashworth Scale. The participant showed improvement on each outcome measure with the largest improvement on the Grade 5 MAL. In follow-up, the participant had good retention of his gains in motor performance and use of his more affected arm for real world activities after 3 months; after a one-week brush-up at 3 months, and at one year post-treatment.

Accelerometer-based wireless body area network to estimate intensity of therapy in post-acute rehabilitation

Directory of Open Access Journals (Sweden)

Hamel Mathieu

2008-09-01

Full Text Available Abstract Background It has been suggested that there is a dose-response relationship between the amount of therapy and functional recovery in post-acute rehabilitation care. To this day, only the total time of therapy has been investigated as a potential determinant of this dose-response relationship because of methodological and measurement challenges. The primary objective of this study was to compare time and motion measures during real life physical therapy with estimates of active time (i.e. the time during which a patient is active physically obtained with a wireless body area network (WBAN of 3D accelerometer modules positioned at the hip, wrist and ankle. The secondary objective was to assess the differences in estimates of active time when using a single accelerometer module positioned at the hip. Methods Five patients (77.4 ± 5.2 y with 4 different admission diagnoses (stroke, lower limb fracture, amputation and immobilization syndrome were recruited in a post-acute rehabilitation center and observed during their physical therapy sessions throughout their stay. Active time was recorded by a trained observer using a continuous time and motion analysis program running on a Tablet-PC. Two WBAN configurations were used: 1 three accelerometer modules located at the hip, wrist and ankle (M3 and 2 one accelerometer located at the hip (M1. Acceleration signals from the WBANs were synchronized with the observations. Estimates of active time were computed based on the temporal density of the acceleration signals. Results A total of 62 physical therapy sessions were observed. Strong associations were found between WBANs estimates of active time and time and motion measures of active time. For the combined sessions, the intraclass correlation coefficient (ICC was 0.93 (P ≤ 0.001 for M3 and 0.79 (P ≤ 0.001 for M1. The mean percentage of differences between observation measures and estimates from the WBAN of active time was -8.7% ± 2.0% using

An intercomparison of biogenic emissions estimates from BEIS2 and BIOME: Reconciling the differences

Energy Technology Data Exchange (ETDEWEB)

Wilkinson, J.G. [Alpine Geophysics, Pittsburgh, PA (United States); Emigh, R.A. [Alpine Geophysics, Boulder, CO (United States); Pierce, T.E. [Atmospheric Characterization and Modeling Division/NOAA, Research Triangle Park, NC (United States)

1996-12-31

Biogenic emissions play a critical role in urban and regional air quality. For instance, biogenic emissions contribute upwards of 76% of the daily hydrocarbon emissions in the Atlanta, Georgia airshed. The Biogenic Emissions Inventory System-Version 2.0 (BEIS2) and the Biogenic Model for Emissions (BIOME) are two models that compute biogenic emissions estimates. BEIS2 is a FORTRAN-based system, and BIOME is an ARC/INFO{reg_sign} - and SAS{reg_sign}-based system. Although the technical formulations of the models are similar, the models produce different biogenic emissions estimates for what appear to be essentially the same inputs. The goals of our study are the following: (1) Determine why BIOME and BEIS2 produce different emissions estimates; (2) Attempt to understand the impacts that the differences have on the emissions estimates; (3) Reconcile the differences where possible; and (4) Present a framework for the use of BEIS2 and BIOME. In this study, we used the Coastal Oxidant Assessment for Southeast Texas (COAST) biogenics data which were supplied to us courtesy of the Texas Natural Resource Conservation Commission (TNRCC), and we extracted the BEIS2 data for the same domain. We compared the emissions estimates of the two models using their respective data sets BIOME Using TNRCC data and BEIS2 using BEIS2 data.

Vacuum therapy in penile rehabilitation after radical prostatectomy: review of hemodynamic and antihypoxic evidence.

Science.gov (United States)

Qian, Sheng-Qiang; Gao, Liang; Wei, Qiang; Yuan, Jiuhong

2016-01-01

Generally, hypoxia is a normal physiological condition in the flaccid penis, which is interrupted by regular nocturnal erections in men with normal erectile function. [1] Lack of spontaneous and nocturnal erections after radical prostatectomy due to neuropraxia results in persistent hypoxia of cavernosal tissue, which leads to apoptosis and degeneration of cavernosal smooth muscle fibers. Therefore, overcoming hypoxia is believed to play a crucial role during neuropraxia. The use of a vacuum erectile device (VED) in penile rehabilitation is reportedly effective and may prevent loss of penile length. The corporal blood after VED use is increased and consists of both arterial and venous blood, as revealed by color Doppler sonography and blood gas analysis. A similar phenomenon was observed in negative pressure wound therapy (NPWT). However, NPWT employs a lower negative pressure than VED, and a hypoperfused zone, which increases in response to negative pressure adjacent to the wound edge, was observed. Nonetheless, questions regarding ideal subatmospheric pressure levels, modes of action, and therapeutic duration of VED remain unanswered. Moreover, it remains unclear whether a hypoperfused zone or PO 2 gradient appears in the penis during VED therapy. To optimize a clinical VED protocol in penile rehabilitation, further research on the mechanism of VED, especially real-time PO 2 measurements in different parts of the penis, should be performed.

Vacuum therapy in penile rehabilitation after radical prostatectomy: review of hemodynamic and antihypoxic evidence

Directory of Open Access Journals (Sweden)

Sheng-Qiang Qian

2016-01-01

Full Text Available Generally, hypoxia is a normal physiological condition in the flaccid penis, which is interrupted by regular nocturnal erections in men with normal erectile function. [1] Lack of spontaneous and nocturnal erections after radical prostatectomy due to neuropraxia results in persistent hypoxia of cavernosal tissue, which leads to apoptosis and degeneration of cavernosal smooth muscle fibers. Therefore, overcoming hypoxia is believed to play a crucial role during neuropraxia. The use of a vacuum erectile device (VED in penile rehabilitation is reportedly effective and may prevent loss of penile length. The corporal blood after VED use is increased and consists of both arterial and venous blood, as revealed by color Doppler sonography and blood gas analysis. A similar phenomenon was observed in negative pressure wound therapy (NPWT. However, NPWT employs a lower negative pressure than VED, and a hypoperfused zone, which increases in response to negative pressure adjacent to the wound edge, was observed. Nonetheless, questions regarding ideal subatmospheric pressure levels, modes of action, and therapeutic duration of VED remain unanswered. Moreover, it remains unclear whether a hypoperfused zone or PO 2 gradient appears in the penis during VED therapy. To optimize a clinical VED protocol in penile rehabilitation, further research on the mechanism of VED, especially real-time PO 2 measurements in different parts of the penis, should be performed.

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.

Patient dissatisfaction with rehabilitation following primary total knee arthroplasty.

Science.gov (United States)

Johnson, Aaron J; Issa, Kimona; Naziri, Qais; Harwin, Steven F; Bonutti, Petter M; Mont, Michael A

2013-12-01

Most patients who receive a total knee arthroplasty (TKA) undergo rehabilitation in the postoperative period. However, these therapies are often not under the direct supervision of the treating physicians, have variable protocols, and have unclear long-term efficacies. The purposes of this study were to assess patient satisfaction with their rehabilitation following TKA and to evaluate whether various factors were different between satisfied and unsatisfied patients. A total of 100 consecutive patients who underwent 107 primary TKA were prospectively surveyed to evaluate their rehabilitation experiences. There were 28 men and 72 women who had a mean age of 61 years (range, 37 to 91 years) at the time of surgery. Patients answered questions regarding the number and duration of therapies, amount of hands-on time with the therapists, number of different therapists, amount of co-pay, and their overall level of satisfaction with their rehabilitation experience. Over one-third of the patients reported not being satisfied with their rehabilitation experiences. The patients who were dissatisfied reported a shorter mean duration of each therapy session spent directly with the therapist, a higher mean number of therapists seen over the duration of their treatment, and an increased number of co-participants during their therapy sessions. The authors believe that to minimize patient dissatisfaction with rehabilitation, surgeons should refer patients to therapists who are willing to spend adequate hands-on time during one-on-one or smaller group therapy sessions with their patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neuroplasticity in the context of motor rehabilitation after stroke

Science.gov (United States)

Dimyan, Michael A.; Cohen, Leonardo G.

2016-01-01

Approximately one-third of patients with stroke exhibit persistent disability after the initial cerebrovascular episode, with motor impairments accounting for most poststroke disability. Exercise and training have long been used to restore motor function after stroke. Better training strategies and therapies to enhance the effects of these rehabilitative protocols are currently being developed for poststroke disability. The advancement of our understanding of the neuroplastic changes associated with poststroke motor impairment and the innate mechanisms of repair is crucial to this endeavor. Pharmaceutical, biological and electrophysiological treatments that augment neuroplasticity are being explored to further extend the boundaries of poststroke rehabilitation. Potential motor rehabilitation therapies, such as stem cell therapy, exogenous tissue engineering and brain–computer interface technologies, could be integral in helping patients with stroke regain motor control. As the methods for providing motor rehabilitation change, the primary goals of poststroke rehabilitation will be driven by the activity and quality of life needs of individual patients. This Review aims to provide a focused overview of neuroplasticity associated with poststroke motor impairment, and the latest experimental interventions being developed to manipulate neuroplasticity to enhance motor rehabilitation. PMID:21243015

Neuroplasticity in the context of motor rehabilitation after stroke.

Science.gov (United States)

Dimyan, Michael A; Cohen, Leonardo G

2011-02-01

Approximately one-third of patients with stroke exhibit persistent disability after the initial cerebrovascular episode, with motor impairments accounting for most poststroke disability. Exercise and training have long been used to restore motor function after stroke. Better training strategies and therapies to enhance the effects of these rehabilitative protocols are currently being developed for poststroke disability. The advancement of our understanding of the neuroplastic changes associated with poststroke motor impairment and the innate mechanisms of repair is crucial to this endeavor. Pharmaceutical, biological and electrophysiological treatments that augment neuroplasticity are being explored to further extend the boundaries of poststroke rehabilitation. Potential motor rehabilitation therapies, such as stem cell therapy, exogenous tissue engineering and brain-computer interface technologies, could be integral in helping patients with stroke regain motor control. As the methods for providing motor rehabilitation change, the primary goals of poststroke rehabilitation will be driven by the activity and quality of life needs of individual patients. This Review aims to provide a focused overview of neuroplasticity associated with poststroke motor impairment, and the latest experimental interventions being developed to manipulate neuroplasticity to enhance motor rehabilitation.

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

Directory of Open Access Journals (Sweden)

Luis Manuel Vaca Benitez

2013-01-01

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

Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo).

Science.gov (United States)

Vos-Vromans, Desirée C W M; Smeets, Rob J E M; Rijnders, Leonie J M; Gorrissen, René R M; Pont, Menno; Köke, Albère J A; Hitters, Minou W M G C; Evers, Silvia M A A; Knottnerus, André J

2012-05-30

Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overcome their fatigue. Although there is no consensus, cognitive behavioural therapy is seen as one of the most effective treatments. Little is known about multidisciplinary rehabilitation treatment, a combination of cognitive behavioural therapy with principles of mindfulness, gradual increase of activities, body awareness therapy and pacing. The difference in effectiveness and cost-effectiveness between multidisciplinary rehabilitation treatment and cognitive behavioural therapy is as yet unknown. The FatiGo (Fatigue-Go) trial aims to compare the effects of both treatment approaches in outpatient rehabilitation on fatigue severity and quality of life in patients with chronic fatigue syndrome. One hundred twenty patients who meet the criteria of chronic fatigue syndrome, fulfil the inclusion criteria and sign the informed consent form will be recruited. Both treatments take 6 months to complete. The outcome will be assessed at 6 and 12 months after the start of treatment. Two weeks after the start of treatment, expectancy and credibility will be measured, and patients will be asked to write down their personal goals and score their current performance on these goals on a visual analogue scale. At 6 and 14 weeks after the start of treatment, the primary outcome and three potential mediators-self-efficacy, causal attributions and present-centred attention-awareness-will be measured. Primary outcomes are fatigue severity and quality of life. Secondary outcomes are physical activity, psychological symptoms, self-efficacy, causal attributions, impact of disease on emotional and physical functioning, present-centred attention-awareness, life satisfaction, patient personal goals, self-rated improvement

A perspective on disability and rehabilitation

Directory of Open Access Journals (Sweden)

D. J. Mothabeng

2007-01-01

Full Text Available This paper is written in honor of the memory of the late Jules Rothstein, editor in chief “emeritus” of the Physical Therapy (the journal of the American Physical Therapy Association - APTA who passed away on the 27-08-2005. It is  fitting to dedicate a paper on disability to Dr. Rothstein, as he himself likened  disability with the identity of physiotherapy. A paper focusing on disability at this time might be the wake up call needed to make physiotherapists heed the African decade of the disabled person, which is more than halfway through. The paper highlights the problem of sparse evidence in rehabilitation and emphasizes the need for an evidence-based approach to rehabilitation. Practical suggestions for the implementation of EBP in rehabilitation using the International Classification of Functioning, Disability (ICF as a framework are proposed. This paper is envisaged to enthuse rehabilitation physiotherapists to embrace EBP, so that their focus is redirected to the ‘eradication of disability’.

Integrating cognitive rehabilitation: A preliminary program description and theoretical review of an interdisciplinary cognitive rehabilitation program.

Science.gov (United States)

Fleeman, Jennifer A; Stavisky, Christopher; Carson, Simon; Dukelow, Nancy; Maier, Sheryl; Coles, Heather; Wager, John; Rice, Jordyn; Essaff, David; Scherer, Marcia

2015-01-01

Interdisciplinary cognitive rehabilitation is emerging as the expected standard of care for individuals with mild to moderate degrees of cognitive impairment for a variety of etiologies. There is a growing body of evidence in cognitive rehabilitation literature supporting the involvement of multiple disciplines, with the use of cognitive support technologies (CSTs), in delivering cognitive therapy to individuals who require cognitive rehabilitative therapies. This article provides an overview of the guiding theories related to traditional approaches of cognitive rehabilitation and the positive impact of current theoretical models of an interdisciplinary approach in clinical service delivery of this rehabilitation. A theoretical model of the Integrative Cognitive Rehabilitation Program (ICRP) will be described in detail along with the practical substrates of delivering specific interventions to individuals and caregivers who are living with mild to moderate cognitive impairment. The ultimate goal of this article is to provide a clinically useful resource for direct service providers. It will serve to further clinical knowledge and understanding of the evolution from traditional silo based treatment paradigms to the current implementation of multiple perspectives and disciplines in the pursuit of patient centered care. The article will discuss the theories that contributed to the development of the interdisciplinary team and the ICRP model, implemented with individuals with mild to moderate cognitive deficits, regardless of etiology. The development and implementation of specific assessment and intervention strategies in this cognitive rehabilitation program will also be discussed. The assessment and intervention strategies utilized as part of ICRP are applicable to multiple clinical settings in which individuals with cognitive impairment are served. This article has specific implications for rehabilitation which include: (a) An Interdisciplinary Approach is an

Nuclear medicine for treatment of thyroid diseases. Diagnostic evaluation and imaging of the intrathyroid metabolism; Einsatz der Nuklearmedizin bei Schilddruesenerkrankungen. Diagnostik und bildliche Darstellung des intrathyreoidalen Stoffwechsels

Energy Technology Data Exchange (ETDEWEB)

Maul, F.D. [Klinik fuer Nuklearmedizin, Staedtisches Klinikum, Karlsruhe (Germany)

1996-05-01

The diagnostic interest of nuclear medicine is focussed on the imaging and quantification of intrathyroidal iodine metabolism. Most frequently the various forms of autonomy will be investigated by functional scintigraphy. Cold nodules and the differential diagnosis of Graves disease are further indications. In the case of a sufficient iodine uptake hyperthyroidism can be treated by 1311. Severe hyperthyroidism requires a medical pretreatment before radioiodine therapy. A rigid age limit for radioiodine therapy is not necessary. Pregnancy and the suspicion of malignancy are contraindications of a radioiodine therapy. The after-treatment depends on the nature of the treated hyperthyroidism and the posttreatment result. If a focal autonomy could be eliminated a sufficient amount of iodine should be supplied. To prevent the development of hypothyroidism clinical and thyroid hormon controls, and if necessary a substitution with thyroxin is necessary. (orig.) [Deutsch] Bei der Diagnostik und Therapie von Schilddruesenerkrankungen steht die Diagnostik und bildliche Darstellung der intrathyreoidalen Stoffwechselstoerung im Zentrum. Am haeufigsten wird die Schilddruesenfunktionsszintigraphie bei den verschiedenen Formen der autonomen Schilddruesenerkrankungen eingesetzt. Sie dient aber auch der Diagnostik kalter Knoten und der Differenzierung von Autoimmunthyreopathien. Ausreichende Iodspeicherung vorausgesetzt, koennen hyperthyreote Erkrankungen der Schilddruese mit {sup 131}I behandelt werden. (orig./MG)

Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury.

Science.gov (United States)

Seel, Ronald T; Corrigan, John D; Dijkers, Marcel P; Barrett, Ryan S; Bogner, Jennifer; Smout, Randall J; Garmoe, William; Horn, Susan D

2015-08-01

To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. Prospective, multicenter, longitudinal cohort study. Acute TBI rehabilitation programs. Patients (N=1946) receiving 138,555 therapy sessions. Not applicable. Effort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS). The Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (Prehabilitation, differences in effort ratings (Prehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (Prehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Music therapy for early cognitive rehabilitation post-childhood TBI: an intrinsic mixed methods case study.

Science.gov (United States)

Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen

2014-10-01

The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

UMA PROSPOSTA DEDUTIVISTA PARA PRINCÍPIOS CONTÁBEIS

OpenAIRE

Paulo Schmidt

2009-01-01

A proposta deste estudo a apresentar um breve relato sobre a evolução do pensamento cientifico ocorrida na física com a substituição dos princípios contábeis e filosófico, desde a Antiguidade grega ate os dias de hoje, como forma de fundamentar o posicionamento contrario ao raciocínio indutivo para o estabelecimento de uma estrutura conceitual para a contabilidade e para o desenvolvimento dos princípios contábeis. Apos essa incursão pelo campo filosófico, será aduzido um dos trabalhos d...

From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences.

Science.gov (United States)

Martínez-Pernía, David; González-Castán, Óscar; Huepe, David

2017-02-01

The development of rehabilitation has traditionally focused on measurements of motor disorders and measurements of the improvements produced during the therapeutic process; however, physical rehabilitation sciences have not focused on understanding the philosophical and scientific principles in clinical intervention and how they are interrelated. The main aim of this paper is to explain the foundation stones of the disciplines of physical therapy, occupational therapy, and speech/language therapy in recovery from motor disorder. To reach our goals, the mechanistic view and how it is integrated into physical rehabilitation will first be explained. Next, a classification into mechanistic therapy based on an old version (automaton model) and a technological version (cyborg model) will be shown. Then, it will be shown how physical rehabilitation sciences found a new perspective in motor recovery, which is based on functionalism, during the cognitive revolution in the 1960s. Through this cognitive theory, physical rehabilitation incorporated into motor recovery of those therapeutic strategies that solicit the activation of the brain and/or symbolic processing; aspects that were not taken into account in mechanistic therapy. In addition, a classification into functionalist rehabilitation based on a computational therapy and a brain therapy will be shown. At the end of the article, the methodological principles in physical rehabilitation sciences will be explained. It will allow us to go deeper into the differences and similarities between therapeutic mechanism and therapeutic functionalism.

Vitex-agnus-castus-Extrakt (Ze 440 zur Symptombehandlung bei Frauen mit menstruellen Zyklusstörungen

Directory of Open Access Journals (Sweden)

Eltbogen R

2015-01-01

Full Text Available Ziel: Diese nichtinterventionelle Beobachtungsstudie (NIS wurde von Schweizer Gynäkologen und Allgemeinmedizinern im Rahmen der üblichen ärztlichen Grundversorgung durchgeführt. Das Ziel der NIS war es, die Wirksamkeit und Sicherheit von Vitex-agnus-castus-(VAC Extrakt (Ze 440: premens, Zeller Medical AG, Romanshorn, Schweiz bei Frauen, die unter menstruellen Zyklusstörungen wie Polymenorrhö, Oligomenorrhö oder Amenorrhö litten, zu untersuchen. Methode: Insgesamt 211 Patientinnen nahmen an dieser NIS teil. Symptome, die mit menstruellen Zyklusstörungen („menstrual cycle irregularities“ [MCIs] und der Menstruationsblutung in Verbindung stehen, wurden bei einer Erstuntersuchung („baseline visit“ [BV] und einer Kontrolluntersuchung („follow-up visit“ [FV] nach Behandlung mit VAC-Extrakt über einen Zeitraum von 3 aufeinanderfolgenden Menstruationszyklen beurteilt. Ergebnisse: Der Anteil der Patientinnen, bei denen eine Beschwerdefreiheit oder eine Besserung der MCIs (insgesamt und spezifischer Beschwerdebilder wie Polymenorrhö, Oligomenorrhö und Amenorrhö erzielt werden konnte, lag bei der FV bei 79–85 %. Bei Symptomen im Zusammenhang mit der Menstruationsblutung wie Dysmenorrhö, Zwischenblutungen, Hypermenorrhö, Menometrorrhagie, Ovulationsblutung, präoder postmenstrueller Blutung betrug der Anteil der Patientinnen, bei denen ein Rückgang oder eine Besserung festgestellt wurde, bei der FV zwischen 60 und 88 %. Von 53 Patientinnen, die bei der BV von einem unerfüllten Kinderwunsch berichteten, wurden 12 Frauen (23 % während der Behandlung mit VAC-Extrakt schwanger. Bei der FV waren 91 % der Ärzte und 92 % der Patientinnen mit den erzielten Behandlungsergebnissen „zufrieden“ oder „sehr zufrieden“ und 80 % der Patientinnen bestätigten, dass sie gerne mit der Behandlung mit VAC-Extrakt fortfahren wollen. Fazit: Diese Beobachtungsstudie im Bereich der ärztlichen Grundversorgung ergab, dass die Behandlung mit VAC

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

OpenAIRE

Ioana Stanescu; Gabriela Dogaru

2016-01-01

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

Virtual reality exergaming as adjunctive therapy in a sub-acute stroke rehabilitation setting: facilitators and barriers.

Science.gov (United States)

Nguyen, Ai-Vi; Ong, Yau-Lok Austin; Luo, Cindy Xin; Thuraisingam, Thiviya; Rubino, Michael; Levin, Mindy F; Kaizer, Franceen; Archambault, Philippe S

2018-03-12

To identify the facilitators and barriers perceived by clinicians to using an Exergaming Room as adjunct to conventional therapy. Phenomenological qualitative study using an interpretive description methodology. Ten clinicians (four physical therapists, six occupational therapists) from the Stroke Program at the Jewish Rehabilitation Hospital (nine female, one male, age range 25-50 years old) who referred clients to the Exergaming Room. Ten to twenty minute semi-structured interviews were conducted with each clinician. Convenience sampling was used. A thematic analysis was performed on the data collected by grouping all the open codes into facilitators and barriers, and then categorized into levels, themes and subthemes. Facilitators and barriers were divided into three levels: organizational, individual and technological. Major facilitators at the organizational level were: institutional support; at the individual level: personal experience of referring clinician, presence of an expert clinician, and relevance of the Exergaming Room for stroke clients; and at the technological level: perceived ease of use of the exergames and possibility of providing additional therapy. Key barriers to successful implementation of the Exergaming Room at the organizational level were: scheduling difficulties and lack of staffing; at the individual level: client functional limitations; at the technological level: low precision in motion capture of the exergame systems. Multiple factors affect the implementation of new technology in rehabilitation settings. In order to successfully integrate exergame systems into practice, institutions are encouraged to take the identified factors (facilitators and barriers) into account. Implications for Rehabilitation Clinicians who have referred individuals with stroke to an "exergames" room over a 1-year period at a rehabilitation hospital have found the service to be highly relevant to their clients. The presence of an expert clinician, who

[Stroke rehabilitation in nursing homes: intensity of and motivation for physiotherapy].

Science.gov (United States)

Wissink, K S; Spruit-van Eijk, M; Buijck, B I; Koopmans, R T C M; Zuidema, S U

2014-06-01

Stroke is a frequent and potential invalidating disease, of which recovery can be improved by rehabilitation. In The Netherlands old and frail stroke patients are rehabilitated in nursing homes. Probably, the intensity of and motivation for physiotherapy are important for successful discharge. The aim was to determine (1) therapy intensity of and motivation for physical therapy of geriatric stroke patients (2) its correlates and (3) the effect on discharge destination. Data were obtained from the 'GRAMPS'-study, a longitudinal observational study of stroke rehabilitation in 15 Dutch nursing homes. Direct time spent on physiotherapy was registered during admission. Motivation was measured by the Pittsburgh Rehabilitation Participation Scale (PRPS). Data of 84 patients were analysed using uni- and multivariate regression analysis. Patients received an average 109 min of physiotherapy per week. 69 patients (82%) were good motivated for physiotherapy (had all PRPS scores 4 or higher). Therapy intensity was positively associated with the presence of a partner and good motivation. No significant independent variables of motivation were found. Therapy-intensity was positively related to discharge to prior living situation. Intensity of physiotherapy of stroke rehabilitation is an independent variable of successful discharge and is higher when the patient has a partner or is better motivated. These findings stress the importance of high motivation and therapy intensity in geriatric stroke rehabilitation.

Evolution und Funktionsvariabilität von bunodonten Molaren bei Primaten

OpenAIRE

Menz, Ulrike Maria (Doktor)

2017-01-01

In der vorliegenden Arbeit werden funktionale Details der Okklusion während der Mastikation bei ausgewählten fossilen und rezenten Primaten quantitativ vergleichend untersucht. Dazu wurden die Okklusionsflächen von antagonistischen Molarenpaaren mit modernen virtuellen Verfahren eingescannt und anhand von 3D Kronenmodellen kartiert und funktional ausgewertet. Die in der Forschergruppe DFG FOR 771 entwickelte Software „Occlusal Fingerprint Analyser“ (OFA) kam erstmals bei einer großen Stichpro...

[Human-robot global Simulink modeling and analysis for an end-effector upper limb rehabilitation robot].

Science.gov (United States)

Liu, Yali; Ji, Linhong

2018-02-01

Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant's functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists' experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients' movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.

Sacroiliitis in children with spondyloarthropathy: therapeutic effect of CT-guided intra-articular corticosteroid injection; Sakroiliitis bei Kinder mit Spondylarthropathie: Therapeutischer Effekt der CT-gestuetzten intraartikulaeren Kortikosteroid-Injektionen

Energy Technology Data Exchange (ETDEWEB)

Fischer, T.; Hermann, K.G.A.; Diekmann, F.; Hamm, B. [Humboldt-Universitaet, Berlin (Germany). Universitaetsklinikum Charite, Inst. fuer Radiologie; Biedermann, T. [HELIOS Klinikum Berlin (Germany). II. Klinik fuer Kinderheilkunde und Jugendmedizin, Abt. Kinderrheumatologie; Braun, J. [Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus (Germany); Bollow, M. [Augusta-Krankenhaus, Bochum (Germany). Inst. fuer Radiologie

2003-06-01

. The follow-up dynamic MRI (0.1 mmol/kg body weight) during therapy showed a statistically significant lower contrast-enhancement in both groups (group 1: 117{+-}43% versus 38{+-}24%, p<0.05; group 2: 127{+-}59% versus 38{+-}22%, p<0.05). One third of the patients of group 2 showed progression of joint destruction despite absence of subjective complaints. (orig.) [German] Ziel: Prospektive Pruefung des therapeutischen Effektes der CT-gesteuerten intraartikulaeren Kortikosteroid-Injektion entzuendlicher Sakroiliakalgelenke (SIG) bei Kindern mit juveniler Spondylarthropathie (jSpA) im Vergleich zur konventionellen Therapie mit nichtsteroidalen Antirheumatika (NSAR) sowie Bestimmung der Wertigkeit der Magnetresonanztomographie (MRT) bei der Indikationsstellung und der Therapieverlaufskontrolle. Material und Methode: Bei 89 Kindern mit bekannter jSpA wurden mittels dynamischer MRT uni- oder bilaterale Sakroiliitiden diagnostiziert. Bei allen 89 Patienten wurde daraufhin eine Therapie mit NSAR eingeleitet bzw. bereits bestehende Therapien fortgesetzt. Vier Wochen nach der diagnostischen MRT wurden zwei Gruppen definiert: 33 Patienten mit klinischem Response auf NSAR (Gruppe 1) und 56 Nonresponder (Gruppe 2). Die Patienten der Gruppe 2 wurden unter Belassung der NSAR zusaetzlich einer CT-gestuetzten (Low-Dose-Technik) intraartikulaeren Kortikosteroid-Injektion zugefuehrt, wobei insgesamt 83 SIG punktiert und infiltriert wurden (27 bilateral, 29 unilateral). Die Indikationsstellung zur Intervention beruhte auf der zuvor MR-tomographisch gesicherten Entzuendungsaktivitaet. Klinische Therapieverlaufskontrollen erfolgten in 8- bis 12-woechigen Intervallen ueber einen Zeitraum von 20 Monaten. MRT-Verlaufskontrollen wurden bei allen 56 Kindern der Gruppe 2 und bei 15 von 33 Kindern der Gruppe 1 in einem Zeitraum von 8{+-}4 Monaten nach der Erstuntersuchung durchgefuehrt. Ergebnisse: Ingesamt 87,5% der komplikationslos punktierten Kinder der Gruppe 2 (Standardtherapie

Occupational therapy needs of patients with thoracic cancer at the time of diagnosis: findings of a dedicated rehabilitation service.

Science.gov (United States)

Bentley, Rachel; Hussain, Asmah; Maddocks, Matthew; Wilcock, Andrew

2013-06-01

Guidelines recommend screening patients with cancer to identify their rehabilitation needs. To help quantify this area of need and associated workload from an occupational therapy perspective in patients with thoracic cancer, we report the experiences of a dedicated rehabilitation service. Consecutive patients were screened soon after diagnosis using items associated with occupational performance in the Sheffield Profile for Assessment and Referral for Care questionnaire. Those reporting predetermined levels of distress underwent a full occupational therapy evaluation; this generated a problem list from which individualised goals and interventions were instigated. Of 540 patients screened, 273 (51 %) reported levels of distress which warranted a full occupational therapy assessment. Of these, 260 (95%) reported a total of 681 problems (median of 4 [2-5] per patient). Mostly these lay within the domain of self care (553, 78%) in the categories of transfers, functional mobility and bathing/showering. A total of 646 goals (median of 2 [1-3] per patient) were formulated, resulting in 652 individual interventions, most frequently the provision of equipment (79%) or advice (32%) and referral to another professional/agency (23%). Patients considered that most goals were achieved (98%) and that the provision of equipment was useful (97%). About half of patients with thoracic cancer screened have occupational therapy needs around the time of diagnosis. Problems are mostly in the area of self-care, with equipment provision the most frequent intervention provided. Future work should examine the efficacy of occupational therapy interventions further.

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

DEFF Research Database (Denmark)

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

2006-01-01

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

Pilzinfektionen des Zentralnervensystems bei immunkompetentem Wirt

NARCIS (Netherlands)

Tintelnot, K.; de Hoog, G.S.; Haase, G.

2014-01-01

Die Mehrzahl von Pilzinfektionen, die zu mykotischen Tumoren führen und bei Patienten ohne jegliche prädisponierende Vorerkrankung auftreten, wird durch Cryptococcus gattii bzw. C. neoformans oder durch Schwärzepilze, insbesondere durch Cladophialophora bantiana, Ramichloridium mackenziei, Exophiala

The utility of a video game system in rehabilitation of burn and nonburn patients: a survey among occupational therapy and physiotherapy practitioners.

Science.gov (United States)

Fung, Vera; So, Ken; Park, Esther; Ho, Aileen; Shaffer, Jennifer; Chan, Elaine; Gomez, Manuel

2010-01-01

The objective of this study was to investigate perceptions of occupational therapists and physiotherapists on the use of Nintendo Wii™ (Nintendo of America Inc., Redmond, WA) in rehabilitation. Occupational therapists and physiotherapists in a rehabilitation hospital trialed four Wii games that addressed physical movement, balance, coordination, and cognitive performance. Then, they completed an opinion survey on the utility of Wii in rehabilitation. The results were compared between burn care therapists (BTs) and nonburn care therapists, using chi(2) with a P benefit from Wii intervention but not cardiac (43%) or organ transplant patients (18%). Participants believed that outcomes using Wii could be measured reliably (49%), and skills learned while playing could be transferable to daily function (60%). The significant differences between BTs and nonburn care therapists' perceptions are that BT-treated younger patients (21-40 years vs >60 years, P benefit of Wii in rehabilitation (93% vs 58%, P = .02), specifically in burn rehabilitation (85% vs 39%, P = .001). Occupational therapists and physiotherapists favored the use of Wii in rehabilitation as an adjunct to traditional therapy because it is therapeutic, engaging, and may increase patient participation in rehabilitation.

Kontrastmittelverstärkte Magnet-Resonanz-Urographie unter forcierter Diurese - Stellenwert in der Differentialdiagnostik bei Obstruktionen des oberen Harntraktes

Directory of Open Access Journals (Sweden)

Jung P

2001-01-01

Full Text Available Die Magnet-Resonanz-Urographie (MRU ist ein relativ neues Verfahren in der Diagnostik des oberen Harntraktes. Das Ziel dieser Studie war der Vergleich der Aussagefähigkeit der MRU unter Gabe von Gadolinium und Furosemid und dem konventionellen Urogramm (IVU in der Diagnostik der Ursache von Obstruktionen im Bereich des Harnleiters. 82 Patienten mit im IVU nachgewiesener Obstruktion des oberen Harntraktes oder urographisch stummer Niere bei sonographisch nachgewiesener Dilatation wurden der MRU zugeführt. Die Bilder beider Untersuchungsmethoden wurden von voneinander unabhängigen Untersuchern befundet. Zwei Urologen befundeten die IVU-Bilder, zwei Radiologen die MRU-Bilder, die Radiologen kannten die IVU-Diagnose nicht. Bei unklarer Diagnose wurden weitere Untersuchungen wie Computertomographie, retrograde Pyelographie oder Ureteroskopie durchgeführt. Die Diagnosen waren: Harnleitersteine bei 72 Patienten, Harnleitertumore bei 8 Patienten und extraureterale Tumore bei 2 Patienten. Eine richtige Diagnose bei den Steinpatienten wurde durch IVU bei 49 von 72 Patienten und durch MRU bei 64 von 72 Patienten gestellt. In dieser Patientengruppe wurden durch die MRU zwei falsche Diagnosen gestellt. Fehlende Kontrastmittelausscheidung war der Hauptgrund für Versagen der IVU. 3 der 8 Patienten mit Harnleitertumoren wurden durch die IVU richtig dignostiziert, bei dreien wurde eine falsche Diagnose gestellt. Durch die MRU konnten in dieser Gruppe 7 von 8 Patienten korrekt diagnostiziert werden, es wurde keine falsche Diagnose erhoben. IVU wird zunächst die Standarduntersuchungstechnik zur Darstellung des oberen Harntraktes bleiben, aber durch diese Studie konnte die Möglichkeit gezeigt werden, die in der MRU in Kombination mit Gadolinium und Furosemid liegt. Die größte Bedeutung dieser Untersuchung liegt in der urographisch stummen Niere, bei Untersuchungen in der Schwangerschaft, bei Kindern und bei Patienten mit Kontrastmittelunverträglichkeit.

Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury

Science.gov (United States)

Seel, Ronald T.; Corrigan, John D.; Dijkers, Marcel P.; Barrett, Ryan S.; Bogner, Jennifer; Smout, Randall J.; Garmoe, William; Horn, Susan D.

2016-01-01

Objective To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. Design Prospective, multicenter, longitudinal cohort study. Setting Acute TBI rehabilitation programs. Participants Patients (N=1946) receiving 138,555 therapy sessions. Interventions Not applicable. Main Outcome Measures Effort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS). Results The Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (Prehabilitation, differences in effort ratings (Pcognitive scores and over time. In linear mixed-effects modeling, age and Comprehensive Severity Index brain injury severity score at admission, days from injury to rehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (Prehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies. PMID:26212400

Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies.

Science.gov (United States)

Chavez, Lina M; Huang, Shiang-Suo; MacDonald, Iona; Lin, Jaung-Geng; Lee, Yu-Chen; Chen, Yi-Hung

2017-10-28

Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care. Clinical trial and meta-analysis findings have demonstrated the efficacy of acupuncture in improving balance function, reducing spasticity, and increasing muscle strength and general well-being post-stroke. The mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation remain unclear. The aim of this study was to conduct a literature review, summarize the current known mechanisms in ischemic stroke rehabilitation through acupuncture and electroacupuncture (EA) therapy, and to detail the frequently used acupoints implicated in these effects. The evidence in this review indicates that five major different mechanisms are involved in the beneficial effects of acupuncture/EA on ischemic stroke rehabilitation: (1) Promotion of neurogenesis and cell proliferation in the central nervous system (CNS); (2) Regulation of cerebral blood flow in the ischemic area; (3) Anti-apoptosis in the ischemic area; (4) Regulation of neurochemicals; and, (5) Improvement of impaired long-term potentiation (LTP) and memory after stroke. The most frequently used acupoints in basic studies include Baihui (GV20), Zusanli (ST36), Quchi (LI11), Shuigou (GV26), Dazhui (GV14), and Hegu (LI4). Our findings show that acupuncture exerts a beneficial effect on ischemic stroke through modulation of different mechanisms originating in the CNS.

Preclinical imaging in animal models of radiation therapy; Praeklinische Bildgebung im Tiermodell bei Strahlentherapie

Energy Technology Data Exchange (ETDEWEB)

Nikolaou, K.; Cyran, C.C.; Reiser, M.F.; Clevert, D.-A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Lauber, K. [Klinikum der Ludwig-Maximilians-Universitaet, Klinik und Poliklinik fuer Strahlentherapie, Muenchen (Germany)

2012-03-15

Modern radiotherapy benefits from precise and targeted diagnostic and pretherapeutic imaging. Standard imaging modalities, such as computed tomography (CT) offer high morphological detail but only limited functional information on tumors. Novel functional and molecular imaging modalities provide biological information about tumors in addition to detailed morphological information. Perfusion magnetic resonance imaging (MRI) CT or ultrasound-based perfusion imaging as well as hybrid modalities, such as positron emission tomography (PET) CT or MRI-PET have the potential to identify and precisely delineate viable and/or perfused tumor areas, enabling optimization of targeted radiotherapy. Functional information on tissue microcirculation and/or glucose metabolism allow a more precise definition and treatment of tumors while reducing the radiation dose and sparing the surrounding healthy tissue. In the development of new imaging methods for planning individualized radiotherapy, preclinical imaging and research plays a pivotal role, as the value of multimodality imaging can only be assessed, tested and adequately developed in a preclinical setting, i.e. in animal tumor models. New functional imaging modalities will play an increasing role for the surveillance of early treatment response during radiation therapy and in the assessment of the potential value of new combination therapies (e.g. combining anti-angiogenic drugs with radiotherapy). (orig.) [German] Die moderne Strahlentherapie profitiert massgeblich von einer detaillierten wie auch funktionellen praetherapeutischen Bildgebung. Die ueblicherweise praetherapeutisch eingesetzten radiologischen Standardverfahren wie die Computertomographie liefern zwar hochwertige morphologische Details, jedoch keine funktionelle Information. Es ist somit ein zunehmender Bedarf an funktionellen und molekularen Bildgebungsmodalitaeten feststellbar, mit denen ergaenzend zur morphologischen Bildgebung auch biologisch

Radiotherapy for treatment of bursitis. Indication, technique, own results, literature survey; Strahlentherapie bei der Periarthropathia humeroscapularis (PHS). Indikation, Technik, eigene Ergebnisse, Literaturuebersicht

Energy Technology Data Exchange (ETDEWEB)

Heyd, R. [Staedtische Kliniken Offenbach am Main (Germany). Strahlenklinik]|[Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Onkologie; Schopohl, B.; Boettcher, H.D. [Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Onkologie

1998-12-31

Our own experience covers 41 primarily chronic cases. The patients have been irradiated with a telecobalt device with isocentric opposing fields, receiving 4x1.0 Gy within two weeks; 15 patients (36.6%) received a second radiation treatment (8 Gy), and one patient (2.4%) a third (12 Gy). After a follow-up period of 44 months on the average, the results were: Complete remittence of pain in 44%, abatement of pain in 44%, and no effect in 12%. Improvement of shoulder joint motility was achieved in 78%. The rate of recidivation was as low as 3%. A statistical evaluation of data acquired revealed that the prognosis is worst in case of a long period of pain preceding commencement of radiotherapy, combined with intensive prior therapy. (orig./CB) [Deutsch] In einer eigenen Untersuchung wurden 41 ueberwiegend chronische Faelle mit 4x1,0 Gy in 2 Wochen an einem Telekobaltgeraet mit isozentrischen Gegenfeldern behandelt, 15 (36,6%) erhielten eine 2. Bestrahlungsserie (8 Gy), ein Fall (2,4%) eine Dritte (12 Gy). Nach einem Nachbeobachtungszeitraum von median 44 Monaten fand sich bei 44% eine komplette Schmerzremission, bei 44% eine Linderung und 12% waren ohne einen Einfluss der Behandlung. Eine Verbesserung der Motilitaet des Schultergelenkes wurde bei 78% erreicht. Die Rezidivrate lag bei nur 3%. Nach statistischer Bearbeitung der Daten erwies sich die Kombination einer langen Beschwerdedauer vor Einleitung der Radiotherapie und intensiver Vortherapie als prognostisch unguenstiger (p=0,02). (orig.)

Rehabilitation Research at the National Institutes of Health:

Science.gov (United States)

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

Medical-oncological aspects in the treatment of pancreatic cancer; Internistisch-onkologische Aspekte bei der Behandlung des Pankreaskarzinoms

Energy Technology Data Exchange (ETDEWEB)

Heinemann, V. [Klinikum Grosshadern, Ludwig-Maximilians-Universitaet Muenchen (Germany). Medizinische Klinik und Poliklinik III

2009-02-15

Pancreatic cancer is a highly malignant disease and despite progress in systemic therapy survival is still short. For patients with R0/R1 resected disease, adjuvant chemotherapy with gemcitabine has been established as the standard treatment. More controversy exists with regard to optimal treatment of locally advanced non-metastatic pancreatic cancer. However, there is evidence to suggest that patients who respond to an initial phase of chemotherapy may be those who benefit most from sequential chemoradiotherapy. Specifically, in the treatment of advanced and metastatic disease chemotherapy or radiotherapy cannot stand alone but must be accompanied by multidisciplinary treatment approaches involving pain management, weight control, psychooncological care and palliative care. Monotherapy with gemcitabine and the combined use of gemcitabine with erlotinib are established standards for treatment of metastatic pancreatic cancer. Patients in a good general condition but where the gemcitabine-based therapy failed should be offered second-line treatment. (orig.) [German] Das Pankreaskarzinom ist eine hochmaligne Erkrankung, die trotz nachweisbarer klinischer Fortschritte weiterhin mit einem meist kurzen Ueberleben verbunden ist. Bei R0/R1-resezierten Patienten gilt eine adjuvante Behandlung mit Gemcitabin gegenwaertig als etablierter Behandlungsstandard. Weniger eindeutig ist die optimale Therapie des lokal fortgeschrittenen, nichtmetastasierten Pankreaskarzinoms (LAPC). Es gibt aber Hinweise dafuer, dass Patienten, die auf eine initiale Chemotherapiephase ansprachen, von einer nachgeschalteten Radiochemotherapie profitieren koennen. Gerade zur Behandlung des metastasierten Pankreaskarzinoms sollten die Chemo- oder die Radiochemotherapie nicht allein stehen, sondern durch multidisziplinaere Behandlungsansaetze unterstuetzt werden. Dazu gehoeren die Schmerz- und Ernaehrungstherapie, Psychoonkologie und Palliativmedizin. Bei der Behandlung des metastasierten

Kulturspezifische Elemente und ihre Problematik bei der Filmsynchronisierung

Directory of Open Access Journals (Sweden)

Prof. Dr. Carmen Cuéllar Lázaro

2013-07-01

Full Text Available Bei der Untersuchung der Übersetzungsproblematik von kulturspezifischen Elementen geht es darum, diese Konzepte begrifflich abzugrenzen, inhaltlich und sprachlich zu klassifizieren sowie die Problematik ihrer Übersetzung zu beschreiben. Bei der Filmsynchronisierung sind außerdem die Merkmale und besonderen Bedingungen des Mediums und des audiovisuellen Textes zu berücksichtigen. Die Zielsetzung dieser Studie ist, die Übersetzung von kulturspezifischen Elementen der Filmsynchronisierung (Deutsch-Spanisch zu analysieren. Wir schlagen ein Zwei-Ebenen-Modell vor: Die erste Ebene berücksichtigt die Art der erfahrenen sprachlichen Bearbeitung. Auf der zweiten Ebene wird die kulturelle Orientierung der Ergebnisse untersucht. Danach werden einige Schlussfolgerungen aus der spanischen Synchronfassung gezogen.

Kulturspezifische Elemente und ihre Problematik bei der Filmsynchronisierung

Directory of Open Access Journals (Sweden)

Prof. Dr. Carmen Cuéllar Lázaro

2013-07-01

Full Text Available Bei der Untersuchung der Übersetzungsproblematik von kulturspezifischen Elementen geht es darum, diese Konzepte begrifflich abzugrenzen, inhaltlich und sprachlich zu klassifizieren sowie die Problematik ihrer Übersetzung zu beschreiben. Bei der Filmsynchronisierung sind außerdem die Merkmale und besonderen Bedingungen des Mediums und des audiovisuellen Textes zu berücksichtigen.   Die Zielsetzung dieser Studie ist, die Übersetzung von kulturspezifischen Elementen der Filmsynchronisierung (Deutsch-Spanisch zu analysieren. Wir schlagen ein Zwei-Ebenen-Modell vor: Die erste Ebene berücksichtigt die Art der erfahrenen sprachlichen Bearbeitung. Auf der zweiten Ebene wird die kulturelle Orientierung der Ergebnisse untersucht. Danach werden einige Schlussfolgerungen aus der spanischen Synchronfassung gezogen.

A tough-love pedagogy in rehabilitation: integration of rehabilitation ideology with local cultures.

Science.gov (United States)

Chang, Ling-Hui; Wang, Jye

2009-09-01

This study problematizes a unique therapeutic relationship in rehabilitation and how the interaction reflects the integration of rehabilitation ideology with local cultures. The data drew from a larger ethnographic study of a rehabilitation unit in Taiwan. Participants included 21 patient-caregiver pairs and their rehabilitation professionals. They participated in in-depth interviews and participant observation. A tough-love pedagogy emerged as a unique therapeutic relationship in the unit. Patients were asked to interpret the stress with therapy as an inevitable, beneficial experience toward recovery. A prevalent supposition that equated poor physical performance with weak morale legitimized the approach. Cultural metaphors used to describe and define rehabilitation transformed the stress that patients experienced with strenuous exercises into a beneficial substance that aids recovery. The transformation of the therapeutic relationship into a pedagogical one helped connect rehabilitation to shared educational experiences. In the unit, the complicit practice of therapists, caregivers, and patients established and perpetuated the practice of a tough-love pedagogy. The congruence between this tough-love approach and traditional Chinese pedagogical principles made the approach legitimate and desired.

The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction

Directory of Open Access Journals (Sweden)

Amir Abbas Ebrahimi

2018-01-01

Full Text Available The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys with the profound sensorineural hearing loss (PTA>90 dB. They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP. For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT was completed pre- and post-intervention with SPS (Synapsys, Marseille, France. Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS, vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05. The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

Spontaneous aliquorrhea syndrome due to cervicothoracic liquor leak; Spontanes Liquorunterdrucksyndrom bei zervikothorakalem Liquorleck

Energy Technology Data Exchange (ETDEWEB)

Kuhl, V.; Thoemke, F.; Hopf, H.C. [Klinik und Poliklinik fuer Neurologie, Johannes-Gutenberg-Univ. Mainz (Germany); Andreas, J. [Klinik und Poliklinik fuer Nuklearmedizin, Johannes-Gutenberg-Univ. Mainz (Germany); Mueller-Forell, W. [Institut fuer Neuroradiologie, Johannes-Gutenberg-Univ. Mainz (Germany)

2000-07-01

The radiological and nuclear medicine methods applied for diagnostic evaluation in the case reported (MRI, myelography, liquor myeloscintigraphy) were the key modalities for diagnosis, explanation of causes, and follow-up and are described in this report. In case of recurrent headaches during therapy, a CCT examination should be performed in order to exclude the presence of subdural hematoma.(orig./CB) [German] Die radiologischen und nuklearmedizinischen Untersuchungsmethoden (MRT, Myelographie, Liquormyeloszintigraphie) nehmen zur Diagnosestellung, Ursachenabklaerung und Verlaufsbeurteilung eine zentrale Schluesselposition ein und wurden anhand unseres Fallbeispieles demonstriert und beschrieben. Bei Wiederauftreten von Kopfschmerzen im Verlauf der Erkrankung sollte zum Ausschluss subduraler Haematome eine CCT-Untersuchung erfolgen. (orig.)

Application physiotherapy in rehabilitation rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Angela Nogas

2017-02-01

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

Harnessing Neuroplasticity to Promote Rehabilitation: CI Therapy for TBI

Science.gov (United States)

2015-10-01

the Tampa VAMC and San Antonio VAMC, which both host Polytrauma Rehabilitation Centers. In addition, we plan to work with the Alabama Brain Injury...sites with those funds, e.g., the Tampa VAMC and San Antonio VAMC, which both host Polytrauma Rehabilitation Centers. In addition, we are seeking

The place of occupational therapy in rehabilitation strategies of complex regional pain syndrome: Comparative study of 60 cases.

Science.gov (United States)

Rome, L

2016-10-01

The purpose of the study was to assess the value of combining occupational therapy (OT) with physical therapy (PT) for the rehabilitation of complex regional pain syndrome (CRPS) and to measure its effectiveness on activities of daily life. Sixty patients with CRPS type 1 were recruited and interviewed between September 1, 2014 and February 1, 2015. Thirty patients had undergone PT and thirty had undergone PT+OT. They were administered the short-form of the "Assessment of Life Habits" questionnaire (v.3.0 LIFE-H) created in Canada. This questionnaire consists of 16 items exploring activities of daily living, which were used to compare the effectiveness of the two rehabilitation protocols. The results of each test were submitted to the Wilcoxon test. After confirming the complexity of CRPS in terms of its etiology, clinical signs and progression, rehabilitation was effective, especially for pain. The patients who received PT+OT had on average 10% better dressing and undressing function, 25% better for meal preparation, and 20% better on personal care than those who underwent PT only. In CRPS, OT combined with PT brings a real benefit in restoring the essential activities of daily life. This strategy could be implemented as soon the diagnosis confirmed and continued for a very long time. It helps to avoid the risk of dependence on third parties. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Multi-User Virtual Reality Therapy for Post-Stroke Hand Rehabilitation at Home

Directory of Open Access Journals (Sweden)

Daria Tsoupikova

2016-04-01

Full Text Available Our paper describes the development of a novel multi-user virtual reality (VR system for post-stroke rehabilitation that can be used independently in the home to improve upper extremity motor function. This is the pre-clinical phase of an ongoing collaborative, interdisciplinary research project at the Rehabilitation Institute of Chicago involving a team of engineers, researchers, occupational therapists and artists. This system was designed for creative collaboration within a virtual environment to increase patients' motivation, further engagement and to alleviate the impact of social isolation following stroke. This is a low-cost system adapted to everyday environments and designed to run on a personal computer that combines three VR environments with audio integration, wireless Kinect tracking and hand motion tracking sensors. Three different game exercises for this system were developed to encourage repetitive task practice, collaboration and competitive interaction. The system is currently being tested with 15 subjects in three settings: a multi-user VR, a single-user VR and at a tabletop with standard exercises to examine the level of engagement and to compare resulting functional performance across methods. We hypothesize that stroke survivors will become more engaged in therapy when training with a multi-user VR system and this will translate into greater gains.

Antivertiginous drug therapy does not hinder the efficacy of individualized vibrotactile neurofeedback training for vestibular rehabilitation - a randomized trial.

Science.gov (United States)

Basta, Dietmar; Borsellino, Liliana; Ernst, Arne

2017-12-01

Vestibular rehabilitation using individualized vibrotactile neurofeedback training (IVNT) can lead to significant improvement in the postural stability of patients with vestibular symptoms of different origins. However, some of these patients have complex, severe dizziness, meaning that a pharmacological pretreatment or parallel (to vestibular rehabilitation) treatment can help them perform the rehabilitation exercises. Hence, the present study investigated the influence of a pharmacological treatment on the efficacy of vibrotactile neurofeedback training in patients with chronic, noncompensated vestibulopathies. All participants performed IVNT for ∼10 min each day for 2 weeks. In addition, every second participant was selected randomly to receive oral medication (20 mg cinnarizine and 40 mg dimenhydrinate per tablet), taking three tables per day. Trunk and ankle sway and postural stability were measured. In addition, the dizziness handicap inventory was evaluated immediately before training on the last day of training and 6 months after training. After the 10-day period of IVNT, both groups showed a statistically significant improvement in all parameters tested. A follow-up analysis after 6 months showed a long-term efficacy for the IVNT, that is, the patients remained significantly improved in their postural stability. The antivertiginous therapy did not hinder the efficacy of the IVNT. The present results indicate that IVNT even in combination with an antivertiginous drug therapy is an effective treatment regime for patients with disabling vertigo of different origins.

Virtual rehabilitation via Nintendo Wii® and conventional physical therapy effectively treat post-stroke hemiparetic patients.

Science.gov (United States)

da Silva Ribeiro, Nildo Manoel; Ferraz, Daniel Dominguez; Pedreira, Érika; Pinheiro, Ígor; da Silva Pinto, Ana Cláudia; Neto, Mansueto Gomes; Dos Santos, Luan Rafael Aguiar; Pozzato, Michele Gea Guimarães; Pinho, Ricardo Silva; Masruha, Marcelo Rodrigues

2015-08-01

The Nintendo® Wii is a simple and affordable virtual therapy alternative. It may be used at home, and it is a motivating recreational activity that provides continuous feedback. However, studies comparing the use of the Nintendo® Wii to conventional physical therapy are needed. To compare the effect of a rehabilitation treatment using the Nintendo® Wii (NW) with conventional physical therapy (CPT) to improve the sensorimotor function and quality of life for post-stroke hemiparetic patients. The present study applied a randomized, blind, and controlled clinical trial. In total, 30 patients with post-stroke hemiparesis were evaluated. A total of 15 patients were randomly assigned to each group. The SF-36 quality of life and Fugl-Meyer scales were used to evaluate the patients. After treatment, the only variable that differed between the groups was the physical functioning domain of the SF-36 in the group that received conventional physical therapy. A significant difference was observed between both groups before and after treatment in terms of the following Fugl-Meyer scale items: passive movement and pain, motor function of the upper limbs (ULs), and balance. The CPT group also showed a significant difference with regard to their UL and lower limb (LL) coordination. The SF-36 scale analysis revealed a significant difference within both groups with regard to the following domains: physical functioning, role limitation due to physical aspects, vitality, and role limitation due to emotional aspects. The NW group also exhibited a significant difference in the mental health domain. The results indicate that both approaches improved the patients' performance in a similar manner. Virtual rehabilitation using the Nintendo Wii® and CPT both effectively treat post-stroke hemiparetic patients by improving passive movement and pain scores, motor function of the upper limb, balance, physical functioning, vitality, and the physical and emotional aspects of role functioning.

Effects of spin-orbit coupling on laser cooling of BeI and MgI

Energy Technology Data Exchange (ETDEWEB)

Wan, Mingjie, E-mail: wanmingjie1983@sina.com; Huang, Duohui; Shao, Juxiang; Li, Yuanyuan [Computational Physics Key Laboratory of Sichuan Province, Yibin University, Yibin 644007 (China); Yu, You [College of Optoelectronic Technology, Chengdu University of Information Technology, Chengdu 610225 (China); Li, Song [College of Physical Science and Technology, Yangtze University, Jingzhou 434023 (China)

2015-10-28

We present the ab initio study of spin-orbit coupling effects on laser cooling of BeI and MgI molecules. Potential energy curves for the X{sup 2}Σ{sup +}{sub 1/2}, A{sup 2}Π{sub 1/2,3/2}, and 2{sup 2}Π{sub 3/2,1/2} states are calculated using multi-reference configuration interaction method plus Davidson corrections. Spectroscopic parameters of BeI and MgI are in excellent agreement with available experimental and theoretical values. The A{sup 2}Π{sub 3/2} state of MgI is a repulsive state. It is an unsuitable scheme for the A{sup 2}Π{sub 3/2}(υ′)← X{sup 2}Σ{sup +}{sub 1/2} (υ″) transition for laser cooling of MgI. Highly diagonally distributed Franck-Condon factors f{sub 00} for the A{sup 2}Π{sub 1/2,3/2} (υ′ = 0) ← X{sup 2}Σ{sup +}{sub 1/2} (υ″ = 0) transitions and suitable radiative lifetimes τ for the A{sup 2}Π{sub 1/2,3/2} (υ′ = 0) of BeI and MgI are obtained. Three laser wavelength drives are required for the A{sup 2}Π{sub 1/2,3/2}(υ′)←X{sup 2}Σ{sup +}{sub 1/2} (υ″) transitions of BeI and MgI. The proposed cooling wavelengths of BeI and MgI are both in the violet region. The results imply the feasibility of laser cooling of BeI and MgI, and that laser cooling of BeI is more possible.

Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo

Directory of Open Access Journals (Sweden)

Vos-Vromans Desirée CWM

2012-05-01

Full Text Available Abstract Background Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overcome their fatigue. Although there is no consensus, cognitive behavioural therapy is seen as one of the most effective treatments. Little is known about multidisciplinary rehabilitation treatment, a combination of cognitive behavioural therapy with principles of mindfulness, gradual increase of activities, body awareness therapy and pacing. The difference in effectiveness and cost-effectiveness between multidisciplinary rehabilitation treatment and cognitive behavioural therapy is as yet unknown. The FatiGo (Fatigue-Go trial aims to compare the effects of both treatment approaches in outpatient rehabilitation on fatigue severity and quality of life in patients with chronic fatigue syndrome. Methods One hundred twenty patients who meet the criteria of chronic fatigue syndrome, fulfil the inclusion criteria and sign the informed consent form will be recruited. Both treatments take 6 months to complete. The outcome will be assessed at 6 and 12 months after the start of treatment. Two weeks after the start of treatment, expectancy and credibility will be measured, and patients will be asked to write down their personal goals and score their current performance on these goals on a visual analogue scale. At 6 and 14 weeks after the start of treatment, the primary outcome and three potential mediators—self-efficacy, causal attributions and present-centred attention-awareness—will be measured. Primary outcomes are fatigue severity and quality of life. Secondary outcomes are physical activity, psychological symptoms, self-efficacy, causal attributions, impact of disease on emotional and physical functioning, present-centred attention-awareness, life

Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen.

Science.gov (United States)

Castellanos-González, Maria; Joven, Beatriz Esther; Sánchez, Julio; Andrés-Esteban, Eva María; Vanaclocha-Sebastián, Francisco; Romero, Pablo Ortiz; Díaz, Raquel Rivera

2016-11-01

Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren. Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis-Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen. Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target-NAPSI-Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035). Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis-Patienten sein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

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

Science.gov (United States)

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

2013-11-01

The goals of this pilot study were to quantify the clinical benefits of using the Hand Exoskeleton Rehabilitation Robot for hand rehabilitation after stroke and to determine the population best served by this intervention. Nine subjects with chronic stroke (one excluded from analysis) completed 18 sessions of training with the Hand Exoskeleton Rehabilitation Robot and a preevaluation, a postevaluation, and a 90-day clinical evaluation. Overall, the subjects improved in both range of motion and clinical measures. Compared with the preevaluation, the subjects showed significant improvements in range of motion, grip strength, and the hand component of the Fugl-Meyer (mean changes, 6.60 degrees, 8.84 percentage points, and 1.86 points, respectively). A subgroup of six subjects exhibited lower tone and received a higher dosage of training. These subjects had significant gains in grip strength, the hand component of the Fugl-Meyer, and the Action Research Arm Test (mean changes, 8.42 percentage points, 2.17 points, and 2.33 points, respectively). Future work is needed to better manage higher levels of hypertonia and provide more support to subjects with higher impairment levels; however, the current results support further study into the Hand Exoskeleton Rehabilitation Robot treatment.

The use of rehabilitation among patients with breast cancer: a retrospective longitudinal cohort study

Directory of Open Access Journals (Sweden)

Lin Yi-Hsien

2012-08-01

Full Text Available Abstract Background Breast cancer is the most common malignancy in women. Along with improvements in treatment, the number of women who survive breast cancer has increased. Rehabilitation can alleviate post-treatment side effects and maintain quality of life. This study aimed to explore the use of rehabilitation among a cohort of patients diagnosed with breast cancer. Methods A retrospective longitudinal cohort study was conducted using a National Health Insurance (NHI research database in Taiwan. The study cohort consisted of 632 patients with breast cancer diagnosed in 2005. Their NHI claims over a period spanning 2005 through 2009 were analyzed. Results Overall, 39.6% of the cohort received rehabilitation therapy, with 9,691 rehabilitation visits claimed (an average of 38.8 visits per user. The prevalence of rehabilitation service use among the cohort was 16.5%, 13.3%, 13.0%, 13.3%, and 12.8% in the years 2005 through 2009, respectively. The average number of visits per rehabilitation user was 16.8, 25.0, 31.1, 24.2, and 23.8 in the years 2005 through 2009, respectively. Most rehabilitation therapy occurred as an outpatient service (96.0%. Physical therapy was the most commonly used form of rehabilitation (84.2%, followed by occupational therapy (15.4%. The most frequently recorded diagnoses were malignant neoplasm of the female breast, peripheral enthesopathies and allied syndromes, and osteoarthrosis and allied disorders. Conclusions Only a small proportion of patients with breast cancer received rehabilitation therapy in the first five years after diagnosis. The average number of rehabilitation visits per user peaked in the third year after diagnosis.

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 ...

Imaging of demyelinating and neoplastic diseases of the spinal cord; Bildgebung bei demyelinisierenden und tumoroesen Erkrankungen des Rueckenmarks

Energy Technology Data Exchange (ETDEWEB)

Mueller-Mang, C. [Institut fuer CT und MRT Gaenserndorf, Gaenserndorf (Austria)

2010-12-15

The clinical symptoms of myelopathy are variable and non-specific. Demyelinating as well as neoplastic spinal cord diseases can cause paresthesia, progressive sensomotoric deficits and bowel and bladder dysfunction. Imaging of the spine, especially with magnetic resonance imaging (MRI), is an essential component in the diagnostic assessment of myelopathy and makes a substantial contribution to achieving the correct diagnosis. Although intramedullary neoplasms are far less common than demyelinating spinal cord diseases, radiologists should be familiar with the three most common entities, astrocytoma, ependymoma and hemangioblastoma, which represent over 70% of all spinal cord neoplasms. An early diagnosis and therapy is essential with neoplastic and demyelinating spinal cord diseases to hold residual neurological deficits as low as possible. (orig.) [German] Die klinische Symptomatik von Myelopathien ist aeusserst variabel und unspezifisch. Sowohl demyelinisierende als auch tumoroese Rueckenmarkerkrankungen koennen Paraesthesien, progrediente sensomotorische Ausfaelle und eine Sphinkterdysfunktion hervorrufen. Bildgebende Untersuchungen, und hier allen voran die MRT, sind ein unerlaesslicher Bestandteil zur Abklaerung von Myelopathien und tragen wesentlich zur korrekten Diagnose bei. Intramedullaere Tumoren sind zwar weitaus seltener als demyelinisierende Rueckenmarkerkrankungen, dennoch sollte der Radiologe mit den Bildmerkmalen der 3 haeufigsten Tumorarten, dem Astrozytom, Ependymom und Haemangioblastom vertraut sein, die ueber 70% aller Rueckenmarktumoren verursachen. Eine moeglichst fruehe Diagnostik und Therapie sind bei tumoroesen und demyelinisierenden Rueckenmarkerkrankungen essenziell, um bleibende neurologische Defizite moeglichst gering zu halten. (orig.)

PET in diagnosing exocrine pancreatic cancer; PET bei Tumoren des exokrinen Pankreas

Energy Technology Data Exchange (ETDEWEB)

Bares, R.; Besenfelder, H.; Dohmen, B.M. [Abt. Nuklearmedizin, Radiologische Klinik des Universitaetsklinikums Tuebingen (Germany)

2003-06-01

Despite dramatic improvements in diagnostic imaging (ultrasonography, in particular endoscopic ultrasound, CT, MRI) treatment results of pancreatic cancer are still poor. Due to the lack of early symptoms, most tumors are diagnosed at an advanced stage of disease which excludes curative surgical treatment. FDG-PET has been shown to be effective in detecting pancreatic cancer as well as differentiating benign from malignant pancreatic tumors. Results might be further improved by applying quantitative analyses, in particular kinetic modelling of FDG metabolism. Nevertheless false negative as well as false positive findings may occur. Small lesions (lymphnode or liver metastases < 1 cm) might be missed, furthermore hyperglycemia often present in patients with pancreatic disease might reduce tumor uptake and subsequently tumor detectability by PET. False positive findings were reported in active pancreatitis and some benign tumors. Although PET proved to be superior to CT or ERCP in detecting cancer, clinical relevance of PET is limited due to the absence of therapeutic consequences to be derived from PET. As a consequence PET should only be used in patients with equivocal findings of morphological imaging (CT, ERCP) who are potential candidates for surgical treatment. (orig.) [German] Trotz verbesserter diagnostischer Moeglichkeiten (endoskopischer Ultraschall, Spiral-CT, MRT) sind die Behandlungsergebnisse bei Tumoren des exokrinen Pankreas nach wie vor unbefriedigend. Aufgrund der spaet einsetzenden klinischen Symptomatik wird die Diagnose meist erst bei lokaler Inoperabilitaet gestellt. Die FDG-PET has sich sowohl im Nachweis von Pankreaskarzinomen als auch bei der Differenzialdiagnose pankreatischer Raumforderungen bewaehrt und den etablierten bildgebenden Verfahren (Ultraschall, CT) als ueberlegen erwiesen. Weitere Verbesserungen erscheinen durch absolute Quantifizierung der FDG-Kinetik moeglich. Dennoch koennen falsch negative wie auch falsch positive Ergebnisse

Increased skin and mucosal toxicity in the combination of vemurafenib with radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Merten, Ricarda; Hecht, Markus; Haderlein, Marlen; Distel, Luitpold; Fietkau, Rainer; Semrau, Sabine [Department of Radiation Oncology University Hospital Erlangen, Erlangen (Germany); Heinzerling, Lucie [University Hospital Erlangen, Department of Dermatology, Erlangen (Germany)

2014-12-15

Palliative radiotherapy is often required for patients with metastatic malignant melanoma in the case of bone or brain metastases. Since BRAF inhibitor therapy is highly efficient in V600-mutated melanomas, there is hesitation to stop it during radiotherapy. Consequently, radiotherapy under simultaneous vemurafenib treatment is frequently needed. We report the case of a patient receiving palliative radiotherapy of spinal bone metastases before and during vemurafenib therapy. The skin reactions were quantitatively scored using computer-assisted digital image evaluation. Radiotherapy without vemurafenib was tolerated very well, whereas radiotherapy under simultaneous vemurafenib treatment resulted in accentuated skin reactions. Furthermore, the patient developed dysphagia and had to be hospitalized for parenteral nutrition. In the quantitative analysis, there was a twofold increase in pigmentation and erythema of the irradiated skin area of the thoracic spine when vemurafenib was combined with radiotherapy compared with radiotherapy treatment alone. This is the first reported case of a patient showing no complications during radiotherapy without vemurafenib but remarkable skin and mucosal toxicity under concurrent vemurafenib therapy. Thus, a genetically conditioned individually elevated radiosensitivity can definitely be excluded. Compared with other reported cases, radiosensitization was not limited to the skin, but also affected the esophageal mucosa. Vemurafenib is a strong radiosensitizer. Patients receiving radiotherapy under simultaneous vemurafenib treatment should be monitored very closely. (orig.) [German] Bei Patienten mit metastasiertem Melanom ist die palliative Bestrahlung von Knochen- oder Hirnmetastasen haeufig erforderlich. Da eine Therapie mit BRAF-Inhibitoren bei Patienten mit V600-mutierten Melanomen hoch effektiv ist, sollte man sie waehrend einer Strahlentherapie nicht unterbrechen. Daher ist eine Strahlentherapie unter laufender Behandlung mit

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson's Disease - A Pilot Study.

Science.gov (United States)

Bukowska, Anna A; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2015-01-01

Idiopathic Parkinson's Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes

MR spectroscopy in dementia; MR-Spektroskopie bei Demenz

Energy Technology Data Exchange (ETDEWEB)

Hauser, T.; Gerigk, L.; Giesel, F.; Schuster, L.; Essig, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung E010, Radiologie, Heidelberg (Germany)

2010-09-15

With an increasingly aging population we are faced with the problem of an increasing number of dementia patients. In addition to clinical, neuropsychological and laboratory procedures, MRI plays an important role in the early diagnosis of dementia. In addition to various morphological changes functional changes can also help in the diagnosis and differential diagnosis of dementia. Overall the diagnosis of dementia can be improved by using parameters from MR spectroscopy. This article focuses on MR spectroscopic changes in the physiological aging process as well as on changes in mild cognitive impairment a precursor of Alzheimer's dementia, in Alzheimer's dementia, frontotemporal dementia, vascular dementia and Lewy body dementia. (orig.) [German] Angesichts einer immer aelter werdenden Bevoelkerung sind wir mit dem Problem einer zunehmenden Zahl an Demenzerkrankungen konfrontiert. Neben klinischen, neuropsychologischen und laborchemischen Verfahren spielt die MRT zur Fruehdiagnostik einer Demenz eine wichtige Rolle. Morphologische Veraenderungen wie auch verschiedene funktionelle Verfahren helfen bei der Diagnostik und Differenzialdiagnostik einer Demenz. Insgesamt kann mittels MR-spektroskopischer Parameter die Diagnostik einer Demenz verbessert werden. In diesem Artikel soll auf MR-spektroskopische Veraenderungen im Rahmen des physiologischen Alterungsprozesses eingegangen werden. Ferner werden speziell Veraenderungen bei leichter kognitiver Beeintraechtigung, einer Vorform der Alzheimer-Demenz, bei Alzheimer-, frontotemporaler, vaskulaerer und Lewy-Koerper-Demenz eroertert. (orig.)

42 CFR 482.56 - Condition of participation: Rehabilitation services.

Science.gov (United States)

2010-10-01

... offered. (1) The director of the services must have the necessary knowledge, experience, and capabilities to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services...

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

Science.gov (United States)

Beyer, Joachim; Seidel, Egbert J

2017-08-01

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

Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control.

Science.gov (United States)

Ueki, Satoshi; Nishimoto, Yutaka; Abe, Motoyuki; Kawasaki, Haruhisa; Ito, Satoshi; Ishigure, Yasuhiko; Mizumoto, Jun; Ojika, Takeo

2008-01-01

This paper presents a virtual reality-enhanced hand rehabilitation support system with a symmetric master-slave motion assistant for independent rehabilitation therapies. Our aim is to provide fine motion exercise for a hand and fingers, which allows the impaired hand of a patient to be driven by his or her healthy hand on the opposite side. Since most disabilities caused by cerebral vascular accidents or bone fractures are hemiplegic, we adopted a symmetric master-slave motion assistant system in which the impaired hand is driven by the healthy hand on the opposite side. A VR environment displaying an effective exercise was created in consideration of system's characteristic. To verify the effectiveness of this system, a clinical test was executed by applying to six patients.

Exercise rehabilitation for smartphone addiction.

Science.gov (United States)

Kim, Hyunna

2013-12-31

Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.

An evaluation of virtual reality technology as an occupational therapy treatment tool in spinal cord injury rehabilitation

LENUS (Irish Health Repository)

McNamara, Angela Dr.

2006-01-01

The introduction of virtual reality (VR) games as an occupational therapy (OT) treatment tool is an attempt to use technology as purposeful activity that is more relevant to a modern patient population than traditional art and craft based activities. It is unclear however if VR games are suitable for clinical applications and the current project examines the usability of video-capture VR games in spinal cord injury (SCI) rehabilitation.\\r\

[The potential of general magnetic therapy for the rehabilitation of the patients presenting with hemorrhagic forms of erysipelas].

Science.gov (United States)

Kuzovleva, E V

2014-01-01

The objective of the present study was to evaluate the possibility and effectiveness of the application of general magnetic therapy for the combined treatment and rehabilitation of the patients presenting with hemorrhagic forms of erysipelas. A total of 102 patients were examined and treated; they were divided into two (control and study) groups matched for age and the main clinical manifestations of the disease. All the patients were given basal therapy, those in the study group were additionally treated using general magnetic therapy. It was shown that the inclusion of this procedure in the combined treatment of hemorrhagic forms of erysipelas promoted rapid and well-apparent elimination of the local inflammatory process, reduced oedema of the affected extremity, improved tissue trophicity, and stimulated microcirculation.

Hand Rehabilitation Robotics on Poststroke Motor Recovery

Science.gov (United States)

2017-01-01

The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics. PMID:29230081

MECHANOKINESITHERAPY IN REHABILITATION OF INDUSTRIAL INJURIES

Directory of Open Access Journals (Sweden)

Раиса Васильевна Гордеева

2018-03-01

Full Text Available The method for the speeded-up restoration of the movements in the injured joints, which raises the range of motions in a short time, quickly relieving a painful syndrome, warning the development of dystrophic changes in the musculoskeletal system has been offered. Subject. Indices of statodynamic functions of the locomotor apparatus in the patients with industrial injuries of the joints at the stage of early rehabilitation with the consistent application of continuous passive motion therapy (CPM-therapy and the pendant system EKZARTA. Objective – rapid recovery of movement functions of the injured joints as a result of industrial traumas at the stage of early patient rehabilitation. Methods. All the patients have been divided into two equivalent groups: the basic and the control. The patients of the basic group from the first days were assigned the restoration of movement functions on the machine-tool of «Kinetec» series with the subsequent transition to kinesitherapy of the pendant systems EKZARTA. The control group of the patients received only СРМ-therapy. Before and after the treatment we carried out the study of statodynamic functions on stable platform along with the definition of significant indices: flexor hip (FH, coefficient of weight load on the foot (CWLF, asymmetry between the extremities (АE, vertical posture (VP. Main results. In the basic group the painful syndrome decreased by 5-7 days before; adaptation to functional loads on injured joints raised. All the patients of the basic group after a rehabilitation course restored the range of motions to the full while in the control group movement restrictions were kept. Scope of application. Occupational pathology, rehabilitation medicine, orthopedics. Conclusions. For the speeded-up restoration of the range of motions in the injured joints resulting from industrial injuries and the decrease in a painful syndrome at the stage of early rehabilitation it is advisable to assign

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 ...

Unfolding the values of work - therapists´ experience of addressing the return to work process in occupational rehabilitation based on Acceptance and Commitment Therapy.

Science.gov (United States)

Klevanger, Nina E; Fimland, Marius S; Johnsen, Roar; Rise, Marit B

2018-04-27

Facilitating return to work can be challenging due to the complexity of work disability. Few studies have examined rehabilitation programs based on Acceptance and Commitment Therapy that intend to support return to work, and none have investigated therapists' experience with providing such programs. The aim of this study was therefore to explore therapists' experience of addressing the return to work process in an inpatient occupational rehabilitation program based on Acceptance and Commitment Therapy. This was a qualitative interview study supported by participant observation. Therapists were interviewed regarding their experiences with addressing return to work in an inpatient occupational rehabilitation program based on Acceptance and Commitment Therapy. In addition, the rehabilitation program was investigated through participant observation. The interviews were analysed according to Interpretative Phenomenological Analysis and informed by an analysis of field notes from the participant observation. Acceptance and Commitment Therapy was experienced as a meaningful approach to facilitate return to work, as it allowed therapists to address all relevant aspects of the individual participant's life that might influence work participation. The therapists' twofold goal was to support participants in building both a meaningful life and sustainable work participation. To do so, they attempted to instil long-term and interrelated processes concerning ownership, causes of sick leave, relation to expectations, the values of work, and the scope of agency. Unfolding values connected to work participation might reconcile the tension between work and family life by integrating work with other areas of life. Providing work participation with personal meaning also seems especially commensurable with a context where economy presents a poor incentive for return to work. Therapists should, however, be attentive to the need to secure the prominence of return to work by relating

"Updates to Model Algorithms & Inputs for the Biogenic Emissions Inventory System (BEIS) Model"

Science.gov (United States)

We have developed new canopy emission algorithms and land use data for BEIS. Simulations with BEIS v3.4 and these updates in CMAQ v5.0.2 are compared these changes to the Model of Emissions of Gases and Aerosols from Nature (MEGAN) and evaluated the simulations against observatio...

[Dysphagia and swallowing rehabilitation].

Science.gov (United States)

Shigematsu, Takashi; Fujishima, Ichiro

2015-02-01

Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

Using Lean principles to manage throughput on an inpatient rehabilitation unit.

Science.gov (United States)

Chiodo, Anthony; Wilke, Ruste; Bakshi, Rishi; Craig, Anita; Duwe, Doug; Hurvitz, Edward

2012-11-01

Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.

Ustekinumab in der Therapie der Pustulosis palmoplantaris - Eine Fallserie mit neun Patienten.

Science.gov (United States)

Buder, Valeska; Herberger, Katharina; Jacobi, Arnd; Augustin, Matthias; Radtke, Marc Alexander

2016-11-01

Die Pustulosis palmoplantaris ist eine chronisch entzündliche Hauterkrankung, die mit bedeutenden Einschränkungen der Lebensqualität und der Belastbarkeit einhergeht. Aufgrund von Zulassungsbeschränkungen und einem häufig therapierefraktären Verlauf sind die Behandlungsmöglichkeiten limitiert. Nach zuvor frustranen Therapien erhielten 9 Patienten mit Pustulosis palmoplantaris nach Ausschluss einer latenten Tuberkulose Ustekinumab (45 mg Ustekinumab bei  100 kg KG) in Woche 0, 4, 12 und 24. Reguläre Visiten erfolgten nach 4 und 12 Wochen, im weiteren Verlauf alle 12 Wochen. Das Durchschnittsalter bei Therapiebeginn betrug 48 Jahre. Drei Patienten waren männlich. Bei n  =  4 Patienten (44,4 %) wurde eine Verbesserung um 75 % des Palmoplantar-Psoriasis-Area-Severity-Index (PPPASI) erreicht. Insgesamt verbesserte sich der PPPASI nach 24 Wochen durchschnittlich um 71,6 %. Eine komplette Abheilung zeigte sich bei n  =  2 Patienten nach 24 Wochen. Bis auf lokale Injektionsreaktionen und leichte Infekte wurden keine unerwünschten Wirkungen beobachtet. Die Fallserie ist ein weiterer Beleg für die Wirksamkeit und Verträglichkeit von Ustekinumab in der Therapie der Pustulosis palmoplantaris. Zur Beurteilung der Langzeitwirkung und -sicherheit sowie der Wirksamkeit einer intermittierenden Therapie sind kontrollierte Studiendaten sowie Beobachtungen im Rahmen von Patientenregistern notwendig. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Rehabilitation of Patients Following Myocardial Infarction.

Science.gov (United States)

Blumenthal, James A.; Emery, Charles F.

1988-01-01

Examines three behavioral strategies in cardiac rehabilitation (CR) for formal treatment for physical and psychosocial sequelae of myocardial infarction (MI): exercise therapy, Type A modification, and nonspecific psychological therapies. Concludes CR improves the quality of life among post-MI patients, but does not prolong life or significantly…

Combined PET/MRI in cerebral and paediatric diagnostics; Kombinierte PET/MRT-Diagnostik bei zerebralen und paediatrischen Fragestellungen

Energy Technology Data Exchange (ETDEWEB)

Pfluger, T.; Vollmar, C.; Porn, U.; Schmid, R.; Dresel, S.; Leinsinger, G.; Schmid, I.; Winkler, P.; Fischer, S.; Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Ludwig-Maximilians-Univ. Muenchen (Germany)

2002-07-01

The aim of this overview is presentation of MRI and PET as synergistic modalities for combined analysis of morphology and function. For operative planning in epilepsy surgery, definition of the epileptogenic focus based on functional PET diagnostics and morphological MRI is decisive. For staging and follow-up examinations in oncology, MRI should be complemented by PET for the assessment of tumor vitality. In paediatric oncology patients we could demonstrate a therapy relevant increase of sensitivity/specificity with combined PET/MRI in contrast to single modalities. In the brain, full spectrum of digital image registration and three-dimensional reconstruction should be used. In extracranial cases, image fusion is disturbing due to a partial loss of image information of single modalities by the fusion process. (orig.) [German] Ziel dieser Uebersicht ist die Darstellung der MRT und PET als synergistische Verfahren zur Analyse von Morphologie und Funktion. Zur Resektionsplanung im Rahmen der Epilepsiechirurgie ist die Definition des Epilepsiefokus anhand der funktionellen PET-Diagnostik und die exakte Kenntnis der zerebralen Morphologie aus der MRT ganz entscheidend. Im Rahmen des onkologischen Stagings und bei Verlaufskontrollen ist wegen der geringeren Spezifitaet der MRT die additive PET zur Beurteilung der Tumorvitalitaet erforderlich. Anhand eines paediatrisch-onkologischen Patientengutes konnten wir zeigen, dass mit der kombinierten PET/MRT-Diagnostik eine therapierelevante Steigerung der Sensitivitaet/Spezifitaet gegenueber den Einzeluntersuchungen moeglich ist. Bei zerebralen Fragestellungen sollte das gesamte Spektrum der digitalen Bildfusion mit direkter Ueberlagerung mehrerer Modalitaeten und anschliessender dreidimensionaler Rekonstruktion ausgeschoepft werden. Bei extrakraniellen Fragestellungen ist die direkte Bildueberlagerung eher hinderlich, da die Bildinformation der Einzelmodalitaeten durch die Fusion teilweise verloren geht. (orig.)

Basics of SCI Rehabilitation

Medline Plus

Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD Kristine Cichowski, MS Read Bio Founding ...

[Robot-aided training in rehabilitation].

Science.gov (United States)

Hachisuka, Kenji

2010-02-01

Recently, new training techniques that involve the use of robots have been used in the rehabilitation of patients with hemiplegia and paraplegia. Robots used for training the arm include the MIT-MANUS, Arm Trainer, mirror-image motion enabler (MIME) robot, and the assisted rehabilitation and measurement (ARM) Guide. Robots that are used for lower-limb training are the Rehabot, Gait Trainer, Lokomat, LOPES Exoskeleton Robot, and Gait Assist Robot. Robot-aided therapy has enabled the functional training of the arm and the lower limbs in an effective, easy, and comfortable manner. Therefore, with this type of therapy, the patients can repeatedly undergo sufficient and accurate training for a prolonged period. However, evidence of the benefits of robot-aided training has not yet been established.

Spatial cognitive rehabilitation and motor recovery after stroke

Science.gov (United States)

Barrett, A.M.; Muzaffar, Tufail

2014-01-01

Purpose of review Stroke rehabilitation needs to take major steps forward to reduce functional disability for survivors. In this article, we suggest that spatial retraining might greatly increase the efficiency and efficacy of motor rehabilitation, directly addressing the burden and cost of paralysis after stroke. Recent findings Combining motor and cognitive treatment may be practical, as well as addressing needs after moderate–to-severe stroke. Spatial neglect could suppress motor recovery and reduce motor learning, even when patients receive appropriate rehabilitation to build strength, dexterity, and endurance. Spatial neglect rehabilitation acts to promote motor as well as visual-perceptual recovery. These findings, and previous underemphasized studies, make a strong case for combining spatial neglect treatment with traditional exercise training. Spatial neglect therapies might also help people who cannot participate in intensive movement therapies because of limited strength and endurance after stroke. Summary Spatial retraining, currently used selectively after right brain stroke, may be broadly useful after stroke to promote rapid motor recovery. PMID:25364954

MRI for myocarditis; MRT bei Myokarditis

Energy Technology Data Exchange (ETDEWEB)

Gutberlet, M.; Luecke, C.; Krieghoff, C.; Hildebrand, L.; Steiner, J.; Adam, J.; Grotthoff, M.; Lehmkuhl, L. [Herzzentrum, Universitaet Leipzig, Abteilung fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Lurz, P.; Eitel, I.; Thiele, H. [Herzzentrum, Universitaet Leipzig, Abteilung Kardiologie, Leipzig (Germany)

2013-01-15

Cardiovascular magnetic resonance imaging (CMRI) has become the primary tool for the non-invasive assessment in patients with suspected myocarditis, especially after exclusion of acute coronary syndrome (ACS) for the differential diagnosis. Various MRI parameters are available which have different accuracies. Volumetric and functional ventricular assessment and the occurrence of pericardial effusion alone demonstrate only a poor sensitivity and specificity. The calculation of the T2-ratio (edema assessment), the early or global relative myocardial enhancement (gRE) and the late gadolinium enhancement (LGE), which represents irreversibly injured myocardium, are more specific parameters. All MRI parameters demonstrate the best accuracy in infarct-like acute myocarditis, whereas in chronic myocarditis sensitivity and specificity are less accurate. Therefore, a multisequential (at least two out of three parameters are positive) approach is recommended. The assessment of the value of newer, more quantitative MRI sequences, such as T1 and T2-mapping is still under investigation. (orig.) [German] Die kardiale MRT stellt die primaere nichtinvasive bildgebende Modalitaet bei Verdacht auf Myokarditis dar, insbesondere auch nach Ausschluss eines akuten Koronarsyndroms (ACS) zur Differenzialdiagnose. Verschiedene MR-Parameter mit unterschiedlicher Wertigkeit stehen zur Verfuegung. Die Beurteilung der Volumetrie und Ventrikelfunktion weisen ebenso wie der Nachweis eines Perikardergusses alleine nur eine geringe Sensitivitaet und Spezifitaet auf. Die spezifischeren MRT-Inflammationsparameter stellen die T2-Ratio (Oedemnachweis), die fruehe Kontrastmittelanreicherung bzw. das globale relative Enhancement (gRE) und die spaete Kontrastmittelanreicherung, das so genannte Late-Gadolinium-Enhancement (LGE) als Zeichen eines irreversiblen Myokardschadens dar. Alle MR-Parameter zeigen die beste diagnostische Genauigkeit bei einer ''infarktaehnlichen'' akuten

A multidisciplinary TBI inpatient rehabilitation programme for active duty service members as part of a randomized clinical trial.

Science.gov (United States)

Braverman, S E; Spector, J; Warden, D L; Wilson, B C; Ellis, T E; Bamdad, M J; Salazar, A M

1999-06-01

To design and describe an effective rehabilitation programme for use in an ongoing trial on the efficacy of multidisciplinary brain injury rehabilitation for moderately head injury military service members. Treatment arm of a randomized control trial. US military tertiary care hospital inpatient rehabilitation programme. Sixty seven active duty military with moderate to severe TBI who were randomized to the treatment arm of the protocol. Eight week rehabilitation programme combining group and individual therapies with an inpatient milieu-oriented neuropsychological focus. Group therapies included fitness, planning and organization, cognitive skills, work skills, medication, and milieu groups, and community re-entry outings. Individual therapy included neuropsychology, work therapy, occupational therapy, and speech and language pathology. Successful return to work and return to duty. At 1 year follow-up, 64 patients returned to work (96%) and 66% (44/67) returned to duty. The described rehabilitation programme demonstrates one successful effort to rehabilitate active duty military service members with TBI who have the potential to return to duty.

Radiotherapy for treatment of induratio penis plastica; Strahlentherapie bei Induratio penis plastica

Energy Technology Data Exchange (ETDEWEB)

Bruns, F.; Kardels, B.; Schaefer, U.; Schoenekaes, K.; Willich, N. [Westfaelische Wilhelms-Univ., Muenster (Germany). Klinik und Poliklinik fuer Strahlentherapie-Radioonkologie

1999-06-01

Radiotherapy is shown to be an effective, low-cost and non-invasive modality for treatment of induratio penis plastica. Its efficiency could be proven especially for inflammatory stages of the disease, or as an alternative after failure of conventional treatment. A total dose of no more than 20-25 Gy was found to achieve clear improvements in two thirds of the patients treated, while avoiding at the same time cosmetically disadvantageous late effects. (orig./CB) [Deutsch] Die Strahlentherapie ist eine wirksame, kostenguenstige und nicht-invasive Behandlungsmoeglichkeit bei Induratio penis plastica. Ihren Stellenwert konnte sie insbesondere im inflammatorischen Stadium und nach Versagen anderer konservativer Therapieansaetze zeigen. Eine Gesamteinstrahldosis von 20-25 Gy reicht aus, um bei 2/3 der Patienten eine deutliche Besserung der Symptomatik zu erzielen bei gleichzeitiger Vermeidung kosmetisch relevanter Spaetnebenwirkungen. (orig.)

Magnetic resonance spectroscopy of brain tumors; MR-Spektroskopie bei Hirntumoren

Energy Technology Data Exchange (ETDEWEB)

Ditter, P.; Hattingen, E. [Universitaetsklinikum Bonn, FE Neuroradiologie, Radiologische Klinik, Bonn (Germany)

2017-06-15

Conventional magnetic resonance imaging (MRI) under consideration of clinical information enables the correct diagnosis and therapy for the majority of cerebral space-occupying lesions. Some important differential diagnoses, e. g. low vs. high-grade tumors, require additional MRI methods. This article critically discusses the importance of magnetic resonance spectroscopy ({sup 1}H-MRS) in brain tumors. The concentration of normal and pathological brain metabolites can be non-invasively measured by {sup 1}H-MRS. It is based on the principle that chemical proton compounds of certain brain metabolites focally attenuate the external magnetic field and change the proton resonance frequency according to typical patterns. In addition, parameter maps of MRS imaging (MRSI) can show the tumor heterogeneity as well as changes in the surrounding brain tissue. In this context, the patterns of N-acetylaspartate, total choline (tCho) and creatine are relatively robust, whereas the patterns of other metabolites, such as myoinositol, glutamate, lactate or lipids greatly depend on the external field strength and echo time. The signal intensity of tCho in vital tumor tissue increases with the WHO grade of the brain tumor, i.e. increases with the level of malignancy. The use of MRSI facilitates the WHO grading of gliomas by determining target points in biopsies. Different distribution patterns and specific metabolite signals enable a better differentiation between abscesses, metastases, central nervous system (CNS) lymphomas and gliomas. The use of {sup 1}H-MRS provides valuable information on the differential diagnosis and graduation of brain tumors; however, so far artefacts, signal strength, parameter selection and a lack of standardization impede the establishment of {sup 1}H-MRS for use in clinical routine diagnostics. (orig.) [German] Die konventionelle MRT ermoeglicht unter Beruecksichtigung klinischer Information bei einem Grossteil zerebraler Raumforderungen die richtige

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

Science.gov (United States)

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

2013-05-01

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

Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study.

Science.gov (United States)

Dennett, Amy M; Peiris, Casey L; Shields, Nora; Morgan, Delwyn; Taylor, Nicholas F

2017-10-01

Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation. A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription. Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals. Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care. © 2016 John Wiley & Sons Australia, Ltd.

[Interdisciplinary cooperation in rehabilitation--problem solving following severe craniocerebral injury].

Science.gov (United States)

Hackspacher, J; Dern, W; Jeschke, H A

1991-05-01

Therapy and rehabilitation of patients with craniocerebral trauma is particularly difficult to programme on account of the neuropsychological defects and personality changes found in this population. The Ulm rehabilitation hospital seeks to face up to this fact by intense interdisciplinary cooperation in the nursing and medical sector, the fields of logopaedics, Occupational Therapy, physiotherapy, immediate post-acute therapy including cerebral training, as well as the entire field of vocational rehabilitation. A dense time schedule has been established for graded introduction of the necessary therapeutic interventions in the sense of a therapy chain, with intense information flows among the therapists involved, thus ensuring a continuous process and joint adjustment of programming to the individual course, to new problems that may arise. The implementation of this concept is set out on the example of a young patient with craniocerebral injury, who had received treatment in various of our departments for a total of 12 months, finally bringing him up to the conclusion of his vocational education.

The role of rehabilitation specialists in Canadian NICUs: a national survey.

Science.gov (United States)

Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.

Science.gov (United States)

Hardison, Mark E; Roll, Shawn C

2016-01-01

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership.

Science.gov (United States)

Jeff, Snodgrass; Douthitt, Shannon; Ellis, Rachel; Wade, Shelly; Plemons, Josh

2008-01-01

The purpose of this research was to serve as a pilot study to investigate the association between occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership. Data for this study were collected using the Multifactor Leadership Questionnaire Form 5X and a self-designed demographic questionnaire. The study working sample included 73 occupational therapy practitioners. Major findings from the study indicate that overall, transformational, and transactional leadership styles are associated with leadership outcomes. Transformational leadership had a significant (p leadership outcomes, whereas transactional leadership had a significant (p leadership outcomes. The contingent reward leadership attribute (although belonging to the transactional leadership construct) was found to be positively associated with leadership outcomes, similar to the transformational leadership constructs. The results of this research suggest that transformational leadership styles have a positive association with leadership outcomes, whereas transactional leadership styles have a negative association, excluding the positive transactional contingent reward attribute. A larger, random sample is recommended as a follow-up study.

Combination benefit of cognitive rehabilitation plus donepezil for Alzheimer's disease patients.

Science.gov (United States)

Matsuzono, Kosuke; Hishikawa, Nozomi; Takao, Yoshiki; Wakutani, Yosuke; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji

2016-02-01

Alzheimer's disease (AD) is one of the most important diseases in aging society, and non-drug therapy might be an alternative therapeutic approach. Thus, we evaluated the add-on effect of cognitive rehabilitation on AD patients under donepezil treatment. We retrospectively analyzed 55 AD patients with a Mini-Mental State Examination score of 15-25, dividing them into two groups depending on whether they were receiving ambulatory cognitive rehabilitation (group D + R, n = 32) or not (group D, n = 23) in Kurashiki Heisei Hospital over 1 year. The present cognitive rehabilitation included physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. Between group D and group D + R, there was no significant difference in baseline data, such as age, Mini-Mental State Examination score, periventricular hyperintensity on magnetic resonance imaging, deep white matter hyperintensity on magnetic resonance imaging or donepezil dose (4.1 mg/day). At 1 year later, however, the Mini-Mental State Examination score improved only in group D + R from 21.7 to 24.0 (**P cognitive rehabilitation plus a choline esterase inhibitor donepezil showed a better effect for the cognitive function of AD patients than drug only therapy at 1 year. © 2015 Japan Geriatrics Society.

Untersuchungen zum Riechvermögen bei Patienten mit schizophrenen Störungen

OpenAIRE

Minovi, A; Dombrowski, T; Brüne, M; Dazert, S; Juckel, G

2014-01-01

Einleitung: Riechstörungen werden bei Patienten mit einer Schizophrenie in vielen Studien beschrieben. Im Rahmen einer prospektiv angelegten Studie untersuchten wir das Riechvermögen von 18 Patienten mit einer Schizophrenie im Vergleich zu einer Kontrollgruppe (n=13). Weiterhin erfolgte eine immunhistochemische Untersuchung der Riechschleimhaut bei 8 Patienten mit einer Schizophrenie.Methoden: Die Riechprüfung erfolgte mit Hilfe der erweiterten Sniffin' Sticks-Testbatterie. Nach Biopsie der...

Biofeedback for robotic gait rehabilitation

Directory of Open Access Journals (Sweden)

Colombo Gery

2007-01-01

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

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

Science.gov (United States)

Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-08-01

Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

Development of early comprehensive stroke inpatient rehabilitation in Poland - current status and future requirements.

Science.gov (United States)

Sarzyńska-Długosz, Iwona; Krawczyk, Maciej; Członkowska, Anna

2011-01-01

Every stroke patient should undergo early rehabilitation. We aimed to evaluate accessibility, development and needs in early stroke inpatient rehabilitation in Poland. A questionnaire evaluating rehabilitation departments was prepared and sent (in 2004 and 2008) to rehabilitation wards in Poland, where stroke patients are treated and undergo early rehabilitation. We divided departments into classes: class A - having comprehensive rehabilitation (physiotherapy minimum 60 minutes/day, speech therapy minimum 30 minutes/5 days/week, rehabilitation of other cognitive impairments minimum 30 minutes/5 days/week, group physiotherapy); B - having the possibility of all types of therapy, but done less frequently; C - physiotherapy and speech therapy; D - physiotherapy and cognitive rehabilitation; E - only physiotherapy. In 2004, we obtained responses from 115 of 172 (66.9%) rehabilitation departments. According to prespecified criteria there were 11 class A, 31 class B, 28 class C, 4 class D, and 41 class E wards. In 2008, we received response from 89 of 149 (59.7%) rehabilitation departments. According to prespecified criteria there were 17 class A, 40 class B, 22 class C, 0 class D, and 10 class E wards. In 2004, 159 beds and in 2008, 294 beds in class A departments were available for stroke patients. The minimal number of needed but lacking beds was 604 in 2004 and 469 in 2008. Development of departments providing early comprehensive stroke rehabilitation from 2004 to 2008 is marked, but still insufficient. In 2008, 19% of rehabilitation departments could provide comprehensive stroke rehabilitation and this was 38.5% of beds actually needed.

Effects of obesity on rehabilitation outcomes after orthopedic trauma.

Science.gov (United States)

Vincent, Heather K; Seay, Amanda N; Vincent, Kevin R; Atchison, James W; Sadasivan, Kalia

2012-12-01

This study examined whether differences existed in inpatient rehabilitation outcomes and therapy participation in nonobese and obese patients with orthopedic trauma. This was a retrospective study of 294 consecutive patients admitted to an inpatient rehabilitation hospital. Main outcomes included participation in therapy sessions, Functional Independence Measure (FIM) ratings, walking distance and stair climb, length of stay, FIM efficiency (FIM score gain/length of stay), and discharge to home. Data were stratified by patient body mass index values (nonobese, obese, ≥30 kg/m). There were no differences in therapy participation or length of stay between groups. Both total and motor FIM ratings at discharge were lower in obese patients compared with nonobese patients (P obese than in the nonobese group (2.6 ± 1.5 vs. 3.1 ± 1.5 points gained per day; P = 0.05). Walking distance and stair climb ability were similar between groups by discharge. Even morbidly obese patients attained some improvement with independence in walking. Obese patients make significant functional improvement during rehabilitation, but at a lesser magnitude and rate as their nonobese counterparts. Even with morbid obesity, small but important functional gains can occur during rehabilitation for orthopedic trauma.

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

Science.gov (United States)

Lo, Ho Shing; Xie, Sheng Quan

2012-04-01

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

Rehabilitation and multiple sclerosis

DEFF Research Database (Denmark)

Dalgas, Ulrik

2011-01-01

In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point......, a paradigm shift is taking place and it is now increasingly acknowledged that exercise therapy is both safe and beneficial. Robot-assisted training is also attracting attention in multiple sclerosis rehabilitation. Several sophisticated commercial robots exist, but so far the number of scientific studies...... promising. This drug has been shown to improve walking ability in some patients with multiple sclerosis, associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation strategies involving these different approaches, or combinations of them, may be of great use in improving...

HandTutor™ enhanced hand rehabilitation after stroke--a pilot study.

Science.gov (United States)

Carmeli, Eli; Peleg, Sara; Bartur, Gadi; Elbo, Enbal; Vatine, Jean-Jacques

2011-12-01

This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p stroke hand function rehabilitation.

[Cardiodoron® bei Patienten mit Schlafstörungen - Ergebnisse einer prospektiven Beobachtungsstudie].

Science.gov (United States)

Rother, Claudia; Schnelle, Martin

Hintergrund: Schlafstörungen gehören zu den häufigsten gesundheitlichen Problemen der heutigen Zeit. Stress und die dadurch bedingte innere Anspannung sowie eine unrhythmische Lebensführung z.B. durch Schichtarbeit sind bekannte auslösende Faktoren. Weniger bekannt ist, dass auch funktionelle Herz-Kreislauf-Beschwerden zu Störungen des Schlafs führen können und dass deren Behandlung zu einer Verbesserung der Schlafqualität beiträgt. Ganzheitlich betrachtet geht es daher um die Wiederherstellung einer gesunden Rhythmik, insbesondere des Herz-/Atem- sowie des Schlaf-Wach-Rhythmus, die Cardiodoron®, eine Heilpflanzenkomposition aus Primula veris, Hyoscyamus niger und Onopordum acanthium, unterstützt. Patienten und Methoden: Mittels einer prospektiven, multizentrischen Beobachtungsstudie sollte ermittelt werden, wie sich funktionelle Herz-Kreislauf-Beschwerden und/oder Schlafstörungen unter der Behandlung mit Cardiodoron® (Dilution) über 3-6 Monate entwickeln. Im Zeitraum von September 2009 bis März 2012 dokumentierten 92 Ärzte 501 Patienten, von denen 380 über Schlafstörungen klagten und deren Daten in dieser Publikation näher betrachtet werden. Nach einer Aufnahmeuntersuchung erfolgte nach 90 Tagen eine Abschlussuntersuchung und bei Fortführung der Therapie nach nochmals 90 Tagen eine Follow-up-Untersuchung. Neben 30 ärztlicherseits bewerteten Symptomen beurteilten die Patienten ihr Befinden mittels Pittsburgh Sleep Quality Index (PSQI) nach Buysse und der Beschwerden-Liste nach von Zerssen (B-L und B-L'). Ergebnisse: Unter der Cardiodoron®-Therapie gingen bei guter Verträglichkeit sowohl die Ausprägung der Schlafstörungen (um 65% von 2,0 auf 0,7 Punkte) als auch die erfassten 30 Symptome (um 59% von 24,3 auf 9,9 Punkte) deutlich zurück (p mit Schlafstörungen (mit oder ohne funktionelle Herz-Kreislauf-Beschwerden) kann die Ausprägung der Beschwerden mit Cardiodoron® deutlich gesenkt werden. Cardiodoron® ist gut verträglich. © 2016 S

Pharmacological/dynamic rehabilitative behavioural therapy for premature ejaculation: Results of a pilot study

Directory of Open Access Journals (Sweden)

Franco Mantovani

2017-06-01

Full Text Available Objectives: Premature ejaculation (PE is a sexual disorder characterised by excessive rapidity of orgasm. It is defined as either primary (60%, present since the onset of sexual activity, or secondary (40%, manifesting later in life. To date, dapoxetine is the only preparation approved for the on-demand treatment of PE. However, side effects, costs associated with the treatment of chronic PE, drug dependence and its variable effectiveness leads to a not insignificant drop-out rate. Dynamic rehabilitative/behavioural therapy may be a viable therapeutic option, working alongside pharmacological treatment, as long as the participation and involvement of both the individual and the couple is optimal. Materials and methods: 18 patients were enrolled, aged between 25 and 55 (mean: 40, all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A; 6 patients began the dynamic rehabilitative treatment (group B; 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C. Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment. Results: Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT values from < 1 to > 6 minutes. Conclusions: the integration of pharmacological treatment with dynamic

Die Rolle von RANK-Ligand und Osteoprotegerin bei Osteoporose

Directory of Open Access Journals (Sweden)

Hofbauer LC

2004-01-01

Full Text Available Receptor activator of nuclear factor (NF- κB ligand (RANKL, sein zellulärer Rezeptor RANK und der Decoy-Rezeptor Osteoprotegerin (OPG stellen ein essentielles Zytokinsystem für die Zellbiologie von Osteoklasten dar. Verschiedene Untersuchungen belegen die Bedeutung von Störungen des OPG/RANKL/RANK-Systems bei der Pathogenese metabolischer Knochenerkrankungen. In dieser Arbeit werden die wichtigsten Störungen des OPG/RANKL/RANK-Systems bei verschiedenen Osteoporoseformen dargestellt. Östrogenrezeptor- (ER- Agonisten wie 17 β-Östradiol, Raloxifen und Genistein stimulieren die osteoblastäre Produktion von OPG durch Aktivierung von ER- α in vitro, während Lymphozyten von Patientinnen mit Östrogenmangel RANKL überexprimieren. Die parenterale Gabe von OPG vermag den mit Östrogenmangel assoziierten Knochenverlust im Tiermodell und in einer kleineren klinischen Studie zu verhindern. Glukokortikoide und Immunsuppressiva steigern gleichzeitig die RANKL-Expression und hemmen die OPG-Produktion in osteoblastären Zellen in vitro. Glukokortikoide sind auch in vivo imstande, die OPG-Serumspiegel deutlich zu reduzieren. Dagegen hemmen biomechanische Reize in vitro die RANKL-Produktion und steigern die OPG-Produktion. Ein Fehlen dieser biomechanischen Reize bei längerer Immobilisierung kann daher den RANKL/OPG-Quotienten steigern, während die tierexperimentelle Immobilisierungs-Osteoporose durch die parenterale Gabe von OPG gemildert werden kann.

Schlafmedizinische Charakterisierung von Parkinson-Patienten mit Schlafattacken unter dopaminerger Therapie

OpenAIRE

Rethfeldt, Mira

2006-01-01

1999 wurden erstmals sogenannte Schlafattacken bei Parkinson-Patienten unter der Therapie mit Nonergolin-Dopaminagonisten berichtet. Später zeigten Studien, dass diese Schlafattacken unter jeglicher dopaminerger Therapie auftreten können. Bis heute ist jedoch die Pathophysiologie dieses Phänomens nicht hinreichend geklärt. Es wird diskutiert, ob diese Attacken als paroxysmales Symptom überhaupt bestehen oder nicht vielmehr ...

Animal assisted therapy (AAT program as a useful adjunct to conventional psychosocial rehabilitation for patients with schizophrenia: results of a small-scale randomized controlled trial.

Directory of Open Access Journals (Sweden)

Paula eCalvo

2016-05-01

Full Text Available Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal-assisted therapy (AAT for specific profiles of patients or participants.The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS and the EuroQoL-5 dimensions questionnaire (EuroQol-5D, pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program.We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning, a community program (intended to facilitate community reintegration and a family program. Each member of the control group (n=8 participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n=14 participated in twice-weekly 1-hour sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial.

Science.gov (United States)

Calvo, Paula; Fortuny, Joan R; Guzmán, Sergio; Macías, Cristina; Bowen, Jonathan; García, María L; Orejas, Olivia; Molins, Ferran; Tvarijonaviciute, Asta; Cerón, José J; Bulbena, Antoni; Fatjó, Jaume

2016-01-01

Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n = 14) participated in twice-weekly 1-h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT

Radiation therapy in old patients. Side effects and results of radiation therapy in old patients; Strahlentherapie des alten Patienten. Vertraeglichkeit und Ergebnisse der Strahlentherapie aelterer Personen

Energy Technology Data Exchange (ETDEWEB)

Geinitz, H.; Zimmermann, F.B.; Molls, M. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

1999-03-01

leads to extensive atherosclerotic vessel damage should be kept in mind. Old patients should be monitored closely during therapy, since the loss of electrolytes or fluid is often not very well tolerated. Conclusion: The indication to radiation therapy of elderly cancer patients should take into account their performance status as well as the extent and the severity of comorbidity. Age per se is seldom a contraindication for radiation therapy. Regarding the available data in literature there is no indication for a dose reduction in radiation therapy only because of age, especially in the curative setting. (orig.) [Deutsch] Hintergrund: Die Anzahl alter Patienten in der Strahlentherapie steigt mit der zunehmenden Alterung der Bevoelkerung. Dennoch werden die damit verbundenen Fragen zur Vertraeglichkeit und Effektivitaet einer Strahlenbehandlung alter Menschen selten diskutiert. Material und Methode: Die Ergebnise einer Literaturrecherche zu epidemiologischen Daten, strahlenbiologischen Aspekten und Ergebnissen der Strahlentherapie alter Patienten werden dargestellt. Ergebnisse: Mit zunehmendem Alter nimmt die Krebsinzidenz zu. Sie liegt bei Maennern aelter als 85 Jahre bei ca. 3,5%. Bei einer durchschnittlichen Lebenserwartung von mehr als vier Jahren ist auch in dieser Altersgruppe der Einsatz einer kurativen Strahlentherapie sinnvoll. Ausserdem deuten verschiedene retrospektive Studien darauf hin, dass die Raten an lokaler Tumorkontrolle und krankheitsspezifischem Ueberleben nach Strahlentherapie mit denen juengerer Patienten vergleichbar sind. Eine Ausnahme bilden unter anderem aeltere Patienten mit Gliomen Grad III bis IV und mit Rektumkarzinom, die ein schlechteres Ueberleben aufweisen. Dieses ist eventuell auf eine weniger aggressive Kombinationstherapie (Tumorresektion) zurueckzufuehren. Obwohl strahlen- und molekularbiologische Daten auf einen Anstieg der Strahlenempfindlichkeit mit zunehmendem Alter hinweisen, wie zum Beispiel das Nachlassen der Kapazitaet

Efficacy of memory rehabilitation therapy: a meta-analysis of TBI and stroke cognitive rehabilitation literature.

Science.gov (United States)

Elliott, Madison; Parente, Frederick

2014-01-01

To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson's r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. RESULTS indicated a significant average ES (r = 0.51) in the treatment intervention conditions, as well as a significant average ES (r = 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. RESULTS showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time.

Graves' disease and toxic nodular goiter - radioiodine therapy; Morbus Basedow und Autonomie - Radioiodtherapie

Energy Technology Data Exchange (ETDEWEB)

Schicha, H.; Dietlein, M. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

2002-04-01

At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [German] In dem vorliegenden Beitrag wird ueber die Radioiodtherapie gutartiger Schilddruesenerkrankungen referiert. Dies betrifft gesetzliche Regelungen in Deutschland, grundlegende Ueberlegungen zur Therapie benigner Schilddruesenerkrankungen, die Diskussion konservative versus definitive Therapieindikation der Hyperthyreose und schliesslich die Themenkomplexe Vorbereitung, Durchfuehrung, Ergebnisse, Nebenwirkungen und Komplikationen, Kosten sowie Nachsorge der Radioiodtherapie. Im Vordergrund steht die Abgrenzung der konservativen Therapieindikation gegenueber der primaeren Radioiodtherapie des Morbus Basedow in Deutschland. Waehrend in den USA 70-90% der Morbus-Basedow-Faelle primaer mit Radioiodtherapie behandelt werden, wird in Deutschland bei 90% zunaechst ein

Precise orbit determination and point positioning using GPS, Glonass, Galileo and BeiDou

Directory of Open Access Journals (Sweden)

Tegedor J.

2014-04-01

Full Text Available State of the art Precise Point Positioning (PPP is currently based on dual-frequency processing of GPS and Glonass navigation systems. The International GNSS Service (IGS is routinely providing the most accurate orbit and clock products for these constellations, allowing point positioning at centimeter-level accuracy. At the same time, the GNSS landscape is evolving rapidly, with the deployment of new constellations, such as Galileo and BeiDou. The BeiDou constellation currently consists of 14 operational satellites, and the 4 Galileo In-Orbit Validation (IOV satellites are transmitting initial Galileo signals. This paper focuses on the integration of Galileo and BeiDou in PPP, together with GPS and Glonass. Satellite orbits and clocks for all constellations are generated using a network adjustment with observation data collected by the IGS Multi-GNSS Experiment (MGEX, as well as from Fugro proprietary reference station network. The orbit processing strategy is described, and orbit accuracy for Galileo and BeiDou is assessed via orbit overlaps, for different arc lengths. Kinematic post-processed multi-GNSS positioning results are presented. The benefits of multiconstellation PPP are discussed in terms of enhanced availability and positioning accuracy.

Healing of Achilles tendon partial tear following focused shockwave: a case report and literature review

Directory of Open Access Journals (Sweden)

Hsu YC

2017-05-01

Full Text Available Yu-Chun Hsu,1,* Wei-Ting Wu,2,* Ke-Vin Chang,2–4 Der-Sheng Han,2–4 Li-Wei Chou5–7 1Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, 2Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, 3National Taiwan University College of Medicine, 4Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 6Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, 7Department of Rehabilitation, Asia University Hospital, Taichung, Taiwan *These authors contributed equally to this work Abstract: Achilles tendinopathy is a common cause of posterior heel pain and can progress to partial tendon tear without adequate treatment. Effects of traditional treatments vary, and many recent reports focus on the use of extracorporeal shockwave therapy (ESWT for Achilles tendinopathy but not for Achilles tendon partial tear. Here, we report the case of a 64-year-old female suffering from severe left heel pain for half a year. All treatment and rehabilitation were less effective until ESWT was applied. Each course of focused shockwave therapy included 2500 shots with energy flux density from 0.142 mJ/mm2 to 0.341 mJ/mm2. The visual analog scale decreased from nine to one degree. High-resolution musculoskeletal ultrasonography was performed before and 1 month after the treatment, which revealed healing of the torn region and decrease in inflammation. ESWT had shown to be an alternative treatment for Achilles tendon partial tear under safety procedure and ultrasound observation. Keywords: focused shockwave, Achilles tendon, partial tear, ultrasonography

Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

OpenAIRE

Chen, Jia-Ching; Shaw, Fu-Zen

2014-01-01

Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulati...

The Johannesburg cardiac rehabilitation programme

African Journals Online (AJOL)

1991-02-16

Feb 16, 1991 ... sion 72,9% of patients were smokers, 26,3% had hypertension and 34,3% had ... Cardiac rehabilitation, including supervised exercise therapy, has become a .... sions on risk factor modification, diet, aspects of heart disease,.

External therapy with radioactive urine: a pitfall during sceletal scintigraphy; Heisse Eigenurintherapie: ein ueberraschender Befund bei der Skelettszintigraphie

Energy Technology Data Exchange (ETDEWEB)

Scheidhauer, K.; Urbannek, V. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany)

1997-12-01

A 41-year old male patient suffering from psoriasis arthropathica underwent a two-phase bone scan for activity of joint affections. Extensive diffuse skin contamination of the extremities in the delayed images was due to the use of the patient`s own radioactive urine as an embrocation for psoriasis exanthema. (orig.) [Deutsch] Bei einem 41jaehrigen Patienten mit Psoriasisarthropathie fiel in der Skelettszintigraphie in den Aufnahmen der Mineralisationsphase eine flaechige Aktivitaetsbelegung der Beine auf. Als Ursache stellte sich das zwischenzeitliche Einreiben der Extremitaeten durch den Patienten mit dem radioaktiven Eigenurin wegen eines Exantherms heraus. (orig.)

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

Science.gov (United States)

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

2017-07-01

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

Laterale 10-fach-Biopsie der Prostata liefert bei Karzinomverdacht überlegene Detektionsraten

Directory of Open Access Journals (Sweden)

von Knobloch R

2012-01-01

Full Text Available Einleitung:Die Sextantenbiopsie der Prostata ist für eine verlässliche Karzinomdiagnostik nicht ausreichend. Vielerorts werden bereits bei der Erstbiopsie 12 Stanzen entnommen. In einer großen Serie von 10-fach-Biopsien unter bilateraler lokaler Leitungsanästhesie, wie bereits 2002 publiziert [1], überprüften wir die Qualität unserer Technik als Standard für die Erstbiopsie. Methode:Zwischen April 2005 und Dezember 2007 führten wir bei 736 Männern (Durchschnittsalter 67,5 ± 8,39 Jahre die Erstbiopsie der Prostata durch. Indikation für die Biopsie war entweder ein erhöhter PSA-Wert oder ein auffälliger Tastbefund. Bei allen Männern erfolgte die Biopsie der Prostata unter bilateraler lokaler Leitungsanästhesie. Es wurden nur Proben aus der peripheren Zone der Prostata unter transrektaler Ultraschallkontrolle entnommen. Ergebnisse:Durch die Biopsie wurde in 372 von 736 Fällen (50,5 % ein Karzinom identifiziert. Die Karzinomdetektionsrate war proportional zum PSA-Wert und indirekt proportional zum Organvolumen. Es zeigte sich eine eindeutige Korrelation zwischen der Anzahl positiver Stanzen bei der Biopsie mit dem pathologischen Stadium des Prostatektomiepräparates. 12 Männer (1,6 % mussten wegen akuter Prostatitis und 5 (0,7 % wegen rektaler Blutung wieder ins Krankenhaus eingewiesen werden. Von den 182 Patienten des Untersuchers R. v. K. wurde der durchschnittliche Schmerz der Biopsie mit 1,69 von maximal 10 angegeben. Die Detektions- und Komplikationsraten dieser Biopsietechnik unterschieden sich nicht nach Durchführung von Assistenz- oder Fachärzten. Schlussfolgerung: Die präsentierte Biopsietechnik liefert mit nur 10 Stanzen eine überlegene Detektionsrate und eine geringe Rate an Komplikationen. Sie sollte als Basis für die Definition eines Standards für die Erstbiopsie der Prostata bei Karzinomverdacht dienen.

EFFECTIVENESS OF SECRETOLYTIC THERAPY IN REHABILITATION PROGRAM IN FREQUENTLY AILING CHILDREN

Directory of Open Access Journals (Sweden)

V.V. Kiselev

2008-01-01

Full Text Available A problem of rehabilitation of frequently ailing children (FAC is one of the actual problems in pediatrics. Disorders of mucosal immunity, depending on different factors including the state of mucociliary transport, play important role in formation of FAC group including patients with recurrent episodes of obstructive bronchitis. Morphological and functional unity of mucous tunic of respiratory tract allows determining the state of mucociliary clearance and effectiveness of secretolytic therapy by the state of mucosal tunic of nose and nasopharynx (it is the most accessible mucosal tunic for the objective examination. Specified rates of time of mucociliary transport in different groups of FAC are presented in this article. An effectiveness of mucoregulatory medication ambroxol in complex treatment of FAC with adenoids and recurrent episodes of obstructive bronchitis, and advisability of its prolonged (14–18 days use for the recovery of disturbed system of mucociliary transport were described in this article.Key words: frequently ailing children, somatotype, mucociliary clearance, treatment.

Kyphoplastie als palliative Therapieoption bei pathologischen Frakturen der Brust- und Lendenwirbelsäule

Directory of Open Access Journals (Sweden)

Hartwig E

2004-01-01

Full Text Available Bedingt durch Fortschritte in der Behandlung von Tumoren hat sich die Lebenserwartung von Krebspatienten deutlich verbessert. Jedoch steigt hiermit auch die Inzidenz von Knochenmetastasen. Mit wenigen Ausnahmen, die primären Knochentumoren betreffend, ist die Art der Behandlung dieser Läsionen in der Regel palliativ. Durch operatives Intervenieren muß bei diesen Patienten ein maximaler palliativer Effekt bei minimaler Morbidität und Mortalität erzielt werden. Die vorwiegenden Ziele sind Schmerzreduktion unter Erhalt der Stabilität und Funktion. Durch die Kyphoplastie wurden Zementierungsverfahren an der Wirbelsäule auch für pathologische Frakturen auf dem Boden metastatischer Manifestationen elegibel. In einer telefonischen Evaluation von 10 Patienten konnte die Wertigkeit des Verfahrens in der palliativen Situation bei Patienten mit Wirbelsäulenmetastasen gezeigt werden.

Aspekte der Osteoporosetherapie und Frakturprävention bei geriatrischen Patienten

Directory of Open Access Journals (Sweden)

Gosch M

2010-01-01

Full Text Available Aktuell beträgt der Anteil der Personen 65 Jahre in Österreich 17 %. Nach Schätzungen der WHO wird sich dieser Anteil bis 2025 verdoppeln. Parallel mit der demographischen Veränderung steigt auch die Inzidenz der Oberschenkelhalsfraktur von zurzeit 16.000/Jahr auf 25.000 im Jahr 2050. Mit einer jährlichen Inzidenz von 19,7/100.000 Einwohner weist Österreich innerhalb der EU eine der höchsten Zahlen auf. Die hüftnahen Frakturen sowie die Wirbelkörperfrakturen treten überwiegend als Folge einer bestehenden Osteoporose auf. Die Qualität der Osteoporosebehandlung stellt die Grundvoraussetzung für einen erfolgreichen präventiven Behandlungsansatz dar. Eine ausreichende Kalzium- und Vitamin-D-Zufuhr hat gerade im höheren Alter große Bedeutung, insbesondere auch im Hinblick auf die Sturzprävention. Für einzelne Bisphosphonate, Teriparatid und Strontiumranelat konnte eine signifikante Reduktion des Frakturrisikos bei geriatrischen Patienten nachgewiesen werden. Aus aktuellen Studien wissen wir, dass wir bei Patienten mit einem hohen Risiko eine „number needed to treat“ (NNT von 1:15 erreichen können. Trotz zahlreicher therapeutischer Möglichkeiten steigt die Inzidenz weiter an. Aus verschiedenen internationalen Studien sind uns mögliche Ursachen für diese Entwicklung bekannt. Neben der ungenügenden Compliance der Patienten ist auch die fehlende Awareness der Ärzte problematisch. Eine weitere Herausforderung in der Behandlung der Osteoporose und deren Folgen stellt beim älteren Patienten das Sturzrisiko dar. Screeninguntersuchungen werden in vielen Leitlinien empfohlen, sind im klinischen Alltag jedoch eher die Ausnahme. Wissenschaftliche Daten für geriatrische Patienten bestätigen die Wirksamkeit einer Therapie auch in dieser Altersgruppe. Bedauerlicherweise fließen die vorliegenden Erkenntnisse kaum in die klinische Praxis ein.

The Knowledge of Rehabilitation Professionals Concerning Fetal Alcohol Spectrum Disorders.

Science.gov (United States)

Birch, Stephanie M; Carpenter, Heidi A; Marsh, Anna M; McClung, Kimberly A; Doll, Joy D

2016-01-01

The purpose of this study was to explore rehabilitation professionals' knowledge regarding signs and symptoms, prevention, and intervention of fetal alcohol spectrum disorders (FASD). Participants were 111 rehabilitation practitioners (e.g., occupational therapy, physical therapy, and speech-language pathology practitioners) recruited through email using a quantitative online survey design with purposive, snowball sampling. Results showed the majority of participants' demonstrated accurate knowledge of the signs and symptoms of FASD. Since professionals who received formal education on FASD reported significantly higher feelings of preparedness to identify children with FASD and manage/coordinate intervention plans, this study suggests rehabilitation professionals may be better prepared to treat individuals with FASD if they participate in formal training.

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.

Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

DEFF Research Database (Denmark)

Søgaard, Rikke; Laurberg, Ida; Christensen, Finn B

2008-01-01

Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full......-scale economic evaluation, including extra-hospital effects such as service utilization in the primary health care sector and return-to-work, is conducted. The objective of this study was to conduct such evaluation i.e. investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen...... with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion...

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

Science.gov (United States)

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

2009-07-01

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

Rehabilitation Interventions for Children With Cerebral Palsy: A Systematic Review

Directory of Open Access Journals (Sweden)

Ali Abbaskhanian

2015-01-01

Full Text Available Context: Cerebral palsy (CP is a group of movement problems that do not worsen over time. They cause physical disability mainly in areas of body movement. It is caused by damage to the motor control centers of developing brain. Management of a child with CP to optimize functional abilities, typically includes the input of many disciplines, including occupational therapy (OT, physical therapy (PT and orthotic treatment. The main aim of this review was to compare the effects of most common rehabilitation intervention on CP. Evidence Acquisition: This systematic review was conducted on published papers that studied rehabilitation interventions approaches for children with CP. A literature search was performed using PubMed, SCOPUS and Google Scholar on papers published from January 1990 to October 2014. Results: From 125 articles related to rehabilitation interventions for children with Cerebral palsy, 36 articles met the inclusion criteria. Conclusions: The efficacy of rehabilitation interventions for children with CP is still inconclusive. Functional ability and social participation should be the main outcome measures in evaluating rehabilitation efficacy.

A Data Set of Human Body Movements for Physical Rehabilitation Exercises.

Science.gov (United States)

Vakanski, Aleksandar; Jun, Hyung-Pil; Paul, David; Baker, Russell

2018-03-01

The article presents University of Idaho - Physical Rehabilitation Movement Data (UI-PRMD) - a publically available data set of movements related to common exercises performed by patients in physical rehabilitation programs. For the data collection, 10 healthy subjects performed 10 repetitions of different physical therapy movements, with a Vicon optical tracker and a Microsoft Kinect sensor used for the motion capturing. The data are in a format that includes positions and angles of full-body joints. The objective of the data set is to provide a basis for mathematical modeling of therapy movements, as well as for establishing performance metrics for evaluation of patient consistency in executing the prescribed rehabilitation exercises.

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson’s Disease – A Pilot Study

Science.gov (United States)

Bukowska, Anna A.; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2016-01-01

Idiopathic Parkinson’s Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes

Pulmonary Rehabilitation: The Reference Therapy for Undernourished Patients with Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Nikolaos Samaras

2014-01-01

Full Text Available Chronic obstructive pulmonary disease (COPD combines the deleterious effects of chronic hypoxia, chronic inflammation, insulin-resistance, increased energy expenditure, muscle wasting, and exercise deconditioning. As for other chronic disorders, loss of fat-free mass decreased survival. The preservation of muscle mass and function, through the protection of the mitochondrial oxidative metabolism, is an important challenge in the management of COPD patients. As the prevalence of the disease is increasing and the medical advances make COPD patients live longer, the prevalence of COPD-associated nutritional disorders is expected to increase in future decades. Androgenopenia is observed in 40% of COPD patients. Due to the stimulating effects of androgens on muscle anabolism, androgenopenia favors loss of muscle mass. Studies have shown that androgen substitution could improve muscle mass in COPD patients, but alone, was insufficient to improve lung function. Two multicentric randomized clinical trials have shown that the association of androgen therapy with physical exercise and oral nutritional supplements containing omega-3 polyinsaturated fatty acids, during at least three months, is associated with an improved clinical outcome and survival. These approaches are optimized in the field of pulmonary rehabilitation which is the reference therapy of COPD-associated undernutrition.

Endokrinologische Behandlung der Geschlechtsdysphorie bei Menschen mit Geschlechtsinkongruenz

Directory of Open Access Journals (Sweden)

Flütsch N

2015-01-01

Full Text Available Es gibt Menschen, die die innere Gewissheit besitzen, dass ihre Geschlechtsidentität nicht zu ihrem biologischen Ursprungsgeschlecht passt. Durch die Entwicklungen in der Medizin in den letzten hundert Jahren ist es möglich geworden, die körperlichen Geschlechtsmerkmale an das innerlich erlebte Geschlecht anzupassen. Die Zahl der Hilfesuchenden in den ärztlichen Ambulanzen und Privatpraxen hat in den vergangenen Jahren deutlich zugenommen. Das Vorgehen bei der Diagnostik und Therapieeinleitung erlebt zurzeit eine deutliche Veränderung hin zu mehr Patientenzentriertheit und Individualisierung des Transitionsprozesses. Dabei bildet die geschlechtsangleichende Hormontherapie ein wesentliches Standbein in der körperlichen Angleichung an das Gegengeschlecht. Unter Beachtung von bestimmten Sicherheitsaspekten ist eine Hormontherapie mit Sexualhormonen sicher und einfach durchzuführen. Regelmäßige Verlaufskontrollen sowie der offene und affirmative Umgang mit den Betroffenen tragen zudem wesentlich zur Sicherheit in der Behandlung bei.

Postacute Stroke Rehabilitation Utilization: Are There Differences between Rural-Urban Patients and Taxonomies?

Science.gov (United States)

Jia, Huanguang; Cowper, Diane C.; Tang, Yuhong; Litt, Eric; Wilson, Lauren

2012-01-01

Purpose: To assess the association between Veterans Affairs (VA) stroke patients' poststroke rehabilitation utilization and their residential settings by using 2 common rural-urban taxonomies. Methods: This retrospective study included all VA stroke inpatients in 2001 and 2002. Rehabilitation utilization referred to rehabilitation therapy received…

Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: their variation, similarities, and association with functional outcomes.

Science.gov (United States)

DeJong, Gerben; Hsieh, Ching-Hui; Putman, Koen; Smout, Randall J; Horn, Susan D; Tian, Wenqiang

2011-12-01

The mix of physical therapy services is thought to be different with different impairment groups. However, it is not clear how much variation there is across impairment groups. Furthermore, the extent to which the same physical therapy activities are associated with functional outcomes across different types of patients is unknown. The purposes of this study were: (1) to examine similarities and differences in the mix of physical therapy activities used in rehabilitation among patients from different impairment groups and (2) to examine whether the same physical therapy activities are associated with functional improvement across impairment groups. This was a prospective observational cohort study. The study was conducted in inpatient rehabilitation facilities. The participants were 433 patients with stroke, 429 patients with total knee arthroplasty (TKA), and 207 patients with traumatic brain injury (TBI). Measures used in this study included: (1) the Comprehensive Severity Index to measure the severity of each patient's medical condition, (2) the Functional Independence Measure (FIM) to measure function, and (3) point-of-care instruments to measure time spent in specific physical therapy activities. All 3 groups had similar admission motor FIM scores but varying cognitive FIM scores. Patients with TKA spent more time on exercise than the other 2 groups (average=31.7 versus 6.2 minutes per day). Patients with TKA received the most physical therapy (average=65.3 minutes per day), whereas the TBI group received the least physical therapy (average=38.3 minutes per day). Multivariate analysis showed that only 2 physical therapy activities (gait training and community mobility) were both positively associated with discharge motor FIM outcomes across all 3 groups. Three physical therapy activities (assessment time, bed mobility, and transfers) were negatively associated with discharge motor FIM outcome. The study focused primarily on physical therapy without

Physical Therapy Activities in Stroke, Knee Arthroplasty, and Traumatic Brain Injury Rehabilitation: Their Variation, Similarities, and Association With Functional Outcomes

Science.gov (United States)

Hsieh, Ching-Hui; Putman, Koen; Smout, Randall J.; Horn, Susan D.; Tian, Wenqiang

2011-01-01

Background The mix of physical therapy services is thought to be different with different impairment groups. However, it is not clear how much variation there is across impairment groups. Furthermore, the extent to which the same physical therapy activities are associated with functional outcomes across different types of patients is unknown. Objective The purposes of this study were: (1) to examine similarities and differences in the mix of physical therapy activities used in rehabilitation among patients from different impairment groups and (2) to examine whether the same physical therapy activities are associated with functional improvement across impairment groups. Design This was a prospective observational cohort study. Methods The study was conducted in inpatient rehabilitation facilities. The participants were 433 patients with stroke, 429 patients with total knee arthroplasty (TKA), and 207 patients with traumatic brain injury (TBI). Measures used in this study included: (1) the Comprehensive Severity Index to measure the severity of each patient's medical condition, (2) the Functional Independence Measure (FIM) to measure function, and (3) point-of-care instruments to measure time spent in specific physical therapy activities. Results All 3 groups had similar admission motor FIM scores but varying cognitive FIM scores. Patients with TKA spent more time on exercise than the other 2 groups (average=31.7 versus 6.2 minutes per day). Patients with TKA received the most physical therapy (average=65.3 minutes per day), whereas the TBI group received the least physical therapy (average=38.3 minutes per day). Multivariate analysis showed that only 2 physical therapy activities (gait training and community mobility) were both positively associated with discharge motor FIM outcomes across all 3 groups. Three physical therapy activities (assessment time, bed mobility, and transfers) were negatively associated with discharge motor FIM outcome. Limitations The study

Evaluation of a regional real-time precise positioning system based on GPS/BeiDou observations in Australia

Science.gov (United States)

Ding, Wenwu; Tan, Bingfeng; Chen, Yongchang; Teferle, Felix Norman; Yuan, Yunbin

2018-02-01

The performance of real-time (RT) precise positioning can be improved by utilizing observations from multiple Global Navigation Satellite Systems (GNSS) instead of one particular system. Since the end of 2012, BeiDou, independently established by China, began to provide operational services for users in the Asia-Pacific regions. In this study, a regional RT precise positioning system is developed to evaluate the performance of GPS/BeiDou observations in Australia in providing high precision positioning services for users. Fixing three hourly updated satellite orbits, RT correction messages are generated and broadcasted by processing RT observation/navigation data streams from the national network of GNSS Continuously Operating Reference Stations in Australia (AUSCORS) at the server side. At the user side, RT PPP is realized by processing RT data streams and the RT correction messages received. RT clock offsets, for which the accuracy reached 0.07 and 0.28 ns for GPS and BeiDou, respectively, can be determined. Based on these corrections, an accuracy of 12.2, 30.0 and 45.6 cm in the North, East and Up directions was achieved for the BeiDou-only solution after 30 min while the GPS-only solution reached 5.1, 15.3 and 15.5 cm for the same components at the same time. A further improvement of 43.7, 36.9 and 45.0 percent in the three directions, respectively, was achieved for the combined GPS/BeiDou solution. After the initialization process, the North, East and Up positioning accuracies were 5.2, 8.1 and 17.8 cm, respectively, for the BeiDou-only solution, while 1.5, 3.0, and 4.7 cm for the GPS-only solution. However, we only noticed a 20.9% improvement in the East direction was obtained for the GPS/BeiDou solution, while no improvements in the other directions were detected. It is expected that such improvements may become bigger with the increasing accuracy of the BeiDou-only solution.

Hyaluronic acid intra-articular injection and exercise therapy: effects on pain and disability in subjects affected by lower limb joints osteoarthritis. A systematic review by the Italian Society of Physical and Rehabilitation Medicine (SIMFER).

Science.gov (United States)

Monticone, Marco; Frizziero, Antonio; Rovere, Giancarlo; Vittadini, Filippo; Uliano, Domenico; LA Bruna, Silvano; Gatto, Renato; Nava, Claudia; Leggero, Vittorio; Masiero, Stefano

2016-06-01

It is debated whether intra-articular viscosupplementation with hyaluronic acid (HA) can lead to improvements in subjects with osteoarthritis (OA) undergoing physical and rehabilitative interventions. To assess the effects of intra-articular viscosupplementation on disability in subjects with OA undergoing physical and rehabilitative interventions. Information on pain and quality of life were also collected. The databases of PubMed, Medline, EMbase and CINAHL were searched for English language full-text randomized controlled trials comparing intra-articular viscosupplementation alone or associated with physical and rehabilitative interventions to viscosupplementation alone, shame treatment, waiting lists, and any type of rehabilitative interventions. Methodological quality of each study was assessed by using the Physiotherapy Evidence Database (PEDro) Scale. A total of 115 references were retrieved, and 8 studies were selected. Three trials compared HA injection and physical therapy in knee OA, with disability and pain improvements in all studies, and between-group differences in favor of physical therapy in two studies; two trials compared HA injection and home exercises in knee OA, with improvements in pain, disability and quality of life in all studies, without between-group differences; two trials compared HA injection plus physical therapy agents and exercises to exercises plus physical therapy agents in knee OA, with improvements in disability and pain in both studies, and between-group differences in favor of the inclusion HA in one study; one trial compared HA injection and home exercises in ankle OA, with improvements in disability and pain in both arms without between-group differences. Physical therapy agents seemed to have greater effects than intra-articular viscosupplementation on disability and pain. In the other cases both intra-articular viscosupplementation and physical and rehabilitative interventions seemed to be equally effective in improving

Eagle Syndrome: diagnostic imaging and therapy; Eagle Syndrom - Bildgebende Diagnostik und Therapie

Energy Technology Data Exchange (ETDEWEB)

Nickel, J.; Andresen, R. [Abt. fuer Bildgebende Diagnostik und Interventionelle Radiologie, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany); Sonnenburg, M. [Fachbelegarztpraxis fuer Mund, Kiefer, Gesichtschirurgie und Plastische Operationen, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany); Scheufler, O. [Klinik fuer Plastische, Wiederherstellungs- und Handchirurgie, Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe Univ. Frankfurt am Main (Germany)

2004-07-01

In the case of clinical symptoms such as dysphagia, foreign-body sensation and chronic neck or facial pain close to the ear, an Eagle syndrome should be considered in the differential diagnosis. Rational diagnostics and therapy are elucidated on the basis of four case reports. Four patients presented in the out-patients clinic with chronic complaints on chewing and a foreign-body sensation in the tonsil region. Upon specific palpation below the mandibular angle, pain radiating into the ear region intensified. In all patients, local anaesthesia with lidocaine only led to a temporary remission of symptoms. Imaging diagnostics then performed initially included cranial survey radiograms according to Clementschitsch as well as in the lateral ray path and an OPTG. An axial spiral-CT was then performed using the thin-layer technique with subsequent 3-D reconstruction. Therapy consisted of elective resection with a lateral external incision from the retromandibular. From a symptomatic point of view, the cranial survey radiograms and the OPTG revealed hypertrophic styloid processes. The geometrically corrected addition of the axial CT images produced an absolute length of 51-58 mm. The 3-D reconstruction made it possible to visualise the exact spatial orientation of the styloid processes. An ossification of the stylohyoid ligament could definitely be ruled out on the basis of the imaging procedures. After resection of the megastyloid, the patients were completely free of symptoms. Spiral-CT with subsequent 3-D reconstruction is the method of choice for exact determination of the localisation and size of a megastyloid, while cranial survey radiograms according to Clementschitsch and in the lateral ray path or an OPTG can provide initial information. The therapy of choice is considered to be resection of the megastyloid, whereby an external lateral incision has proved effective. (orig.) [German] Bei klinischen Beschwerden wie Dysphagie, Fremdkoerpergefuehl und chronischen

Shoulder injuries in overhead sports; Schultergelenkverletzungen bei Ueberkopfsportarten

Energy Technology Data Exchange (ETDEWEB)

Woertler, K. [Technische Universitaet Muenchen (Germany). Institut fuer Roentgendiagnostik

2010-05-15

Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence. This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes. (orig.) [German] Ueberkopfsportarten stellen grosse Anforderungen an das Schultergelenk. Schulterbeschwerden bei Ueberkopf- und Wurfsportlern koennen in der Mehrzahl der Faelle auf eine chronische Ueberlastung von Sehnen und Kapsel-Band-Strukturen oder auf die Folgen einer Mikroinstabilitaet und sekundaerer Impingementsyndrome zurueckgefuehrt werden. Wegen ihres grossen Einflusses auf die Therapieentscheidung stellt die Bildgebung bei Athleten mit unklaren Schulterbeschwerden eine Herausforderung dar. Die MR-Arthrographie ist in diesem Zusammenhang als Schnittbildverfahren der ersten Wahl anzusehen, da sie den Nachweis bzw. Ausschluss pathologischer Veraenderungen aller relevanten Gelenkstrukturen mit ausreichender Sicherheit ermoeglicht. Dieser Artikel gibt eine Uebersicht ueber biomechanische und klinische Aspekte sowie MR-arthrographische Befunde der haeufigsten Schultergelenkpathologien bei Ueberkopfsportlern, wie Bizepstendinopathie, Superior-labral-anterior-posterior- (SLAP-)Laesionen, Laesionen der

Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes

Directory of Open Access Journals (Sweden)

Jia H

2017-03-01

Full Text Available Huanguang Jia,1 Qinglin Pei,1 Charles T Sullivan,1 Diane C Cowper Ripley,1 Samuel S Wu,1 W Bruce Vogel,1 Xinping Wang,1 Douglas E Bidelspach,2 Jennifer L Hale-Gallardo,1 Barbara E Bates3 1Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL, 2Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Washington, DC, 3Aleda E. Lutz VA Medical Center, Saginaw, MI, USA Introduction: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors’ functional recovery and daily living activities. The US Department of Veterans Affairs (VA places veterans needing post-acute institutional care in private community nursing homes (CNHs. These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans’ health services as well as the geographic variation of the service utilization. Aim: The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. Methods: This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents for the study CNHs was linked with veterans’ inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation

Introducing Acceptance and Commitment Therapy to a physiotherapy-led pain rehabilitation programme: an Action Research study.

Science.gov (United States)

Barker, Karen L; Heelas, Leila; Toye, Francine

2016-02-01

Recent developments in pain rehabilitation emphasise the importance of promoting psychological flexibility. Acceptance and Commitment Therapy (ACT) is one approach that has been shown to be effective for the treatment of chronic musculoskeletal pain. However, studies have shown that introducing innovative approaches such as ACT into established health care can cause some anxiety for professional groups. We used Action Research to evaluate the implementation of ACT to a physiotherapy-led pain rehabilitation programme. All staff in the pain service were invited to participate. Participants took part in focus groups, engaged in reflective sessions/meetings and completed reflective diaries. The analysis was undertaken by an experienced qualitative researcher using constant comparison. Participants reviewed emerging themes and validated the findings. Four key themes emerged from the study: (a) the need to see pain as an embodied, rather than dualistic, experience; (b) the need for a more therapeutic construction of 'acceptance'; (c) value-based goals as profound motivation for positive change; and (d) it's quite a long way from physiotherapy. Integral to a therapeutic definition of acceptance was the challenge of moving away from 'fixing' towards 'sitting with'. Participants described this as uncomfortable because it did not fit their biomedical training. This article describes how Action Research methodology was used in the introduction of ACT to a physiotherapy-led pain rehabilitation programme. The innovation of this study is that it helps us to understand the potential barriers and facilitators to embedding an ACT philosophy within a physiotherapy setting.

Rehabilitation of hamstring muscle injuries: a literature review

Directory of Open Access Journals (Sweden)

Gabriel Amorim Ramos

Full Text Available ABSTRACT Hamstring injuries are among the most frequent in sports. The high relapse rate is a challenge for sports medicine and has a great impact on athletes and sport teams. The treatment goal is to provide the athlete the same functional level as before the injury. Thus, functional rehabilitation is very important to the success of the treatment. Currently, several physical therapy modalities are used, according to the stage of the lesion, such as cryotherapy, laser therapy, therapeutic ultrasound, therapeutic exercise, and manual therapy. However, the evidence of the effectiveness of these modalities in muscle injuries is not fully established due to the little scientific research on the topic. This article presents an overview of the physiotherapy approach in the rehabilitation of hamstring muscle injuries.

Gebrauch von Komplementärmedizin bei Patienten mit metastasierendem Melanom unter Therapie mit Ipilimumab innerhalb einer klinischen Studie.

Science.gov (United States)

Huebner, Jutta; Mohr, Peter; Simon, Jan-Christoph; Fluck, Michael; Berking, Carola; Zimmer, Lisa; Loquai, Carmen

2016-05-01

In Deutschland wenden 40-90 % aller Krebspatienten Methoden der komplementären and alternativen Medizin (KAM) an. Bis dato gibt es kein Datenmaterial zum Einsatz der KAM bei Melanompatienten. Das Ziel unserer Studie war es, Daten über den Gebrauch, die Informationsquellen und Ziele von Patienten mit metastasierendem Melanom zu erfassen. Einhundertsechsundfünfzig Patienten aus 25 Studienzentren nahmen an der DecOG-MM-PAL Multibasket Studie teil. Die beteiligten Personen wurden auch gebeten, an einer Nebenstudie teilzunehmen, die ihren Gebrauch von KAM erfassen sollte. Dazu wurde während der Behandlung ein standardisierter Fragebogen zu genau festgelegten Zeitpunkten ausgeteilt. Insgesamt gingen 55 Fragebögen von 32 (21 %) Melanompatienten ein. Von diesen gaben 17 (53 %) ein Interesse an KAM an, und sieben (22 %) machten von KAM Gebrauch. Die Hauptinformationsquellen (31 %) waren Familienmitglieder und Freunde, gefolgt von Ärzten (19 %). Die Hauptgründe für die Anwendung von KAM waren die Stärkung des Immunsystems (41 %) und des Körpers (34 %). Nahrungsergänzungsmittel (Vitamine und Spurenelemente) wurden am häufigsten angewendet (28 %). Eine relativ hohe Anzahl an Patienten mit metastasierendem Melanom machte trotz Teilnahme an einer klinischen Studie von KAM Gebrauch. Wechselwirkungen könnten durch biologisch basierte KAM auftreten, und hier besonders bei immunmodulierenden KAM- Strategien. Um Risiken zu vermeiden, sollte die Kommunikation zwischen den Ärzten und den Patienten verbessert werden. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Tryptophanabhängige Synthese von indolhaltigen Pigmenten bei verschiedenen humanpathogenen Asco- und Basidiomyceten

OpenAIRE

Nies, Silke Marie

2006-01-01

Der Begriff "Pigment" beschreibt in erster Linie farbige Substanzen. Pigmente sind aber darüber hinaus für wichtige metabolische oder physiologische Prozesse verantwortlich. Im Reich der Pilze gibt es eine Vielzahl von Pigmenten. Zu ihnen zählen die Melanine, die Carotenoide, die Naphthoquinone, die Phenoxazine, die Flavonoide sowie indolhaltige Pigmente. Gewisse Indolderivate wurden von einer Arbeitsgruppe um Prof. Mayser 1998 erstmals bei der Hefe Malassezia furfur beschrieben, bei der ...

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

Science.gov (United States)

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

2017-02-01

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

Transdermales Testosterongel verbessert die Parameter Sexualfunktion, Stimmung, Muskelkraft und Körperzusammensetzung bei hypogonadalen Männern

Directory of Open Access Journals (Sweden)

Wang C

2003-01-01

Full Text Available Eine Testosterontherapie bei hypogonadalen Männern sollte die klinisch manifesten Symptome eines Testosteronmangels im Sinne der Verbesserung der Sexualfunktion, der Vermehrung der Muskelmasse und -kraft sowie der Verringerung des Körperfettanteils korrigieren, ohne gleichzeitig nennenswerte Nebenwirkungen hervorzurufen. Wir haben bereits gezeigt, daß die Verabreichung eines neuen transdermalen Testosterongels an Männer mit Hypogonadismus zu dosisabhängigen Erhöhungen des Serumtestosteronspiegels in den Normalbereich erwachsener Männer führt. Wir berichten nun über die Auswirkungen einer 6-monatigen Behandlung mit diesem 1 %igen Testosterongel (50 bzw. 100 mg Testosteron pro Tag, enthalten in 5 bzw. 10 g Gel im Vergleich zu einem Penetrationsvermittler enthaltenden Testosteronpflaster (5 mg/Tag auf bestimmte Wirksamkeitsparameter bei 227 Männern mit Hypogonadismus. In den mit Testosterongel behandelten Gruppen wurde die Dosis am Studientag 90 auf 75 mg/Tag (enthalten in 7,5 g Gel erhöht oder gesenkt, wenn die Serumtestosteronspiegel über oder unter dem Normalbereich für erwachsene Männer lagen. In der Gruppe mit Testosteronpflaster wurde keine Dosisanpassung vorgenommen. Die Sexualfunktion und Stimmungsveränderungen wurden anhand eines Fragebogens, die Körperzusammensetzung anhand der DEXA-Methode und die Muskelkraft mit einer speziellen Technik("one repetitive maximum technique" durch Pressen der Beine und Arme ermittelt. Sexualfunktion und Stimmung verbesserten sich bereits am Tag 30 der Behandlung maximal, ohne Unterschied zwischen den Gruppen, und zeigten bei Fortsetzung der Therapie keine weitere Besserung. Die mittlere Muskelkraft bei der Beinpreßübung erhöhte sich in allen Gruppen nach 90 Behandlungstagen um 11 bis 13 kg und verbesserte sich anschließend bis zum Ende der Behandlung am Tag 180 nicht weiter. Zu mäßigen Steigerungen der Kraftentwicklung kam es auch an der Schulter- und Armmuskulatur. Nach 90 Tagen

Shortcomings of the industrial quality assurance of {sup 106}Ru ophthalmic plaques; Therapierelevante Schwachstellen bei der industriellen Qualitaetssicherung von {sup 106}Ru-Augenapplikatoren

Energy Technology Data Exchange (ETDEWEB)

Kaulich, T.W.; Nuesslin, F. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Medizinische Physik; Zurheide, J. [BrainLAB AG, Heimstetten (Germany); Fluehs, D. [Abt. Strahlentherapie, Bereich klinische Strahlenphysik, Universitaetsklinikum Essen (Germany); Haug, T. [Isotopenlabor der Univ. Tuebingen (Germany); Bamberg, M. [Abt. Radioonkologie, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany)

2001-11-01

Background: Beta emitting {sup 106}Ru applicators manufactured by Bebig GmbH (Berlin, Germany) are widely used to treat intraocular tumors. The applicators are fixed to the bulbus and removed after several days. The following therapy relevant defects have been detected by an internal clinical acceptance test: risk of leakage and inconsistent dose-rate specifications by the manufacturer. In the meantime, components of the internal clinical acceptance test have been adopted successfully by the manufacturer of the {sup 106}Ru ophthalmic plaques. Material and Method: {sup 106}Ru ophthalmic plaques were tested with the following internal clinical acceptance tests: visual inspection, surface contamination, leakage, and dose-rate verification. The surface contamination test consists of a wet wipe test at moderate pressure. For the leakage test of the {sup 106}Ru ophthalmic plaques a clinically relevant scenario was developed in which the contact of the applicator with human tissue is simulated. In the course of it the applicator is inserted into Ringer's solution for several days. The certified energy dose-rate statements of the manufacturer are examined with a 1 mm{sup 3} plastic scintillator for consistency. (orig.) [German] Hintergrund: {sup 106}Ru-Augenapplikatoren der Fa. Bebig (Berlin) werden zur strahlentherapeutischen Behandlung von intraokularen Tumoren eingesetzt. Die Applikatoren werden sklerakontaktierend am Bulbus fixiert und nach mehreren Tagen wieder entfernt. Durch eine klinikinterne Eingangspruefung wurden folgende therapierelevante Maengel bei den Augenapplikatoren entdeckt: mangelhafte Dichtheit und inkonsistente Dosisleistungsangaben des Herstellers. Ein Teil dieser klinikinternen Eingangspruefung wurde inzwischen vom Hersteller der {sup 106}Ru-Augenapplikatoren uebernommen und erfolgreich eingesetzt. Material und Methode: Es wurden {sup 106}Ru-Augenapplikatoren durch folgende klinikinterne Eingangspruefungen getestet: optische Inspektion

Cytoprotection with amifostine in the simultaneous radio-chemotherapy of recurrent head and neck cancer; Zytoprotection mit Amifostin im Rahmen der Radiochemotherapie bei vorbestrahlten Kopf-Hals-Karzinomen

Energy Technology Data Exchange (ETDEWEB)

Buentzel, J.; Weinaug, R.; Kuettner, K. [Zentralklinikum gGmbH Suedthueringen, Suhl (Germany). Klinik fuer Hals-Nasen-Ohren-Heilkunde, Plastische Operationen; Glatzel, M.; Froehlich, D. [Zentralklinikum gGmbH Suedthueringen, Suhl (Germany). Klinik fuer Strahlentherapie; Schuth, J. [Essex Pharma, Muenchen (Germany)

1999-11-01

Purpose: The radiotherapeutic possibilities are limited for patients with a recurrent or second head and neck cancer if the patient was already irradiated in the first therapy. In the presented study we investigated the changes of this situation due to the usage of amifostine in the case of re-irradiation (simultaneous radio-chemotherapy). Patients and methods: Between 1995 and 1997 we treated 14 patients with a recurrent or second malignancy of the head and neck region by a simultaneous radio-chemotherapy (20x1.5 Gy, Carboplatin 70 mg/m{sup 2} BSA on days 1 to 5 and 16 to 20, 500 mg amifostine prior to every carboplatin infusion). Six out of 14 patients got an additional brachytherapy (10 to 15 Gy) to increase the local dose because of a residual tomor. In 4 cases the treatment was an adjunctive one, following the surgical tumor debulking. Results: We have seen 3 complete remissions (21.4%), and 8 partial remissions (57.1%). The median time of observation in 13 months now. Three out of 14 patients died, 2 because of the tumor. Hematological toxicities: Side effects Grade 2 WHO were seen only in 1 patient. Acute non-hematological toxicities: Mucositis Grade 0/1 in 7 patients, mucositis Grade 2 in 7 patients, dysphagia Grade 0/1 in 9 patients, dysphagia Grade 2 in 5 patients, xerostomia Grade 1 in 9 patients, xerostomia Grade 2 in 3 patients. We registrated only 1 serious late toxicity due to radio-chemotherapy: 4 months after brachytherapy a patient (with laryngectomy) developed a submental fistula. Conclusion: These first results suggest that the usage of amifostine offers new potential ways for re-irradiation of patients with recurrent or second malignancies in the head neck region. (orig.) [German] Ziel: Bei einem Rezidiv- oder Zweitkarzinom im Kopf-Hals-Bereich sind die radiotherapeutischen Moeglichkeiten bei bereits vorbestrahlten Patienten sehr begrenzt. Inwieweit die Integration des selektiven Zytoprotektivums Amifostin in eine nochmalige Radiochemotherapie

Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

DEFF Research Database (Denmark)

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

2015-01-01

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

Model of iodine metabolism in a T3-thyrotoxic patient undergoing I-131 therapy

International Nuclear Information System (INIS)

Ahuja, S.; Price, R.; Brill, A.B.; Dobyns, B.M.; Berman, M.

Data on radioactivity in the thyroid, urine, serum, butanol-extractable iodine (BEI) and chromatographic fractionations of BEI, obtained during four I-131 therapeutic treatments of a T 3 -thyrotoxic patient, have been analyzed and simulated with the help of a 7-compartment model. Good fits to most of the data can be obtained with both the dose-independent and dose-dependent models. A model with 3 or 4 compartments, which provides adequate fits to iodine kinetic data in most euthyroid and hyperthyroid patients is not satisfactory in the case of this patient. Thus, to represent iodine metabolism during T 3 -thyrotoxicosis therapy, we find that it is necessary to provide for separate biochemical pathways for the BEI components as well as the butanol-insoluble compounds released by the thyroid gland

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.

Benign paroxysmal positional vertigo (BPPV): influence of pharmacotherapy and rehabilitation therapy on patients' recovery rate and life quality.

Science.gov (United States)

Maslovara, Sinisa; Soldo, Silva Butkovic; Puksec, Mirjana; Balaban, Branka; Penavic, Ivana Pajic

2012-01-01

This prospective clinical study includes 96 BPPV patients with the results of DHI testing ≥ 40 points. They were segregated to be taken into this study and randomly divided into two therapy groups: 48 patients in Group I were treated pharmacotherapeutically with Betahistine Chloride (BC) and 48 patients in Group II underwent a rehabilitation treatment by performing an Epley maneuver. Total study duration was eight weeks, during which the patients were first examined upon arrival, checked after one, and rechecked after eight weeks. The tests included otoneurological examination and VNG, as well as completing three questionnaires: DHI, SF-36®, and HADS®. During the first checkup after one week, 86.96% of patients in Group I and 93.33% in Group II had negative results at the Dix-Hallpike test. During the second checkup after an eight weeks' treatment, 95.65% in Group I and 97.78% patients in Group II had a negative result. At the beginning of the study, the values of patients' physical, emotional, and functional health (QoL) were equally distributed in both therapy groups, compared to standardized values of healthy population. During the first checkup, the values were significantly higher and by the second checkup, reached the statistic average, which corresponds with the healthy population. There was an obviously faster and more complete recovery of the patients in Group II, who underwent a rehabilitation treatment.

Rehabilitative Games for Stroke Patients

Directory of Open Access Journals (Sweden)

A. Pyae

2015-07-01

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

METABOLIC MEDICATIONS FOR THE REHABILITATION OF CHILDREN BORN TO DRUG ADDICTED WOMEN

Directory of Open Access Journals (Sweden)

A.A. Dzhumagaziev

2007-01-01

Full Text Available The authors presented the study results of the physical and neuro psychic growth of children, who were born to drug addicted women. they studied the active state of the dehydrogenase peripheral blood lymphocytes, reflecting the metabolic disorder at the tissue level and body level in general, as well as the ways to correct them with metabolic therapy assisted by glycine and biotredin. They also analyzed the results of the complex therapy and rehabilitation of the children, who were born to drug addicted women.Key words: drug embryopathy, metabolic therapy, children, rehabilitation.

Therapy for Cerebral Palsy by Human Umbilical Cord Blood Mesenchymal Stem Cells Transplantation Combined With Basic Rehabilitation Treatment

Directory of Open Access Journals (Sweden)

Che Zhang MD

2015-03-01

Full Text Available Background. Cerebral palsy (CP is the most common cause leading to childhood disability. Human umbilical cord blood mesenchymal stem cells (hUCB-MSCs transplantation is a promising alternative considering the safety and efficacy in current reports. This report represents a case of hUCB-MSCs transplantation combined with basic rehabilitation treatment beginning as early as age 6 months with follow-up as long as 5 years. Methods. A 6-year-old female patient was diagnosed with CP at age 6 months. The patient accepted 4 infusions of intravenous hUCB-MSCs in each course and received 4 courses of transplantation totally. A series of assessments were performed before the first transplantation, including laboratory tests, CDCC Infant Mental Development Scale, and Gross Motor Function Measure-88 (GMFM-88. Then annual assessments using the GMFM-88, Ashworth spasm assessment, and comprehensive function assessment scale were made in addition to the annual laboratory tests. In addition, electroencephalography and brain magnetic resonance imaging were conducted before transplantation and in the follow-up phase. Rehabilitation and safety follow-up have been ongoing for 5 years up to date. Results. There was no complaint about adverse effects during hospitalization or postoperative follow-up. Motor function recovered to normal level according to the evaluation of scales. Language function improved significantly. Linguistic rehabilitation therapy was enhanced for further improvement. Conclusions. The clinical application of hUC-MSCs combined with basic rehabilitation treatment was effective and safe for improving motor and comprehensive function in a patient with CP.

Effects of horticultural therapy on mood and heart rate in patients participating in an inpatient cardiopulmonary rehabilitation program.

Science.gov (United States)

Wichrowski, Matthew; Whiteson, Jonathan; Haas, François; Mola, Ana; Rey, Mariano J

2005-01-01

To assess the effects of horticultural therapy (HT) on mood state and heart rate (HR) in patients participating in an inpatient cardiac rehabilitation program. Cardiac rehabilitation inpatients (n = 107) participated in the study. The HT group consisted of 59 subjects (34 males, 25 females). The control group, which participated in patient education classes (PECs), consisted of 48 subjects (31 males, 17 females). Both HT sessions and PEC are components of the inpatient rehabilitation program. Each group was evaluated before and after a class in their respective modality. Evaluation consisted of the completion of a Profile of Mood States (POMS) inventory, and an HR obtained by pulse oximetry. Changes in the POMS total mood disturbance (TMD) score and HR between preintervention and postintervention were compared between groups. There was no presession difference in either TMD score (16 +/- 3.6 and 19.0 +/- 3.2, PEC and HT, respectively) or HR (73.5 +/- 2.5 and 79 +/- 1.8, PEC and HT, respectively). Immediately following the intervention, the HT TMD was significantly reduced (post-TMD = 1.6 +/- 3.2, P < .001), while PEC TMD was not significantly changed (TMD = 17.0 +/- 28.5). After intervention, HR fell in HT by 4 +/- 9.6 bpm (P < .001) but was unchanged in PEC. These findings indicate that HT improves mood state, suggesting that it may be a useful tool in reducing stress. Therefore, to the extent that stress contributes to coronary heart disease, these findings support the role of HT as an effective component of cardiac rehabilitation.

Potenzielle Arzneimittelwechsel-wirkungen und unerwünschte Arzneimittelwirkungen bei stationären dermatologischen Patienten.

Science.gov (United States)

Koch, Lukas; Kränke, Birger; Aberer, Werner

2016-11-01

Informationen zur Häufigkeit von Arzneimittelwechselwirkungen und unerwünschten Arzneimittelwirkungen zu präsentieren und Hilfestellung zu leisten, wie diese wichtigen Probleme in der pharmakologischen Behandlung stationärer dermatologischer Patienten minimiert werden können. Die Medikation von 1 099 stationären dermatologischen Patienten wurde retrospektiv mittels einer Internet-basierten Software für Medikamenteninteraktionen (Diagnosia ® Check) auf Arzneimittelwechselwirkungen und unerwünschte Arzneimittelwirkungen analysiert. Wir beschreiben eine Gesamthäufigkeit relevanter Arzneimittelwechselwirkungen von 51,7 % mit durchschnittlich 3,2 Interaktionen pro betroffenem stationären Patienten. Arzneimittelkombinationen, die gemieden werden sollten, wurden bei 5,7 % der Studienpopulation festgestellt. Der wichtigste Risikofaktor war die Gesamtzahl der verabreichten Medikamente. Die Arzneimittelgruppen, die bei der Mehrzahl der Wechselwirkungen beteiligt waren, waren Analgetika, Herz-Kreislauf-Medikamente und gerinnungshemmende Medikamente sowie Antidepressiva. Das Risiko unerwünschte Arzneimittelwirkungen auszubilden wurde bei 53,1 % der stationären Patienten als "hoch" eingestuft. Die fünf wichtigsten unerwünschten Nebenwirkungen in dieser Patientengruppe waren Blutungen, Obstipation, anticholinerge Effekte, Sedierung und orthostatische Effekte. Potenzielle Arzneimittelwechselwirkungen sowie unerwünschte Arzneimittelwirkungen sind bei stationären dermatologischen Patienten alarmierend häufig. Bei jedem zweiten Patienten besteht die Gefahr, derartige Wechselwirkungen oder unerwünschte Nebenwirkungen zu erleiden und jeder zwanzigste Patient erhält eine Arzneimittelkombination, die nicht verabreicht werden sollte. Erhöhte Wachsamkeit ist erforderlich, um die gefährdeten Patienten zu erkennen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Spinal metastases of malignant gliomas; Spinale Metastasierung bei malignen Gliomen. Zwei Fallbeschreibungen

Energy Technology Data Exchange (ETDEWEB)

Materlik, B; Steidle-Katic, U; Feyerabend, T; Richter, E [Medizinische Univ. Luebeck (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin; Wauschkuhn, B [Medizinische Univ. Luebeck (Germany). Klinik fuer Neurologie

1998-09-01

Purpose: Extracranial metastases of malignant gliomas are rare. We report 2 cases with spinal metastases in patients suffering from glioma. Patients and Method: Two patients (33 and 57 years old) developed spinal canal metastases of a glioblastoma multiforme and anaplastic astrocytoma Grade III respectively 25 and 9 months after surgical resection and radiotherapy. Both metastases were confirmed pathohistologically. Results: Intraspinal metastases were irradiated with a total dose of 12.6 Gy and 50 Gy. Treatment withdrawal was necessary in one patient due to reduced clinical condition. Regression of neurological symptoms was observed in the second patient. Conclusions: Spinal spread of malignant glioma should be considered during care and follow-up in glioma patients with spinal symptoms. (orig.) [Deutsch] Hintergrund: Maligne Gliome metastasieren aeusserst selten extrakraniell. Wir stellen zwei Faelle einer spinalen Filialisierung bei Gliompatienten vor. Patientengut und Methode: Zwei Patienten (33 und 57 Jahre alt) entwickelten 25 bzw. neun Monate nach Resektion und postoperativer Radiatio eines Glioblastoma multiforme und eines anaplastischen Astrozytoms WHO-Grad III histologisch gesicherte intraspinale Metastasen, welche durch Sensibilitaetsstoerungen der Beine symptomatisch wurden. Ergebnisse: Die intraspinalen Filiae wurden mit 12,6 Gy bzw. 50 Gy bestrahlt. Bei einem Patienten musste die Radiatio wegen zunehmender Verschlechterung des Allgemeinzustandes abgebrochen werden, bei dem zweiten Patienten besserte sich die neurologische Symptomatik. Schlussfolgerung: Bei der Betreuung von Gliompatienten sollte, insbesondere in der Nachsorge, an die Moeglichkeit der spinalen Metastasierung mit entsprechender Symptomatik gedacht werden. (orig.)

Factors influencing visual rehabilitation after occlusion therapy in unilateral amblyopia in children.

Science.gov (United States)

Menon, Vimla; Chaudhuri, Zia; Saxena, Rohit; Gill, Kulwant; Sachdeva, M M

2005-12-01

Amblyopia is one of the most common causes of visual impairment in adults and children, and visual loss may be permanent if not treated in time. Though many studies have been done on occlusion therapy which is the mainstay in the treatment of unilateral amblyopia, discrepancies exist in literature about quantification of treatment and follow up measures. The present study was undertaken to evaluate the factors responsible for the successful outcome of treatment and the optimum time required for the same in children with unilateral amblyopia. Baseline characteristics of 63 verbal patients with unilateral amblyopia (strabismic, anisometropic, mixed) referred to the Strabismus and Amblyopia Clinic at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi between September 2001 to December 2002 who improved to the desired level of visual acuity after treatment for amblyopia in the mentioned time period, were analyzed to assess for factors that directly or indirectly influenced the optimum visual rehabilitation and the average duration of therapy required for the same. The evaluation included assessment of the baseline best-corrected visual acuity (BCVA) and refractive status in both eyes, the age at presentation, the type of amblyopia present, fixation pattern in the amblyopic eye, inter-eye visual acuity difference, and evaluation of compliance through a parental diary system. Baseline BCVA in the amblyopic eye was similar in all the three groups. Patients with anisometropic amblyopia showed a quicker response to therapy. Compliance to treatment was the major factor affecting the overall time required for a successful outcome in most cases. The overall time required for the treatment to be successful (including the period of maintenance) was about 1,089 h. This hospital-based study showed that the average duration of occlusion therapy to achieve stable isoacuity was 7.2 months with an average occlusion of 6-7 h/day. Compliance to therapy was the most

Virtual rehabilitation--benefits and challenges.

Science.gov (United States)

Burdea, G C

2003-01-01

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

Serious Games for Parkinson's Disease Fine Motor Skills Rehabilitation Using Natural Interfaces.

Science.gov (United States)

Foletto, Antônio Augusto; Cordeiro d'Ornellas, Marcos; Cervi Prado, Ana Lucia

2017-01-01

Parkinson's Disease rehabilitation can be long and boring being difficult to maintain patient engagement on therapy programs. Novel technologies are allowing computer games to be played throught natural interfaces. This paper presents the development and assessment of a system of serious games for fine motor skills rehabilitation using natural interfaces. The games were assessed throught a questionnaire that evaluated the game experience through seven components: immersion, flow, competence, tension, challenge and positive and negative affect. In addition, a conceptual framework for development of serious games for fine motor skills rehabilitation was proposed. The results from the quantitative questionnaire suggested that the player experience was positive on all components assessed. Also, player experience between the three games was statistically the same, implying that the games can be used with consistency in a physical therapy rehabilitation program.

Hand Rehabilitation Learning System With an Exoskeleton Robotic Glove.

Science.gov (United States)

Ma, Zhou; Ben-Tzvi, Pinhas; Danoff, Jerome

2016-12-01

This paper presents a hand rehabilitation learning system, the SAFE Glove, a device that can be utilized to enhance the rehabilitation of subjects with disabilities. This system is able to learn fingertip motion and force for grasping different objects and then record and analyze the common movements of hand function including grip and release patterns. The glove is then able to reproduce these movement patterns in playback fashion to assist a weakened hand to accomplish these movements, or to modulate the assistive level based on the user's or therapist's intent for the purpose of hand rehabilitation therapy. Preliminary data have been collected from healthy hands. To demonstrate the glove's ability to manipulate the hand, the glove has been fitted on a wooden hand and the grasping of various objects was performed. To further prove that hands can be safely driven by this haptic mechanism, force sensor readings placed between each finger and the mechanism are plotted. These experimental results demonstrate the potential of the proposed system in rehabilitation therapy.

Rehabilitation program for children with brachial plexus and peripheral nerve injury.

Science.gov (United States)

Ramos, L E; Zell, J P

2000-03-01

An aggressive and integrated physical and occupational therapy program is essential in the treatment of congenital brachial plexus injuries and other severe upper extremity nerve injuries. This article addresses the evaluation, identification of needs, establishment of goals, and the approaches to rehabilitation treatment for patients with brachial plexus palsy and other peripheral nerve injuries. Rehabilitative therapy can preserve and build on gains made possible by medical or surgical interventions; however, therapy is vital to these children regardless of whether surgery is indicated. The therapist uses a problem-solving approach to evaluate the patient and select appropriate occupational and physical therapy treatment modalities. Therapy is continually adjusted based on each child's unique needs. An understanding of the therapy principles aids in making appropriate referrals and prescriptions, and helps to coordinate care between the therapist, pediatrician, neurologist, and surgeon.

A Data Set of Human Body Movements for Physical Rehabilitation Exercises

Directory of Open Access Journals (Sweden)

Aleksandar Vakanski

2018-01-01

Full Text Available The article presents University of Idaho-Physical Rehabilitation Movement Data (UI-PRMD, a publically available data set of movements related to common exercises performed by patients in physical rehabilitation programs. For the data collection, 10 healthy subjects performed 10 repetitions of different physical therapy movements with a Vicon optical tracker and a Microsoft Kinect sensor used for the motion capturing. The data are in a format that includes positions and angles of full-body joints. The objective of the data set is to provide a basis for mathematical modeling of therapy movements, as well as for establishing performance metrics for evaluation of patient consistency in executing the prescribed rehabilitation exercises.

Die Rolle von Osteoklasten bei der arthritischen Knochenerosion

Directory of Open Access Journals (Sweden)

Schett G

2003-01-01

Full Text Available Knöcherne Erosionen stellen eine wesentliche Ursache für die funktionelle Einschränkung von Patienten mit rheumatoider Arthritis dar. Bis vor kurzem war über den Pathomechanismus dieser Veränderungen nur wenig bekannt. Dieser Review faßt die letzten Erkenntnisse über die Ausbildung einer Knochenschädigung bei entzündlichen Gelenkerkrankungen zusammen und fokussiert insbesondere die Rolle von Osteoklasten. Es wird ein Überblickzu den Hinweisen für eine Präsenz von Osteoklasten im entzündlich veränderten Gelenk gegeben. Weiters werden die Faktoren diskutiert, die die Osteoklastogenese im Rahmen einer Gelenkentzündung aktivieren können. Hier wird im besonderen auf die Rolle von Receptor-Activator of Nuclear Factor Kappa B Ligand (RANKL eingegangen. Im weiteren werden die Auswirkungen einer Osteoklastenhemmung in den verschiedenen Arthritismodellen zusammengefaßt und Möglichkeiten einer therapeutischen Nutzung bei rheumatoider Arthritis diskutiert.

Therapeutic effects of intensive inpatient rehabilitation in advanced Parkinson's disease

OpenAIRE

Kaseda, Yumiko; Ikeda, Junko; Sugihara, Katsunobu; Yamawaki, Takemori; Kohriyama, Tatsuo; Matsumoto, Masayasu

2016-01-01

Abstract Background The importance of rehabilitation therapy in Parkinson's disease is well recognized. However, the effects of an inpatient rehabilitation program for advanced Parkinson's disease have not been fully investigated. Aim To assess the effects of intensive inpatient rehabilitation. Methods We enrolled 31 patients (mean age 69.5 ? 9.4 years; mean disease duration 8.8 ? 6.4 years) with advanced Parkinson's disease, without severe cognitive impairment. The median Hoehn?Yahr stage wa...

OPTIMIZATION OF EARLY PHYSICAL REHABILITATION OF PATIENTS WITH SPASTIC INFANTILE CEREBRAL PALSIES

Directory of Open Access Journals (Sweden)

G. S. Lupandina-Bolotova

2014-01-01

Full Text Available Infantile cerebral palsy is an urgent issue of pediatric neurology all over the world. Adequate choice of the term and methods of rehabilitation helps children with this pathology to adapt to the society and improves prognosis of motor and mental development thereof. The article presents the optimal methods of physical rehabilitation at early stages of a child’s development based on the current understanding of neuroplasticity, reserve capabilities of a developing brain, as well as of pathophysiological aspects of recovery and compensation of the damaged structures of the central nervous system. The authors demonstrate crucial differences between approaches to rehabilitation of children under and over 2 years of age. Despite the selected methods of rehabilitation of children with infantile cerebral palsy, successful results of the therapy require a multidisciplinary approach characterized by early onset, balanced combination of methods of physical rehabilitation and drug therapy, physiotherapy and psychological-pedagogic support. 

Strahlungsfeldbedingungen bei der Ionisationsdosimetrie

Science.gov (United States)

Krieger, Hanno

Bei der Dosimetrie von Photonenstrahlungen mit luftgefüllten Ionisationskammern werden in diesem Kapitel zwei Grenzfälle unterschieden. Der eine Fall ist die Bedingung des so genannten Sekundärelektronengleichwichts im Kammervolumen. In diesem Fall bestimmen ausschließlich die Photonen im Messvolumen die dosimetrische Anzeige. Der zweite Grenzfall ist gegeben, wenn das Luftvolumen und die Kammer das Strahlungsfeld im Phantom so wenig stören, dass der Sekundärelektronenfluss unverändert bleibt. Diese Bedingungen nennt man BRAGG-GRAY-Bedingungen. Beide Grenzfälle sind in der Praxis nur näherungsweise zu verwirklichen. Abweichungen müssen durch entsprechende Korrekturen oder Kalibrierungen berücksichtigt werden.

Neuere Untersuchungen zur Prädiktion von EEG-Signalen bei Epilepsie

Directory of Open Access Journals (Sweden)

C. Niederhöfer

2007-06-01

Full Text Available Seit einigen Jahren ist die Analyse von EEG-Signalen bei Epilepsie Gegenstand zahlreicher wissenschaftlicher Arbeiten; Zielvorstellung ist dabei die Entwicklung von Verfahren zur Erkennung eines möglichen Voranfallszustandes. Im Vordergrund steht beispielsweise die Approximation einer so genannten effektiven Korrelationsdimension, die Bestimmung der maximalen Lyapunov-Exponenten, Detektionsverfahren für Muster bei Zellularen Nichtlinearen Netzwerken, die Bestimmung der mittleren Phasenkohärenz und Verfahren zur nichtlinearen Prädiktion von EEG-Signalen. Trotz umfangreicher Bemühungen kann bis heute eine Erkennung von Anfallsvorboten mit einer Sensitivität und Spezifität, die eine automatisierte Anfallsvorhersage ermöglichen würde, noch nicht durchgeführt werden. In diesem Beitrag werden neue Ergebnisse zur Prädiktion von EEG-Signalen bei Epilepsie vorgestellt. Dabei werden Signale, welche mittels intrakranieller electrocorticographischer (ECoG und stereoelectroencephalographischer (SEEG Ableitungen registriert wurden, segmentweise analysiert. Unter der Annahme, dass sich Änderungen des Systems ,,Gehirn" als Änderungen im Prädiktor, d.h. in seinen Systemparametern widerspiegeln, könnte eine nähere Betrachtung der Prädiktoreigenschaften zu einer Erkennung von Anfallsvorboten führen.

Steam and hot air injection for thermal rehabilitation of contaminated sites; Wasserdampf- und Heissluftinjektion zur thermischen Sanierung kontaminierter Standorte

Energy Technology Data Exchange (ETDEWEB)

Schmidt, R

2001-07-01

Thermal in situ rehabilitation technologies are a promising alternative to conventional methods of cleaning up contaminated sites. The fact that an increase in temperature changes the physical properties of materials makes it possible, in principle, to release large quantities of pollutants within short time periods. The use of pure steam or steam/air mixtures as fluid thermal carriers permits converting subterranean non-aqueous-phase pollutants into the gas phase through increased vapour pressure and transporting them to the surface by means of soil air aspiration for further treatment. The purpose of the present two-stage research project was to systematically develop a thermal in situ rehabilitation technology using steam as fluid heat carrier and use it for land rehabilitation operations on a pilot basis. In the first, fundamental project phase aspects of heat transport (Faerber, 1997) and pollutant behaviour (Betz, 1998)in homogenous porous media upon pure steam injection were explored at a laboratory and technical scale using containers of different sizes (1D, 2D, 3D). The results were used to derive application criteria for this technology. [German] Thermische In-situ-Sanierungstechnologien stellen bei der Reinigung kontaminierter Standorte eine vielversprechende Alternative zu konventionellen Verfahren dar. Die Veraenderung physikalischer Stoffeigenschaften mit steigender Temperatur ermoeglicht grundsaetzlich hohe Schadstoffaustraege innerhalb kurzer Zeitraeume. Beim Einsatz von reinem Wasserdampf oder Wasserdampf-Luft-Gemischen als Waermetraegerfluid koennen im Untergrund in nicht waessriger Phase vorliegende Schadstoffe hauptsaechlich wegen der erhoehten Dampfdruecke in die Gasphase ueberfuehrt, ueber eine Bodenluftabsaugung an die Oberflaeche transportiert und dann einer weiteren Behandlung zugefuehrt werden. Zielsetzung eines zweistufigen Forschungsvorhabens war die systematische Entwicklung einer thermischen In-situ-Sanierungstechnologie unter

Rehabilitation effect of exercise with soft tissue manipulation in ...

African Journals Online (AJOL)

Rehabilitation effect of exercise with soft tissue manipulation in patients with lumbar muscle strain. H Li, H Zhang, S Liu, Y Wang, D Gai, Q Lu, H Gan, Y Shi, W Qi. Abstract. Objective: To study the rehabilitation effect of exercise with soft tissue manipulation therapy for patients with lumbar muscle strain. Methods: Patients with ...

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

NARCIS (Netherlands)

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

2013-01-01

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

Comprehensive rehabilitation of the child with osteogenesis imperfecta.

Science.gov (United States)

Binder, H; Conway, A; Hason, S; Gerber, L H; Marini, J; Berry, R; Weintrob, J

1993-01-15

Children with osteogenesis imperfecta (OI) that results in considerable deformity are often viewed as poor candidates for aggressive physical therapy and rehabilitation. To determine if this view is realistic, we have entered almost 50 children with OI type III and OI type IV into a comprehensive graduated rehabilitation program, based at the National Institutes of Health, but designed to be implemented by continuing involvement of community resources. Children are begun in the program early with emphasis on gain of head and trunk control and progression to sitting and walking, if possible, with the aid of a variety of physical supports, including internal and external bracing. Although not conducted in a randomized fashion, the program's success in bringing children into graded exercise regimes and fostering their increased involvement in school and social situations suggest that aggressive physical therapy and rehabilitation have a major place in the overall care of the infants and children with OI.

Targeting, Monitoring and Effect of Oral Iron Therapy on Haemoglobin Levels in Older Patients Discharged to Primary Care from Inpatient Rehabilitation: A Cohort Study Using Routinely Collected Data.

Science.gov (United States)

Thomson, Zach; Hands, Katherine J; Witham, Miles D

2016-08-01

Oral iron is commonly prescribed to older patients with suspected or confirmed iron-deficiency anaemia; however, few studies have examined the effectiveness of oral iron therapy in the real world in this population. We therefore determined the prevalence of iron deficiency in older people prescribed oral iron, examined the response mounted to therapy and ascertained predictors of response to oral iron. We analysed a routinely collected, linked dataset from older patients who had undergone inpatient rehabilitation between 1999 and 2011. An initial analysis examined patients within this cohort who were prescribed iron after rehabilitation and derived three groups based upon their ferritin and transferrin indices: probably, possibly and not iron deficient. A second analysis compared pre- and post-treatment haemoglobin to determine the degree of response to iron therapy across each category of deficiency. Finally, patient demographics, linked biochemistry data and comorbid disease based on International Classification of Disease (ICD-10) codes from previous hospital admissions were used in regression modelling to evaluate factors affecting response to therapy. A total of 490 patients were prescribed oral iron within 90 days of rehabilitation discharge. Of these, 413 (84 %) had iron indices performed; 94 (23 %) were possibly deficient, 224 (54 %) were probably deficient, and 95 (23 %) were not deficient. Of the 490 patients, 360 had both pre- and post-treatment haemoglobin data and iron indices; probably deficient patients mounted a slightly greater response to oral iron (17 vs. 12 g/L for not deficient; p < 0.05). Only pre-treatment haemoglobin, mean cell volume and lower gastrointestinal pathology were significant predictors of a response to oral iron therapy. Notably, acid-suppressant use was not a predictor of response. We conclude that many older patients are exposed to oral iron without good evidence of either iron deficiency or a significant response to

Systematic overview of economic evaluations of health-related rehabilitation.

Science.gov (United States)

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

[The results of the combined application of extracorporeal shock-wave therapy and radon baths during the rehabilitative treatment of the patients presenting with gonarthrosis].

Science.gov (United States)

Razumov, A N; Puriga, A O; Yurova, O V

2015-01-01

Osteoarthritis (OA) is one of the leading diseases of the musculoskeletal system and the main cause of arthritic joint damage. The objective of the present study was to evaluate the effectiveness of the combined application of radon baths and shock-wave therapy in the patients suffering from knee OA. The study involved 75 patients at the age of 35 to 62 years with the confirmed diagnosis of stage II and III gonarthrosis; they were divided into 3 groups. The patients of the main group received the combined treatment including extracorporeal shock-wave therapy and radon baths The patients comprising the group of comparison were given the course of radon therapy alone while those in the control group were offered the standard treatment including physiotherapy, magnetic therapy, and NSAIDs. The study has demonstrated the high effectiveness of the combined application of the radon baths and extracorporeal shock-wave therapy for the rehabilitation of the patients with deforming arthrosis of the knee that was apparent from the substantial decrease of pain syndrome, the increase of the range of motions in the knee joints, and the overall improvement of the quality of life. These beneficial changes persisted for a period of up to 6 months. The results of the present study give reason to recommend the proposed method of the remedial treatment for the wide practical application as a component in the framework of the medical rehabilitation programs.

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

Science.gov (United States)

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.

Comparative study of conventional therapy and additional yogasanas for knee rehabilitation after total knee arthroplasty

Directory of Open Access Journals (Sweden)

Nilima Bedekar

2012-01-01

Full Text Available Background: Amongst various modalities of post operative rehabilitation in a total knee replacement (TKR surgery, this study focuses on evaluating the effect of additional yoga therapy on functional outcome of TKR patients. Materials and Methods: A comparative study was done to compare the effects of conventional physiotherapy and additional yoga asanas, on 56 patients undergoing total knee arthroplasty due to osteoarthritis. After obtaining written informed consent, the patients were alternately assigned to two groups: Conventional and experimental. Baseline WOMAC scores for pain and stiffness were taken on third post operative day. The subjects in conventional group received physiotherapy rehabilitation program of Sancheti Institute where the study was conducted, the experimental group received additional modified yoga asanas once daily by the therapist. After discharge from the hospital, patients were provided with written instructions and photographs of the asanas, two sets of WOMAC questionnaire with stamped and addressed envelopes and were instructed to perform yoga asanas 3 days/week. Subjects filled the questionnaire after 6 weeks and 3 months from the day of surgery and mailed back. The primary outcome measure was WOMAC questionnaire which consists of 24 questions, each corresponding to a visual analog scale, designed to measure patient′s perception of pain, stiffness and function. Results: The results suggest that there was a significant change (P<0.05 for all the groups for pain, stiffness and function subscales of WOMAC scale. The pain and stiffness was found to be less in experimental group receiving additional yoga therapy than in conventional group on 3 rd post operative day, 6 weeks and 3 months after the surgery. Conclusion: A combination of physiotherapy and yoga asana protocol works better than only physiotherapy protocol. Larger and blinded study is needed.

PENGARUH CORPORATE GOVERNANCE TERHADAP TAX AVOIDANCE (Perusahaan Pertambangan yang terdaftar di BEI

Directory of Open Access Journals (Sweden)

Sri Mulyani

2018-05-01

Full Text Available he purpose of this research is to know the influence of institutional ownership, independent commissioner, audit committee and audit quality to tax avoidance at mining company listed on BEI year 2014-2016. The population of this study is mining companies listed on the BEI 2014-2016 as many as 46 companies. Sampling used in this research purposive sampling method. Data source is secondary data obtained from company website and BEI website (www.idx.co.id. This study uses multiple regression analysis to analyze data with the help of SPSS 21 edition program. The results of this study indicate that the variables of institutional ownership, audit committee and audit quality have significant influence on tax avoidance, while independent commissioner variable has no significant effect on tax avoidance. The results of this study are expected to be an additional consideration of the management in conducting tax avoidance is correct and efficient without violating applicable tax laws, and can provide additional information for users of financial statements in investment decision making.

Conference Report: 6th Annual International Symposium on Regenerative Rehabilitation.

Science.gov (United States)

Loghmani, M Terry; Roche, Joseph A

2018-04-03

The 6th International Symposium on Regenerative Rehabilitation, hosted by the Alliance for Regenerative Rehabilitation Research and Training (AR 3 T), included a preconference meeting of institutional representatives of the International Consortium of Regenerative Rehabilitation, keynote talks from distinguished scientists, platform and poster presentations from experts and trainees, panel discussions and postconference workshops. The following priorities were identified: increasing rigor in basic, preclinical and clinical studies, especially the use of better controls; developing better outcome measures for preclinical and clinical trials; focusing on developing more tissue-based interventions versus cell-based interventions; including regenerative rehabilitation in curricula of professional programs like occupational and physical therapy; and developing better instruments to quantify rehabilitative interventions.

Influence of hormone substitution therapy on postmenopausal uterus; Einfluss einer Hormonsubstitution auf den postmenopausalen Uterus

Energy Technology Data Exchange (ETDEWEB)

Otte, A.; Ruedisueli, A.; Goetze, M.; Leibundgut, U.; Mueller-Brand, J. [Inst. fuer Nuklearmedizin, Kantonsspital, Universitaetskliniken, Basel (Switzerland); Nitzsche, E.U. [Abt. Nuklearmedizin, Radiologische Universitaetsklinik, Freiburg (Germany)

1997-12-01

In a 58-year-old postmenopausal woman blood flow and blood pool images of bone scintigraphy showed a focus of increased activity in the right pelvic region. Computed tomography and ultrasound exhibited no abnormalities in the abdomen; especially the uterus and ovaries were normal. Careful anamnestic evaluation revealed that the patient received a long-term peroral estrogen/gestagen replacement therapy for the prevention of osteoporosis, but did not have menstruation-like bleedings for the last twelve months of therapy. At time of admission, the patient was on day 25 of hormone replacement therapy, and the uterus wash, therefore, in a premenstrual stage. Hence, despite cessation of bleedings in postmenopausal women, one should think of hormone replacement therapy as an explanation for vascular pelvic tumors seen by the first two phases of bone scintigraphy, before further diagnostic steps are undertaken. (orig.) [Deutsch] Bei der Skelettszintigraphie einer 58jaehrigen postmenopausalen Frau erkannte man in der Perfusions- und Blood-pool-Phase einen unklaren Fokus erhoehter Aktivitaet im rechten Becken. Computertomographie und Sonographie des Abdomens, insbesondere des Uterus und der Ovarien, waren unauffaellig. Nach eingehender anamnestischer Befragung stellte sich heraus, dass die Patientin unter einer mehrjaehrigen peroralen Oestrogen-/Gestagen-Hormonsubstitutionstherapie zur Osteoporose-Prophylaxe stand, jedoch seit den letzten zwoelf Monaten der Therapie ueber keine menstruationsaehnlichen Abbruchblutungen mehr berichten konnte. Bei ihrer Zuweisung befand sich die Patientin am 25. Tag der Hormonsubstitutionstherapie und ihr Uterus somit in einem praemenstruellen Stadium. Trotz Ausbleibens der Blutung bei postmenopausalen Frauen sollte somit an die Moeglichkeit der Hormonsubstitution gedacht und danach gefragt werden, wenn in den ersten beiden Phasen der Skelettszintigraphie eine unklare, gut vaskularisierte Struktur im kleinen Becken gefunden wird, bevor weitere

BDNF genotype interacts with motor-function to influence rehabilitation responsiveness post-stroke

Directory of Open Access Journals (Sweden)

Christine T Shiner

2016-05-01

Full Text Available Background. Persistent motor impairment is common but highly heterogeneous post-stroke. Genetic polymorphisms, including those identified on the brain derived neurotrophic factor (BDNF and apolipoprotein E (APOE genes, may contribute to this variability by limiting the capacity for use-dependent neuroplasticity, and hence rehabilitation responsiveness.Objective. To determine whether BDNF and APOE genotypes influence motor improvement facilitated by post-stroke upper-limb rehabilitation. Methods. BDNF Val66Met and APOE isoform genotypes were determined using leukocyte DNA for 55 community-dwelling patients 2-123 months post-stroke. All patients completed a dose-matched upper-limb rehabilitation program of either Wii-based Movement Therapy or Constraint-induced Movement Therapy. Upper-limb motor-function was assessed pre- and post-therapy using a suite of functional measures. Results. Motor-function improved for all patients post-therapy, with no difference between therapy groups. In the pooled data, there was no significant effect of BDNF or APOE genotype on motor-function at baseline, or following the intervention. However, a significant interaction between the level of residual motor-function and BDNF genotype was identified (p=0.029, whereby post-therapy improvement was significantly less for Met allele carriers with moderate and high, but not low motor-function. There was no significant association between APOE genotype and therapy outcomes. Conclusions. This study identified a novel interaction between the BDNF Val66Met polymorphism, motor-function status and the magnitude of improvement with rehabilitation in chronic stroke. This polymorphism does not preclude, but may reduce, the magnitude of motor improvement with therapy, particularly for patients with higher but not lower residual motor-function. BDNF genotype should be considered in the design and interpretation of clinical trials.

Manipulation of Auditory Inputs as Rehabilitation Therapy for Maladaptive Auditory Cortical Reorganization

Directory of Open Access Journals (Sweden)

Hidehiko Okamoto

2018-01-01

Full Text Available Neurophysiological and neuroimaging data suggest that the brains of not only children but also adults are reorganized based on sensory inputs and behaviors. Plastic changes in the brain are generally beneficial; however, maladaptive cortical reorganization in the auditory cortex may lead to hearing disorders such as tinnitus and hyperacusis. Recent studies attempted to noninvasively visualize pathological neural activity in the living human brain and reverse maladaptive cortical reorganization by the suitable manipulation of auditory inputs in order to alleviate detrimental auditory symptoms. The effects of the manipulation of auditory inputs on maladaptively reorganized brain were reviewed herein. The findings obtained indicate that rehabilitation therapy based on the manipulation of auditory inputs is an effective and safe approach for hearing disorders. The appropriate manipulation of sensory inputs guided by the visualization of pathological brain activities using recent neuroimaging techniques may contribute to the establishment of new clinical applications for affected individuals.

Comparing the effects of rehabilitation swallowing therapy vs. neuromuscular electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study.

Science.gov (United States)

Permsirivanich, Wutichai; Tipchatyotin, Suttipong; Wongchai, Manit; Leelamanit, Vitoon; Setthawatcharawanich, Suwanna; Sathirapanya, Pornchai; Phabphal, Kanitpong; Juntawises, Uma; Boonmeeprakob, Achara

2009-02-01

Dysphagia after stroke is associated with increased mortality, higher dependence, and longer hospitalization. Different therapeutic strategies have been introduced to improve swallowing impairment. There are no current studies that compare rehabilitation swallowing therapy (RST) and neuromuscular electrical stimulation therapy (NMES). To compare treatment outcomes between RST and NMES intervention in stroke patients with pharyngeal dysphagia. A randomized controlled study. Twenty-three stroke patients with persistent pharyngeal dysphagia (RST 11, NMES 12) were enrolled in the present study. The subjects received 60 minutes of either RST or NMES treatment for five consecutive days, had two days off and then five more consecutive days of treatment for a four-week period or until they reached functional oral intake scale (FOIS) level 7. The outcome measures assessed were change in FOIS, complications related to the treatment and number of therapy sessions. There were no significant differences in the stroke characteristics and the VFSS results between the two groups. At the end of treatment, the average numbers of therapy sessions per subject in the RST and NMES groups were 18.36 +/- 3.23 and 17.25 +/- 5.64, respectively, a non-significant difference. Average changes in FOIS scores were 2.46 +/- 1.04 for the RST group and 3.17 +/- 1.27 for the NMES group, statistically significant at p stroke patients, NMES was significantly superior.

Einflussfaktoren auf den persönlichen Stress bei Studienanfängern in der Humanmedizin

OpenAIRE

Schulze, Johannes; Duderstadt, Monika; Hodjat, Beheshta; Wu, Yue-Ying

2013-01-01

Die derzeitige Regelung der Zulassung zum Medizinstudium berücksichtigt die Abiturnote und Wartezeiten; universitäre Parameter können diese Kriterien modifizieren. Hierzu zählen z.B. die Leistungskurswahl, wie es an der Goethe-Universität Frankfurt gehandhabt wird. Im Rahmen der Untersuchung zu Stress und Resilienz bei Medizinstudenten haben wir bei den Studenten des 1. vorklinischen Semesters soziodemographische Daten erhoben, die einen Kohortenvergleich erlauben. Die chronische Stressbelast...

EFFECTS OF DANCE AND MUSIC THERAPY

OpenAIRE

Dr. Saroj Kothari

2017-01-01

Arts have consistently been part of life as well as healing throughout the history of humankind. Today, expressive therapies have an increasingly recognized role in mental health, rehabilitation and medicine. The expressive therapies are defined as the use of art, music, dance/movement drama, poetry/creative writing, play and sand play within the context of psychotherapy, counseling, rehabilitation or health care. Through the centuries, the healing nature of these expressive therapies has bee...

E2Rebot: A robotic platform for upper limb rehabilitation in patients with neuromotor disability

Directory of Open Access Journals (Sweden)

Juan C Fraile

2016-08-01

Full Text Available The use of robotic platforms for neuro-rehabilitation may boost the neural plasticity process and improve motor recovery in patients with upper limb mobility impairment as a consequence of an acquired brain injury. A robotic platform for this aim must provide ergonomic and friendly design, human safety, intensive task-oriented therapy, and assistive forces. Its implementation is a complex process that involves new developments in the mechanical, electronics, and control fields. This article presents the end-effector rehabilitation robot, a 2-degree-of-freedom planar robotic platform for upper limb rehabilitation in patients with neuromotor disability after a stroke. We describe the ergonomic mechanical design, the system control architecture, and the rehabilitation therapies that can be performed. The impedance-based haptic controller implemented in end-effector rehabilitation robot uses the information provided by a JR3 force sensor to achieve an efficient and friendly patient–robot interaction. Two task-oriented therapy modes have been implemented based on the “assist as needed” paradigm. As a result, the amount of support provided by the robot adapts to the patient’s requirements, maintaining the therapy as intensive as possible without compromising the patient’s health and safety and promoting engagement.

Design of an exercise glove for hand rehabilitation using spring mechanism

NARCIS (Netherlands)

Serbest, K.; Ates, Sedar; Stienen, Arno; Isler, Y.

2017-01-01

Hand muscles do not perform their functions because of different reasons such as disease, injury and trauma. It is implemented some treatments for the hand therapy at hospitals and rehabilitation centers. One of these is using orthotic or robotic devices for rehabilitation. One of the important

PC-BEIS: a personal computer version of the biogenic emissions inventory system

International Nuclear Information System (INIS)

Pierce, T.E.; Waldruff, P.S.

1991-01-01

The US Environmental Protection Agency's Biogenic Emissions Inventory System (BEIS) has been adapted for use on IBM-compatible personal computers (PCs). PC-BEIS estimates hourly emissions of isoprene, α-pinene, other monoterpenes, and unidentified hydrocarbons for any county in the contiguous United States. To run the program, users must provide hourly data on ambient temperature, relative humidity, wind speed, cloud cover, and a code that identifies the particular county. This paper provides an overview of the method used to calculate biogenic emissions, shows an example application, and gives information on how to obtain a copy of the program

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.

Excessive sedentary time during in-patient stroke rehabilitation.

Science.gov (United States)

Barrett, Matthew; Snow, John Charles; Kirkland, Megan C; Kelly, Liam P; Gehue, Maria; Downer, Matthew B; McCarthy, Jason; Ploughman, Michelle

2018-04-03

Background and Purpose Previous research suggests that patients receiving inpatient stroke rehabilitation are sedentary although there is little data to confirm this supposition within the Canadian healthcare system. The purpose of this cross-sectional study was to observe two weeks of inpatient rehabilitation in a tertiary stroke center to determine patients' activity levels and sedentary time. Methods Heart rate (HR) and accelerometer data were measured using an Actiheart monitor for seven consecutive days, 24 h/day, on the second week and the last week of admission. Participants or their proxies completed a daily logbook. Metabolic equivalent (MET) values were calculated and time with MET rehabilitation, there was excessive sedentary time and therapy sessions were less frequent and of lower intensity than recommended levels. Conclusions In this sample of people attending inpatient stroke rehabilitation, institutional structure of rehabilitation rather than patient-related factors contributed to sedentary time.

Bewältigungsstrategien der Oberwalliser Primarlehrpersonen und Massnahmen der Gesundheitsförderung an Oberwalliser Primarschulen bei Stress und Burnout

OpenAIRE

Imhof, Barbara; Mattig, Astrid

2009-01-01

Die vorliegende Studie befasst sich mit der Gesundheitsförderung bei Stress und Burnout an den Oberwalliser Primarschulen und der Bewältigungsstrategien der Oberwalliser Primarlehrpersonen bei Stress und Burnout. Der theoretische Teil befasst sich mit Stress und Burnout und der Bewältigung von Stress und Burnout. Verschiedene Aspekte des Lehrerberufs werden näher angeschaut und es werden mögliche Massnahmen der Gesundheitsförderung bei Stress und Burnout aufgeführt. Die Untersuchung zeigt, da...

Model of iodine metabolism in a T₃-thyrotoxic patient undergoing I-131 therapy

Energy Technology Data Exchange (ETDEWEB)

Ahuja, S.; Price, R.; Brill, A. B.; Dobyns, B. M.; Berman, M.

1975-06-01

Data on radioactivity in the thyroid, urine, serum, butanol-extractable iodine (BEI) and chromatographic fractionations of BEI, obtained during four I-131 therapeutic treatments of a T₃-thyrotoxic patient, have been analyzed and simulated with the help of a 7-compartment model. Good fits to most of the data can be obtained with both the dose-independent and dose-dependent models. A model with 3 or 4 compartments, which provides adequate fits to iodine kinetic data in most euthyroid and hyperthyroid patients is not satisfactory in the case of this patient. Thus, to represent iodine metabolism during T₃-thyrotoxicosis therapy, we find that it is necessary to provide for separate biochemical pathways for the BEI components as well as the butanol-insoluble compounds released by the thyroid gland. (auth)

Feasibility and effectiveness of circuit training in acute stroke rehabilitation.

Science.gov (United States)

Rose, Dorian; Paris, Trevor; Crews, Erin; Wu, Samuel S; Sun, Anqi; Behrman, Andrea L; Duncan, Pamela

2011-02-01

Task-specificity, repetition and progression are key variables in the acquisition of motor skill however they have not been consistently implemented in post-stroke rehabilitation. To evaluate the effectiveness of a stroke rehabilitation plan of care that incorporated task-specific practice, repetition and progression to facilitate functional gain compared to standard physical therapy for individuals admitted to an inpatient stroke unit. Individuals participated in either a circuit training (CTPT) model (n = 72) or a standard (SPT) model (n = 108) of physical therapy, 5 days/week. Each 60 minute circuit training session, delivered according to severity level, consisted of four functional mobility tasks. Daily exercise logs documented both task repetition and progression. The CTPT model was successfully implemented in an acute rehabilitation setting. The CTPT group showed a significantly greater improved change in gait speed from hospital admission to discharge than the SPT group (0.21 ± 0.25 m/sec vs. 0.13 ± 0.22 m/sec; p = 0.03). The difference between groups occurred primarily among those who were ambulatory upon admission. There were no significant differences between the two cohorts at 90 days post-stroke as measured by the FONE-FIM, SF-36 and living location. Therapy focused on systematically progressed functional tasks can be successfully implemented in an inpatient rehabilitation stroke program. This circuit-training model resulted in greater gains in gait velocity over the course of inpatient rehabilitation compared to the standard model of care. Community-based services following hospital discharge to maintain these gains should be included in the continuum of post-stroke care.

NEUROLOGIC MUSIC THERAPY TRAINING FOR MOBILITY AND STABILITY REHABILITATION WITH PARKINSON’S DISEASE – A PILOT STUDY.

Directory of Open Access Journals (Sweden)

Anna A. Bukowska

2016-01-01

Full Text Available Idiopathic Parkinson’s Disease (PD is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn & Yahr stage 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance . All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions 4 times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP, Pattern Sensory Enhancement (PSE and Rhythmic Auditory Stimulation (RAS were used in every 45-minute session for practicing daily life activities, balance, pre-gait and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation.The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey.

Science.gov (United States)

Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Sarfo-Kantanka, Osei; Ovbiagele, Bruce

2017-10-15

The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants' attitudes towards telemedicine administered rehabilitation intervention. Mean±SD age of study participants was 57.2±13.3years of which 51.0% were males with a mean duration of stroke of 1.3±2.2years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80-93%). However, while 85% owned mobile phones, only 35% had smart phones. Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed

Goal-orientated cognitive rehabilitation for dementias associated with Parkinson's disease-A pilot randomised controlled trial.

Science.gov (United States)

Hindle, John V; Watermeyer, Tamlyn J; Roberts, Julie; Brand, Andrew; Hoare, Zoe; Martyr, Anthony; Clare, Linda

2018-05-01

To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study. This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9). Primary outcomes were ratings of goal attainment and satisfaction with goal attainment. Secondary outcomes included quality of life, mood, cognition, health status, everyday functioning, and carers' ratings of goal attainment and their own quality of life and stress levels. Assessments were at 2 and 6 months following randomisation. At 2 months, cognitive rehabilitation was superior to treatment-as-usual and relaxation therapy for the primary outcomes of self-rated goal attainment (d = 1.63 and d = 1.82, respectively) and self-rated satisfaction with goal attainment (d = 2.04 and d = 1.84). At 6 months, cognitive rehabilitation remained superior to treatment-as-usual (d = 1.36) and relaxation therapy (d = 1.77) for self-rated goal attainment. Cognitive rehabilitation was superior to treatment as usual and/or relaxation therapy in a number of secondary outcomes at 2 months (mood, self-efficacy, social domain of quality of life, carers' ratings of participants' goal attainment) and at 6 months (delayed recall, health status, quality of life, carer ratings of participants' goal attainment). Carers receiving cognitive rehabilitation reported better quality of life, health status, and lower stress than those allocated to treatment-as-usual. Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson's disease. Copyright © 2018 John Wiley & Sons, Ltd.

The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.

Science.gov (United States)

Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia

2016-08-01

Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

Psychosocial rehabilitation and democratic development in Nepal

DEFF Research Database (Denmark)

Triantafillou, Peter; Sassene, Michel

2011-01-01

Today, centres and programmes for the rehabilitation of torture victims are found all over the world. In Nepal, one of the world's poorest countries, the Centre for Victims of Torture (CVICT) has since 1990 provided advanced psychosocial rehabilitation programmes. These and similar psychosocial i....... On both a discursive and a technical-practical level, the psychosocial therapy offered by the CVICT is trying to make torture victims align their personal desires and freedom with the political objectives of turning Nepal into a liberal democracy....

Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review

Directory of Open Access Journals (Sweden)

Paul Tamayo-Serrano

2018-03-01

Full Text Available A stroke is a life-changing event that may end up as a disability, with repercussions on the patient’s quality of life. Stroke rehabilitation therapies are helpful to regain some of the patient’s lost functionality. However, in practice stroke patients may suffer from a gradual loss of motivation. Gamified systems are used to increase user motivation, hence, gamified elements have been implemented into stroke rehabilitation therapies in order to improve patients’ engagement and adherence. This review work focuses on selecting and analyzing developed and validated gamified stroke rehabilitation systems published between 2009 and 2017 to identify the most important features of these systems. After extensive research, 32 articles have met the selection criteria, resulting in a total of 28 unique works. The works were analyzed and a total of 20 features were identified. The features are explained, making emphasis on the works that implement them extensively. Finally, a classification of features based on objectives is proposed, which was used to identify the relationships between features and implementation gaps. It was found that there is a tendency to develop low-cost solutions as in-home therapy systems and provide a variety of games. This review allowed the definition of the opportunities for future research direction such as systems addressing the three rehabilitation areas; data analytics to make decisions; motivational content identification based on automatic engagement detection and emotion recognition; and alert systems for patient´s safety.

Rehabilitation needs of persons discharged from an African trauma center

Directory of Open Access Journals (Sweden)

Asare Christian

2011-11-01

Full Text Available f these injuries and 14% were related to violence. Eleven subjects had disability measured using L.I.F.E and all were classified as having major disabilities. Only 14 patients (17% received any rehabilitation therapy which consisted of only physical therapy provided at a frequency of once a day for less than one week duration. CONCLUSION: This study found that most persons admitted to a sophisticated trauma unit in Ghana are discharged without adequate rehabilitation services, and that the level of disability experienced by these people can be measured, even while they are still sick and in the hospital, using L.I.F.E. The implications are clear: African trauma systems must measure the long term outcomes from their treatments and provide the inpatient medical rehabilitation services that are a standard of care for trauma victims elsewhere in the world.

Rehabilitation in multiple sclerosis.

Science.gov (United States)

Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

2017-07-01

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

Artabilitation ICMC Panel paper Denmark 2007:Non-Formal Rehabilitation via Immersiveinteractive Music Environments

DEFF Research Database (Denmark)

Brooks, Tony; Petersson, Eva; Eaglestone, Barry

2007-01-01

This paper brings together perspectives of the ICMC 2007 ArtAbilitation Panel on non-formal rehabilitation via immersive interactive music environments. Issues covered are sound therapy, musical topologies, brainwave control and research methodology.......This paper brings together perspectives of the ICMC 2007 ArtAbilitation Panel on non-formal rehabilitation via immersive interactive music environments. Issues covered are sound therapy, musical topologies, brainwave control and research methodology....