Sample records for active rehabilitation program

  1. Impact of activities in self-esteem of patients in a pulmonary rehabilitation program

    PubMed Central

    de Oliveira, Juliana Nascimento; Tavares, Cecilia Melo Rosa; Squassoni, Selma Denis; Machado, Nadine Cristina; Cordoni, Priscila Kessar; Bortolassi, Luciene Costa; Lapa, Mônica Silveira; Fiss, Elie

    2015-01-01

    Objective To evaluate self-esteem and self-image of respiratory diseases patients in a Pulmonary Rehabilitation Program, who participated in socialization and physical fitness activities, and of patients who participated only in physical fitness sessions. Methods A descriptive cross-sectional exploratory study. Out of a total of 60 patients analyzed, all enrolled in the Pulmonary Rehabilitation Program, 42 participated in at least one of the proposed activities, 10 did not participate in any activity and 8 were excluded (7 were discharged and 1 died). Results When the two groups were compared, despite the fact that both demonstrated low self-esteem and self-image, the difference between them was relevant (p<0.05) regarding self-esteem, indicating that those who participated in the proposed socialization activities had better self-esteem than the individuals who only did the physical fitness sessions. Regarding self-image, the difference between the groups was not relevant (p>0.05). Conclusion The Pulmonary Rehabilitation Program patients evaluated presented low self-esteem and self-image; however, those carrying out some socialization activity proposed had better self-esteem as compared to the individuals who did only the physical fitness sessions. PMID:25993068

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

    PubMed

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

    2016-09-01

    Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models. Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p < 0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p < 0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t = 4.08, p < 0.001; 12-month follow-up, t = 3.13, p < 0.006). Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.

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

    PubMed

    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 < .003 for all). The findings indicate that an interdisciplinary 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.

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

    PubMed

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

    2015-08-01

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

  5. Active LifestyLe Rehabilitation interventions in aging spinal cord injury (ALLRISC): a multicentre research program.

    PubMed

    van der Woude, L H V; de Groot, S; Postema, K; Bussmann, J B J; Janssen, T W J; Post, M W M

    2013-06-01

    With today's specialized medical care, life expectancy of persons with a spinal cord injury (SCI) has considerably improved. With increasing age and time since injury, many individuals with SCI, however, show a serious inactive lifestyle, associated with deconditioning and secondary health conditions (SHCs) (e.g. pressure sores, urinary and respiratory tract infections, osteoporosis, upper-extremity pain, obesity, diabetes, cardiovascular disease) and resulting in reduced participation and quality of life (QoL). Avoiding this downward spiral, is crucial. To understand possible deconditioning and SHCs in persons aging with a SCI in the context of active lifestyle, fitness, participation and QoL and to examine interventions that enhance active lifestyle, fitness, participation and QoL and help prevent some of the SHCs. A multicentre multidisciplinary research program (Active LifestyLe Rehabilitation Interventions in aging Spinal Cord injury, ALLRISC) in the setting of the long-standing Dutch SCI-rehabilitation clinical research network. ALLRISC is a four-study research program addressing inactive lifestyle, deconditioning, and SHCs and their associations in people aging with SCI. The program consists of a cross-sectional study (n = 300) and three randomized clinical trials. All studies share a focus on fitness, active lifestyle, SHCs and deconditioning and outcome measures on these and other (participation, QoL) domains. It is hypothesized that a self-management program, low-intensity wheelchair exercise and hybrid functional electrical stimulation-supported leg and handcycling are effective interventions to enhance active life style and fitness, help to prevent some of the important SHCs in chronic SCI and improve participation and QoL. ALLRISC aims to provide evidence-based preventive components of a rehabilitation aftercare system that preserves functioning in aging persons with SCI.

  6. [Documenting a rehabilitation program using a logic model: an advantage to the assessment process].

    PubMed

    Poncet, Frédérique; Swaine, Bonnie; Pradat-Diehl, Pascale

    2017-03-06

    The cognitive and behavioral disorders after brain injury can result in severe limitations of activities and restrictions of participation. An interdisciplinary rehabilitation program was developed in physical medicine and rehabilitation at the Pitié-Salpêtriere Hospital, Paris, France. Clinicians believe this program decreases activity limitations and improves participation in patients. However, the program’s effectiveness had never been assessed. To do this, we had to define/describe this program. However rehabilitation programs are holistic and thus complex making them difficult to describe. Therefore, to facilitate the evaluation of complex programs, including those for rehabilitation, we illustrate the use of a theoretical logic model, as proposed by Champagne, through the process of documentation of a specific complex and interdisciplinary rehabilitation program. Through participatory/collaborative research, the rehabilitation program was analyzed using three “submodels” of the logic model of intervention: causal model, intervention model and program theory model. This should facilitate the evaluation of programs, including those for rehabilitation.

  7. 77 FR 37022 - Disability and Rehabilitation Research Projects and Centers Program; Rehabilitation Engineering...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...; Rehabilitation Engineering Research Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers (RERC). SUMMARY... amended (Rehabilitation Act). Rehabilitation Engineering Research Centers Program (RERCs) The purpose of...

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

    PubMed Central

    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

  9. Rehabilitation Training Program and Special Capacity Building Program, 1997-1998: Catalog of Projects under the Rehabilitation Services Administration.

    ERIC Educational Resources Information Center

    Office of Special Education and Rehabilitative Services (ED), Washington, DC.

    This directory lists programs funded by rehabilitation training grants funded under the Rehabilitation Act of 1973 (Section 304a). These programs are grouped under the following categories: (1) rehabilitation long-term training; (2) experimental and innovative training; (3) state vocational rehabilitation unit in-service training; (4)…

  10. Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders

    PubMed Central

    Hardison, Mark E.

    2017-01-01

    Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation included gender, number of sessions completed, and performance of work simulation activities. Maximum hours per session was the only significant predictor of success in the comprehensive rehabilitation program. This study identifies new factors associated with success in occupational rehabilitation, specifically highlighting the importance of intensity (i.e., session length and number of sessions) of therapy and occupation-based activities for this population. PMID:28027046

  11. 78 FR 66344 - Applications for New Awards; Rehabilitation Training: Rehabilitation Long-Term Training Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ...-Term Training Program--Vocational Rehabilitation Counseling AGENCY: Office of Special Education and...: Rehabilitation Long- Term Training Program--Vocational Rehabilitation Counseling Notice inviting applications for... in the priority area of rehabilitation counseling. Absolute Priority 2: This priority is from the...

  12. 34 CFR 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What activities must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.32 What activities must a Rehabilitation Engineering Research...

  13. 34 CFR 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false What activities must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.32 What activities must a Rehabilitation Engineering Research...

  14. 34 CFR 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false What activities must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.32 What activities must a Rehabilitation Engineering Research...

  15. 34 CFR 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What activities must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.32 What activities must a Rehabilitation Engineering Research...

  16. 34 CFR 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What activities must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.32 What activities must a Rehabilitation Engineering Research...

  17. Improving practice with integration of patient directed activity during inpatient rehabilitation.

    PubMed

    Trammell, Molly; Kapoor, Priyanka; Swank, Chad; Driver, Simon

    2017-01-01

    Early initiation of rehabilitation following stroke promotes better long-term outcomes than delayed onset, emphasizing the importance of inpatient therapy. However, literature indicates that following stroke individuals in inpatient rehabilitation spend the majority of their day in their bedroom and inactive. Consequently, since amount of functional activity is posited to relate to outcomes, the current rehabilitation model needs to be challenged with innovative solutions to maximize recovery. In an attempt to promote greater activity and higher doses of therapy during inpatient rehabilitation, we implemented the "Patient Directed Activity Program" to facilitate specific movement and improve outcomes for patients post stroke. Our interdisciplinary activity program was conceptualized on a theoretical model for stroke recovery and principles of experience-dependent neural plasticity. The "Patient Directed Activity Program" includes distinct activity stations designed to increase repetition, stimulation, attention, and activity of the affected upper extremities, lower extremities, and trunk. Each task-specific activity was easily graded to achieve moderate- to high-intensity. The activity program prescribed individuals up to three additional 30-minute bouts of activities daily that were to be completed independently, and in addition to standard of care. Clinical application: After implementing this program in our facility for one year as a quality improvement project, the intervention has been delivered as an Institutional Review Board approved randomized controlled trial (Clinical Trial #NCT02446197). Challenges with people and facilities have been overcome, resulting in a feasible program that can be delivered in an inpatient setting. High satisfaction has been reported by patients and clinicians.

  18. Cultural competence education in university rehabilitation programs.

    PubMed

    Matteliano, Mary A; Stone, John H

    2014-01-01

    The Center of International Rehabilitation Research, Information, and Exchange (CIRRIE) has prepared curriculum guides for rehabilitation professionals in occupational therapy, physical therapy, speech language pathology, and rehabilitation counseling. The objective is to provide a resource to faculty who wish to include or strengthen cultural competency education in their program and courses. CIRRIE assessed students'cultural needs, and solicited assistance from experts in the field to assist with the development of the guides. After the guides were published CIRRIE conducted surveys to assess their usefulness. Survey responses were highest among occupational therapy faculty. Among faculty who responded, most intended to use the cultural competence activities, case studies, and resources that the guides offer throughout their curriculum.

  19. Adult Offenders' Perceptions of Rehabilitation Programs in Africa

    ERIC Educational Resources Information Center

    Ngozwana, Nomazulu

    2017-01-01

    This article reflects on adult offenders' perceptions of rehabilitation programs in Africa. It also evaluates whether offenders are consulted when planning rehabilitation programs. Adult education principles were used as a lens to understand offenders' perceptions of rehabilitation programs. Using an interpretive paradigm and qualitative approach,…

  20. Rehabilitation exercise program after surgical treatment of pectoralis major rupture. A case report.

    PubMed

    Vasiliadis, Angelo V; Lampridis, Vasileios; Georgiannos, Dimitrios; Bisbinas, Ilias G

    2016-07-01

    To present a rehabilitation exercise program and suggest a schedule of activities for daily living and participation in sports after surgical treatment of a pectoralis major rupture. A single case study. Hospital-based study, Thessaloniki, Greece. We present a 30-year-old male athlete (height, 196 cm; weight, 90 kg; right hand dominant) with a complete rupture of the pectoralis major tendon after a fall. The athlete received a post-operative rehabilitation exercise program for 16 weeks. During the program, there was a gradual increase in the exercise program regime and load across the sessions according to the specific case demands. Shoulder function was evaluated using Constant score. Magnetic resonance imaging (MRI) confirmed the diagnosis and the patient had surgical treatment repairing-reattaching the tendon back to its insertion using a bone anchor. At the end of the rehabilitation exercise program, the patient had full range of movement, normal muscle power and a return back to his previous level of athletic activities achieved. Post-operatively, a progressive rehabilitation protocol contributed to the patients' full recovery and allowed an early return to activities of daily living and participation in sports. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. A Post-Hospital Nursing Home Rehabilitation Program.

    ERIC Educational Resources Information Center

    Petchers, Marcia K.; And Others

    1987-01-01

    Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

  2. Multivisceral Transplantation Rehabilitation Program-Case Report.

    PubMed

    Loschi, T M; Cinacchi, M P R G; Baccan, M D T A; Marques, F; Pedroso, P T; Meira Filho, S P; Scacchetti, T; Pavão, D N

    2018-04-01

    Multivisceral transplantation is the treatment for multiple abdominal organ failure. The patient experiences reduced food intake and absorption of nutrients, contributing to weight loss and decreased muscle mass, reducing functional capacity. A physical and nutritional rehabilitation program based on adequate caloric intake associated with supervised physical exercise seems to support a gain of muscle mass, re-establishing its capacity and functional independence. A rehabilitation program was carried out, consisting of low-intensity aerobic exercise on treadmill, exercises of global strengthening (50% of 1 maximum repetition [1RM], with progressive increase), and nutritional monitoring (oral hypercaloric diet, hyperproteic supplementation daily and after exercise). Initial and final evaluation included weight, muscle mass index, brachial circumference (BC), tricipital cutaneous fold (TCF), hand grip strength (HGS), 6-minute walk test (6MWT), 1RM, vital capacity (VC), and respiratory muscle strength. After the program, functional capacity was evaluated through the 6MWT (92%), 1RM test, VC (55%), respiratory muscle strength, HGS at 5 kg, weight gain (4.75%), increase of BC in 2 cm, and TCF in 2 mm. The program contributed to functional independence, improved quality of life, and social reintegration, suggesting the importance of a supervised physical activity program associated with adequate nutritional intake after multivisceral transplantation. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Process of pulmonary rehabilitation and program organization.

    PubMed

    Wouters, E F M; Augustin, I M L

    2011-09-01

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

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

    PubMed

    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

  5. Leisure time physical activity of patients in maintenance cardiac rehabilitation.

    PubMed

    Schairer, John R; Keteyian, Steven J; Ehrman, Jonathan K; Brawner, Clinton A; Berkebile, Nichole D

    2003-01-01

    PURPOSE Increasing caloric expenditure through physical activity is associated with reduced mortality. On the basis of observational studies, previous authors have suggested that at least 1000 kcal per week and possibly 1500 kcal per week of physical activity is necessary for health benefits. The authors have previously reported that patients in maintenance cardiac rehabilitation accumulate approximately 230 kcal per exercise session, suggesting that additional activity outside of cardiac rehabilitation is needed to achieve the goal of 1500 kcal per week. The authors estimated the amount of energy expenditure performed each week by patients in cardiac rehabilitation during both program participation and leisure time. METHODS For this study, 104 patients enrolled in a supervised maintenance cardiac rehabilitation program at both tertiary care and community settings for at least 6 months completed a self-administered physical activity questionnaire. Energy expenditure in cardiac rehabilitation and leisure time activity was measured in kilocalories. Total caloric expenditure was determined by adding up the number of kilocalories expended by the patients each week climbing stairs, walking, participating in cardiac rehabilitation, and engaging in sports. RESULTS Patients in cardiac rehabilitation expended weekly, on the average, 1504 +/- 830 kcal in physical activity, 830 +/- 428 kcal in cardiac rehabilitation, and 675 +/- 659 kcal in leisure time activity. There was a significant difference in caloric expenditure between men and women, between those with a body mass index (BMI) less than 30 and those with a BMI of 30 or more, and between those younger than 70 years and those 70 years or older. There was no difference between races. Whereas 43% of the patients accumulated 1500 kcal, 57% did not. CONCLUSIONS The findings showed that 72% of the patients in cardiac rehabilitation accumulated at least 1000 kcal of energy expenditure per week and met public health guidelines

  6. Prevention of cognitive and physical decline by enjoyable walking-habituation program based on brain-activating rehabilitation.

    PubMed

    Murai, Tatsuhiko; Yamaguchi, Tomoharu; Maki, Yohko; Isahai, Mikie; Kaiho Sato, Ayumi; Yamagami, Tetsuya; Ura, Chiaki; Miyamae, Fumiko; Takahashi, Ryutaro; Yamaguchi, Haruyasu

    2016-06-01

    Evaluating effects of an enjoyable walking-habituation program. We carried out a 12-week intervention, consisting of an enjoyable walking-habituation program based on five principles of brain-activating rehabilitation: pleasant atmosphere, interactive communication, social roles, praising each other and errorless support. The program, once a week for 90 min, was carried out in small groups. Participants were 71 community-dwelling people (72.2 ± 4.3) without dementia. Cognitive function was evaluated in five cognitive domains: memory, executive function, word fluency, visuospatial abilities and sustained attention. Additionally, quality of life, depressive state, functional capacity, range of activities, social network and subjective memory complaints were assessed using questionnaires. Motor function was also evaluated. Measurement was carried out before the observation period, after observation and after intervention. A total of 63 participants were included in the analysis. Daily steps, executive function, subjective memory complaints, functional capacity and 5-m maximum walking time significantly improved during the intervention period (after observation to after intervention) compared with the observation period (before the observation period to after observation). No significant differences were seen in other evaluations. At 6 months after the intervention, 52 of 63 participants (82.5%) continued to walk once a week or more, and all of them were confident about continuing to walk in the future. Furthermore, all participants were satisfied with our walking-habituation program and all replied that they felt delighted. The intervention program, based on the five principles of brain-activating rehabilitation, resulted in improvement of some cognitive and physical functions, as well as a high walking-habituation rate at 6 months' follow up. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  7. Treatment and postrelease rehabilitative programs for juvenile offenders.

    PubMed

    Underwood, Lee A; Knight, Pamela

    2006-04-01

    The juvenile justice system has become notably aware of the increasing use of postrelease rehabilitative treatment interventions for offenders. In many instances, juvenile justice systems are required to ensure that core treatment needs of youth are met. As a result of the heightened awareness of the need for postrelease rehabilitation treatment programs, many researchers and providers are calling for more systematic approaches to offender treatment. This article summarizes a body of literature on juvenile offenders who have specialized postrelease rehabilitative treatment needs. It reviews cognitive-behavioral theoretical models and core postrelease treatment strategies. It presents a review of youth who have specialized needs in light of postrelease practices, describes several model postrelease rehabilitation programs, and reviews outcomes of these programs.

  8. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the Rehabilitation Training program? 385.1... § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed... CFR part 386). (2) Experimental and Innovative Training (34 CFR part 387). (3) State Vocational...

  9. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What is the Rehabilitation Training program? 385.1... § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed... CFR part 386). (2) Experimental and Innovative Training (34 CFR part 387). (3) State Vocational...

  10. Annual Report of the Rehabilitation Services Administration to the President and the Congress on Federal Activities Related to the Administration of the Rehabilitation Act of 1973, as Amended. Fiscal Year 1979.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (DHEW), Washington, DC.

    The annual report discusses the FY 1979 administration of the Rehabilitation Act of 1973. Covered are five aspects (sample subtopics in parentheses): program operations (basic vocational rehabilitation program, services to the blind and visually handicapped, rehabilitation for American Indians); program development activities (special projects for…

  11. A sensorimotor stimulation program for rehabilitation of chronic stroke patients.

    PubMed

    de Diego, Cristina; Puig, Silvia; Navarro, Xavier

    2013-01-01

    The hypothesis of this study is that intensive therapy by means of a sensory and motor stimulation program of the upper limb in patients with chronic hemiparesis and severe disability due to stroke increases mobility and sensibility, and improves the use of the affected limb in activities of daily living (ADL). The program consists of 16 sessions of sensory stimulation and functional activity training in the rehabilitation center, and daily sessions of tactile stimulation, mental imaginery and practice of ADL at home, during 8 weeks. An experimental group (EG) of 12 patients followed this program, compared with a control group (CG) of 9 patients under standard rehabilitation. The efficacy of the program was evaluated by Fugl Meyer Assessment (FMA), Motor Activity Log (MAL) and Stroke Impact Scale-16 (SIS-16) scores, and a battery of sensory tests. The results show that in both groups, the motor FMA and the SIS-16 improved during the 8 weeks, this improvement being higher in the EG. Significant improvements were observed for the sensory tests in the EG. The intensive sensorimotor stimulation program for the upper extremity may be an efficacious method for improving function and use of the affected limb in ADL in chronic stroke patients.

  12. A system for diagnosis, referral, and rehabilitation of persons convicted of driving while intoxicated : a special rehabilitation program for multiple offenders

    DOT National Transportation Integrated Search

    1977-11-01

    A rehabilitation program is presented for multiple DWI offenders. The program includes education related to alcohol use and abuse and therapeutic activities to help a client learn new techniques for living and alternatives to alcohol abuse. /Abstract...

  13. Effects of a sexual rehabilitation intervention program on stroke patients and their spouses.

    PubMed

    Song, HoSook; Oh, HyunSoo; Kim, HwaSoon; Seo, WhaSook

    2011-01-01

    The present study was conducted to examine whether a sexual rehabilitation intervention program, which was developed during the present study and designed for stroke patients and their spouses, was effective in terms of sexual knowledge and satisfaction and frequency of sexual activity at 1 month after intervention. The study subjects were conveniently selected from stroke patients admitted to the neurology department at a university hospital located in Incheon, South Korea. A total of 46 subjects (12 couples for the experimental group and 11 couples for the control group) were included. Sexual knowledge, sexual satisfaction, frequency of sexual activity, level of cognitive function, and performance with respect to daily living activities were measured. The results obtained demonstrated that the devised sexual rehabilitation intervention program significantly increased sexual satisfaction and frequency of sexual activity, but that it did not promote sexual knowledge. The present study has meaning because the intervention program could be used as a practical guideline for post-stroke sexual rehabilitation. In addition, the findings of this study provide evidence regarding the usefulness of sexual education and counseling on the sexual health of post-stroke patients and their spouses.

  14. 34 CFR 350.22 - What activities must a Rehabilitation Research and Training Center conduct?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Training Center conduct? 350.22 Section 350.22 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Research and Training Centers Does the Secretary Assist? § 350.22 What activities must a Rehabilitation Research and Training...

  15. [Cognitive impairment in earthquake brain injury treated with comprehensive program of acupuncture and rehabilitation: a randomized controlled trial].

    PubMed

    Zhou, Jian-Wei; Zhang, An-Ren; Qiu, Ling; Huang, Shu; Wang, Wen-Chun; Hu, Yong-He; Zhang, Zhao; Xie, Hui-Jun; Zhao, Jing-Jing; Zhai, Jia-Li; Jiang, Yue; Tian, Tian; Liu, Di; Zheng, Xu; Wang, Min

    2014-02-01

    To explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury. The multi-central randomized controlled trial was adopted. The qualified subjects were randomized into an acupuncture + rehabilitation group (38 cases) and a rehabilitation group (35 cases). In the acupuncture + rehabilitation group, acupuncture, hyperbaric oxygen (HBO) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment. In the rehabilitation group, HBO and cognitive rehabilitation training were adopted. The efficacy and safety were assessed. (1) After treatment of 2 months, the intelligent state, cognitive function and activity of daily life of patients were improved in the both groups (all P < 0.01). (2) After treatment of 2 months, the score of MMSE and the score of activity of daily life were (24.11 +/- 4.08) and (75.45 +/- 13.95) in the acupuncture + rehabilitation group, which were more significant as compared with (17.05 +/- 43.84), (66.06 +/- 12.75) in the rehabilitation group, respectively (both P < 0.01). In 6-month follow-up visit after treatment, the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group, which was more significant as compared with the rehabilitation group (P < 0.01, P < 0.05). The integrated Chinese and western medicine of acupuncture, HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury. The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine.

  16. Early rehabilitation programs after laparoscopic colorectal surgery: Evidence and criticism

    PubMed Central

    Kim, Duck-Woo; Kang, Sung-Bum; Lee, Soo-Young; Oh, Heung-Kwon; In, Myung-Hoon

    2013-01-01

    During the past several decades, early rehabilitation programs for the care of patients with colorectal surgery have gained popularity. Several randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal resection. Patients cared for based on these protocols had a rapid recovery of bowel movement, shortened length of hospital stay, and fewer complications compared with traditional care programs. However, most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic resection. Currently, limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection, although this procedure seems to be associated with a higher morbidity than that reported with traditional care. In this article, we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal surgery. We investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these studies. We also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery, focusing on laparoscopic resection. PMID:24379571

  17. Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers.

    PubMed

    Baumann, Freerk T; Bieck, Oliver; Oberste, Max; Kuhn, Rafaela; Schmitt, Joachim; Wentrock, Steffen; Zopf, Eva; Bloch, Wilhelm; Schüle, Klaus; Reuss-Borst, Monika

    2017-04-01

    Although physical activity has been demonstrated to increase cancer survival in epidemiological studies, breast cancer patients tend toward inactivity after treatment. Breast cancer patients were quasi-randomly allocated to two different groups, intervention (IG) and control (CG) groups. The intervention group (n = 111) received an individual 3-week exercise program with two additional 1-week inpatient stays after 4 and 8 months. At the end of the rehabilitation, a home-based exercise program was designed. The control group (n = 83) received a 3-week rehabilitation program and did not obtain any follow-up care. Patients from both groups were measured using questionnaires on physical activity, fatigue, and quality of life (QoL) at five time points, 4 months (t1), 8 months (t2), 12 months (t3), 18 months (t4), and 24 months (t5) after the beginning of the rehabilitation. After 2 years, the level of physical activity (total metabolic rate) increased significantly from 2733.16 ± 2547.95 (t0) to 4169.71 ± 3492.27 (t5) metabolic equivalent (MET)-min/week in the intervention group, but just slightly changed from 2858.38 ± 2393.79 (t0) to 2875.74 ± 2590.15 (t5) MET-min/week in the control group (means ± standard deviation). Furthermore, the internal group comparison showed significant differences after 2 years as well. These results came along with a significantly reduced fatigue syndrome and an increased health-related quality of life. The data indicate that an individual, according to their preferences, and physical-resource-adapted exercise program has a more sustainable impact on the physical activity level in breast cancer patients than the usual care. It is suggested that the rehabilitation program should be personalized for all breast cancer patients.

  18. 38 CFR 21.310 - Rate of pursuit of a rehabilitation program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... rehabilitation program. 21.310 Section 21.310 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Rate of Pursuit § 21.310 Rate of pursuit of a rehabilitation program. (a...

  19. Patient preferences for cardiac rehabilitation and desired program elements.

    PubMed

    Filip, J; McGillen, C; Mosca, L

    1999-01-01

    Data evaluating the efficacy of traditional cardiac rehabilitation programs to meet patient needs are limited. The authors studied patient-perceived preferences in cardiac rehabilitation programs and desired program elements to evaluate differences by gender or age. The authors surveyed 199 patients (136 men, 60.0 +/- 11.6 years; 63 women, 63.7 +/- 12.7 years; P = 0.045) discharged from a tertiary referral hospital with acute myocardial infarction. Participants completed a standardized questionnaire regarding enrollment in rehabilitation and preferences for six program types on a 10-point scale (1 = little or no agreement, 10 = strongly agree). In this study, 54.3% of subjects enrolled in cardiac rehabilitation. Older patients (> or = 65 years) were more likely to enroll in home-based programs compared with younger patients (< 65 years) (11.8% versus 1.4%, P = 0.02). Younger patients preferred a short-term rehabilitation facility more than older patients (7.4 +/- 3.5 versus 5.1 +/- 4.1 units on the 10-point scale, P = 0.001), and rated the following more favorably than older patients: local health club programs (6.2 +/- 3.7 versus 4.5 +/- 4.0, P = 0.01), long-term programs (6.5 +/- 3.8 versus 4.9 +/- 4.2, P = 0.02), and comprehensive programs (6.6 +/- 3.7 versus 4.9 +/- 2.2, P = 0.02). Younger patients rated the following program elements more favorably compared with older patients: stress management (7.0 +/- 3.5 versus 5.7 +/- 4.1, P = 0.04), vocational counseling (5.1 +/- 3.9 versus 1.9 +/- 2.4, P = 0.001), and smoking cessation (4.9 +/- 4.4 versus 2.7 +/- 3.4, P = 0.001). Program preferences differed significantly by age, but not gender. Older patients enrolled in home-based programs over clinic-based programs. Younger patients rated stress management, vocational counseling, and smoking cessation more favorably than older patients. Strategies to enhance patient participation in cardiac rehabilitation should incorporate patient age and preferences for program

  20. Specializations in Rehabilitation Counseling: One Program's Vision

    ERIC Educational Resources Information Center

    Bernacchio, Charles; Burker, Eileen J.; Falvo, Donna; Porter, Patricia; Carone, Stacia

    2008-01-01

    The option for specialization is explored to address expanding roles for rehabilitation counselors. Several important considerations are identified for Rehabilitation Counselor Education (RCE) program faculty opting for a specialization. Development of specialty tracks in psychiatric and developmental disabilities are offered as viable options for…

  1. Strategies to manage activities in everyday life after a pain rehabilitation program.

    PubMed

    Kallhed, Cecilia; Mårtensson, Lena

    2018-03-01

    Owing to the complexity of the pain experience, it is important to understand how persons with chronic pain manage their condition, in order to provide an indication of how occupational therapists can enable participation in meaningful everyday activities during pain rehabilitation. The aim of this study was to explore how persons with chronic pain reason about their use and choice of strategies to manage activities of everyday life. A qualitative approach was used to capture experiences of strategies employed to manage activities while living with chronic pain. Eight persons agreed to participate. An overall theme, 'adjusting to life with chronic pain', encompasses the underlying meaning and the relations between the categories: finding new ways to perform activities, reaching for a reasonable balance of activities and using activities to achieve other purposes. Persons with chronic pain use various strategies as means to enable performance in activities of everyday life despite living with pain, which supports the conception that occupational therapists should focus on activities and strategies rather than the pain condition during pain rehabilitation.

  2. Evaluation of an occupational rehabilitation program.

    PubMed

    Goodman, Glenn; Browning, Margaret; Campbell, Sims; Hudak, Huison

    2005-01-01

    The purpose of this study was to report the findings of a program evaluation for an occupational rehabilitation program in the Midwest. An ex-post facto chart review was performed on 50 charts using demographic data, results from tests of performance and pain measures, and data from patient satisfaction questionnaires to find evidence of excellence in the program, and to identify areas for improvement. Over 97% of the participants actually completed the program and 76% returned to work within 3 months after program completion. Ninety-two percent indicated overall satisfaction with the program, and all aspects of the program were rated with a mean score of 4.25 or above on a 1 to 5 Likert scale. Evaluation of perceived pain scales of the participants indicate no discernable relationship between intensity of pain and successful return to work. The program showed a high completion rate, a high return to work rate, and high levels of patient satisfaction. Suggestions for improvement include an increase in use of real and simulated work activities, better documentation of pain measures, better programs to address psychosocial issues, lengthening the program, and increased communication with case managers and professionals outside of the work program.

  3. The effect of the rehabilitation program on balance, gait, physical performance and trunk rotation in Parkinson's disease.

    PubMed

    Stożek, Joanna; Rudzińska, Monika; Pustułka-Piwnik, Urszula; Szczudlik, Andrzej

    2016-12-01

    Parkinson's disease (PD) is a progressive, neurodegenerative disease which leads to postural and gait disorders, limitation in mobility, activities of daily living and disability. The aim of the study is to assess the effects of the rehabilitation program on balance, gait, motor performance and trunk rotations in PD patients. Sixty-four patients with 1.5-3.0 stage PD in the Hoehn and Yahr scale were randomly allocated to rehabilitation and control groups. Sixty-one patients completed the study. Patients were assessed three times, at month intervals. Between the first and second assessments, the rehabilitation group participated in a rehabilitation training program focused on mobility, balance and gait exercises, consisting of 28 sessions. Balance was assessed with tandem stance and the Pastor test (shoulder tug). Gait was assessed with a 10 m walk at preferred speed and 360° turn. Motor performance was evaluated by means of the Physical Performance Test (PPT) and timed motor activities. The trunk rotations were measured in the lumbar and thoraco-lumbar spine with a tape measure. The rehabilitation group significantly improved (p < 0.05) in balance and gait outcomes, PPT score, timed activities and trunk rotations both in comparison to the control group and baseline results. The positive effects of the exercise program maintained for at least 1 month. The 4-week rehabilitation training program focused on mobility, balance and gait exercises improved balance, gait, physical performance and trunk rotations in patients with PD.

  4. A Meta-Analysis of Skills Training Programs for Rehabilitation Clients.

    ERIC Educational Resources Information Center

    Bolton, Brian; Akridge, Robert L.

    1995-01-01

    Summarized the results of 15 experimental studies of 10 small-group skills training interventions developed for use with vocational rehabilitation clients. Concluded that the typical participant in skills training interventions received substantial benefit from the activity. Skills training programs should be implemented more widely with clients…

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

    PubMed

    Besemann, Markus

    2011-12-01

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

  6. Humanistic psychology and rehabilitation programs in mental hospitals.

    PubMed

    Steele, R L

    1976-07-01

    A humanistic growth-oriented theory, specifically Maslow's need-satisfaction theory, was used as a basis for examining the contributions work and employment make toward rehabilitation of the state mental hospital patient. Research literature reviewed indicated that if the rehabilitation program is to be viable and optimally effective, satisfying the belongingness and esteem needs of the patient is important. Research that stresses the therapeutic benefit of work, as well as research that raises the issue of workshops inhibiting independence and fostering dependence are presented. Modifications of rehabilitation programs that resulted in reports of increased program effectiveness are discussed. Fundamental features of these alternative or ancillary programs were: 1. a definite structure that allows various levels of advancement; 2. group participation; 3. patient initiative; 4. an orientation that reflects the competitive nature of employment; and 5. early community involvement. The importance of evaluating each client's needs and planning for growth before his/her job placement is considered vital to the program and to the individual.

  7. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed... CFR part 386). (2) Experimental and Innovative Training (34 CFR part 387). (3) State Vocational...

  8. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed... CFR part 386). (2) Experimental and Innovative Training (34 CFR part 387). (3) State Vocational...

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

    PubMed

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

    2017-07-01

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

  10. Rehabilitation Services Administration Annual Report, Fiscal Year 2004: Report on Federal Activities under the "Rehabilitation Act"

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    The "Rehabilitation Act of 1973," as amended (the act), provides the legislative basis for programs and activities that assist individuals with disabilities in the pursuit of gainful employment, independence, self-sufficiency and full integration into community life. This report is intended to provide a description of accomplishments and…

  11. Rehabilitation at the County Jail Level: A Model Program.

    ERIC Educational Resources Information Center

    Stearns, James D.

    The Ingham County, Michigan, Jail Rehabilitation Program is described. Attempting, as it does, to deal constructively with cell- and subsequent street-adjustment, the program is concerned with counseling and rehabilitation, and the provision of a bridge to the community. Efforts have been hindered by the brevity of sentences in a county jail, the…

  12. Rehabilitation Prevocational Support Services. Program Outline.

    ERIC Educational Resources Information Center

    Musgrove, Ann

    This outline decribes the Rehabilitation Prevocational Support Service program at Northwest Community College (Alabama), designed to help prepare selected students for occupational training programs or job placement and to enhance their academic level. Students are assigned to individualized learning modules based on pretesting by a variety of…

  13. Business Enterprise Program | Division of Vocational Rehabilitation

    Science.gov Websites

    About Us > Business Enterprise Program Business Enterprise Program The Division of Vocational Rehabilitation's (DVR) Business Enterprise Program (BEP) provides employment opportunities to people who experience contact their DVR counselor or the BEP coordinator. List of Business Enterprise Program Vendors BEP Policy

  14. The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

    PubMed

    McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

    2017-03-01

    Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Increased brain connectivity and activation after cognitive rehabilitation in Parkinson's disease: a randomized controlled trial.

    PubMed

    Díez-Cirarda, María; Ojeda, Natalia; Peña, Javier; Cabrera-Zubizarreta, Alberto; Lucas-Jiménez, Olaia; Gómez-Esteban, Juan Carlos; Gómez-Beldarrain, Maria Ángeles; Ibarretxe-Bilbao, Naroa

    2017-12-01

    Cognitive rehabilitation programs have demonstrated efficacy in improving cognitive functions in Parkinson's disease (PD), but little is known about cerebral changes associated with an integrative cognitive rehabilitation in PD. To assess structural and functional cerebral changes in PD patients, after attending a three-month integrative cognitive rehabilitation program (REHACOP). Forty-four PD patients were randomly divided into REHACOP group (cognitive rehabilitation) and a control group (occupational therapy). T1-weighted, diffusion weighted and functional magnetic resonance images (fMRI) during resting-state and during a memory paradigm (with learning and recognition tasks) were acquired at pre-treatment and post-treatment. Cerebral changes were assessed with repeated measures ANOVA 2 × 2 for group x time interaction. During resting-state fMRI, the REHACOP group showed significantly increased brain connectivity between the left inferior temporal lobe and the bilateral dorsolateral prefrontal cortex compared to the control group. Moreover, during the recognition fMRI task, the REHACOP group showed significantly increased brain activation in the left middle temporal area compared to the control group. During the learning fMRI task, the REHACOP group showed increased brain activation in the left inferior frontal lobe at post-treatment compared to pre-treatment. No significant structural changes were found between pre- and post-treatment. Finally, the REHACOP group showed significant and positive correlations between the brain connectivity and activation and the cognitive performance at post-treatment. This randomized controlled trial suggests that an integrative cognitive rehabilitation program can produce significant functional cerebral changes in PD patients and adds evidence to the efficacy of cognitive rehabilitation programs in the therapeutic approach for PD.

  16. ICU early physical rehabilitation programs: financial modeling of cost savings.

    PubMed

    Lord, Robert K; Mayhew, Christopher R; Korupolu, Radha; Mantheiy, Earl C; Friedman, Michael A; Palmer, Jeffrey B; Needham, Dale M

    2013-03-01

    To evaluate the potential annual net cost savings of implementing an ICU early rehabilitation program. Using data from existing publications and actual experience with an early rehabilitation program in the Johns Hopkins Hospital Medical ICU, we developed a model of net financial savings/costs and presented results for ICUs with 200, 600, 900, and 2,000 annual admissions, accounting for both conservative- and best-case scenarios. Our example scenario provided a projected financial analysis of the Johns Hopkins Medical ICU early rehabilitation program, with 900 admissions per year, using actual reductions in length of stay achieved by this program. U.S.-based adult ICUs. Financial modeling of the introduction of an ICU early rehabilitation program. Net cost savings generated in our example scenario, with 900 annual admissions and actual length of stay reductions of 22% and 19% for the ICU and floor, respectively, were $817,836. Sensitivity analyses, which used conservative- and best-case scenarios for length of stay reductions and varied the per-day ICU and floor costs, across ICUs with 200-2,000 annual admissions, yielded financial projections ranging from -$87,611 (net cost) to $3,763,149 (net savings). Of the 24 scenarios included in these sensitivity analyses, 20 (83%) demonstrated net savings, with a relatively small net cost occurring in the remaining four scenarios, mostly when simultaneously combining the most conservative assumptions. A financial model, based on actual experience and published data, projects that investment in an ICU early rehabilitation program can generate net financial savings for U.S. hospitals. Even under the most conservative assumptions, the projected net cost of implementing such a program is modest relative to the substantial improvements in patient outcomes demonstrated by ICU early rehabilitation programs.

  17. Neuromuscular adaptations after a rehabilitation program in patients with chronic low back pain: case series (uncontrolled longitudinal study)

    PubMed Central

    2013-01-01

    Background To investigate the impact of a short-term multimodal rehabilitation program for patients with low back pain (LBP) on trunk muscle reflex responses and feedforward activation induced by postural perturbations. Methods Case series (uncontrolled longitudinal study). Thirty chronic patients with LBP (21 women and 19 men, mean age 42.6 ± 8.6 years, mean weight 73 ± 14 kg, mean height 174 ± 10 cm) were included. The intervention consisted in a 5-day program including therapeutic education sessions (360 min), supervised abdominal and back muscle strength exercises (240 min), general aerobic training (150 min), stretching (150 min), postural education (150 min) and aqua therapy (150 min). Feedforward activation level and reflex amplitude determined by surface electromyographic activity triggered by postural perturbations were recorded from abdominal and paraspinal muscles in unexpected and expected conditions. Subjects were tested before, just after and again one month after the rehabilitation program. Results No main intervention effect was found on feedforward activation levels and reflex amplitudes underlining the absence of changes in the way patients with LBP reacted across perturbation conditions. However, we observed a shift in the behavioral strategy between conditions, in fact feedforward activation (similar in both conditions before the program) decreased in the unexpected condition after the program, whereas reflex amplitudes became similar in both conditions. Conclusions The results suggest that a short-term rehabilitation program modifies trunk behavioral strategies during postural perturbations. These results can be useful to clinicians for explaining to patients how to adapt to daily life activities before and after rehabilitation. PMID:24063646

  18. Home-Based Cardiac Rehabilitation.

    ERIC Educational Resources Information Center

    Fardy, Paul S.

    1987-01-01

    Although cardiac rehabilitation has become increasingly popular, only 15 percent of eligible candidates participate in supervised and monitored programs. This article reviews alternative home-based cardiac rehabilitation, discussing types of activities, monitoring, diet, motivation, and coordination with traditional program staff. (Author/MT)

  19. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... technical assistance, to assist in increasing the numbers of qualified personnel trained in providing... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Training program? 385.1... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING General...

  20. 34 CFR 389.1 - What is the Rehabilitation Continuing Education Program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the Rehabilitation Continuing Education Program? 389.1 Section 389.1 Education Regulations of the Offices of the Department of Education (Continued... CONTINUING EDUCATION PROGRAMS General § 389.1 What is the Rehabilitation Continuing Education Program? This...

  1. 34 CFR 389.1 - What is the Rehabilitation Continuing Education Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Continuing Education Program? 389.1 Section 389.1 Education Regulations of the Offices of the Department of Education (Continued... CONTINUING EDUCATION PROGRAMS General § 389.1 What is the Rehabilitation Continuing Education Program? This...

  2. INTEGRATION OF STRENGTH AND CONDITIONING PRINCIPLES INTO A REHABILITATION PROGRAM

    PubMed Central

    Lorenz, Daniel S.

    2011-01-01

    Background and Purpose: Rehabilitation and strength and conditioning are often seen as two separate entities in athletic injury recovery. Traditionally an athlete progresses from the rehabilitation environment under the care of a physical therapist and/or athletic trainer to the strength and conditioning coach for specific return to sport training. These two facets of return to sport are often considered to have separate goals. Initial goals of each are often different due to the timing of their implementation encompassing different stages of post-injury recovery. The initial focus of post injury rehabilitation includes alleviation of dysfunction, enhancement of tissue healing, and provision of a systematic progression of range-of-motion and strength. During the return to function phases, specific return to play goals are paramount. Understanding of specific principles and program parameters is necessary when designing and implementing an athlete's rehabilitation program. Communication and collaboration amongst all individuals caring for the athlete is a must. The purpose of this review is to outline the current evidence supporting utilization of training principles in athletic rehabilitation, as well as provide suggested implementation of such principles throughout different phases of a proposed rehabilitation program. Evidence Acquisition: The following electronic databases were used to identify research relevant to this clinical commentary: MEDLINE (from 1950–June 2011) and CINAHL (1982–June 2011), for all relevant journal articles written in English. Additional references were accrued by independent searching of references from relevant articles. Results: Currently evidence is lacking in the integration of strength and conditioning principles into the rehabilitation program for the injured athlete. Numerous methods are suggested for possible utilization by the clinician in practice to improve strength, power, speed, endurance, and metabolic capacity

  3. Does a Nintendo Wii exercise program provide similar exercise demands as a traditional pulmonary rehabilitation program in adults with COPD?

    PubMed

    LeGear, Tyler; LeGear, Mark; Preradovic, Dejan; Wilson, Geoffrey; Kirkham, Ashley; Camp, Pat G

    2016-05-01

    The chronic obstructive pulmonary disease (COPD) population can experience lower activity and fitness levels than the non-COPD population. The Nintendo Wii may be an appropriate at-home training device for the COPD population, which could be used as a supplement for a pulmonary rehabilitation program. This study was a randomized, within-subject, cross-over study involving 10 adults with COPD previously enrolled in St Paul's Hospital's pulmonary rehabilitation program. This study attempted to determine if specific Wii activities resulted in similar energy expenditures to that of a more traditional pulmonary rehabilitation activity. Participants completed two 15-min exercise interventions in a single session, with a washout period of 30 min in-between. The interventions were an experimental Wii intervention and a traditional treadmill intervention. There was no significant difference in total energy expenditure between the two 15-min exercise interventions [mean difference 36.3 joules; 95% confidence interval (CI): 31.4, 104]. There was no significant difference in heart rate (mean difference -0.167 beats per minute; 95% CI: -4.83, 4.50), rating of perceived exertion (mean difference 0.100; 95% CI: -0.416, 0.616) and Borg dyspnea scale (mean difference 0.267; 95% CI: -0.004, 0.537) between the two 15-min exercise interventions. There was a significant difference in SpO2 between the two 15-min exercise interventions (Wii intervention mean difference 2.33% > treadmill intervention; 95% CI: 1.52, 3.15). Gaming technology can provide an exercise program that has similar cardiovascular demands to traditional pulmonary rehabilitation programs for patients with COPD. Further research is necessary to address feasibility and long-term adherence. © 2014 John Wiley & Sons Ltd.

  4. Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

    PubMed

    McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

    2004-09-01

    Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

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

    PubMed

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

    2016-08-01

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

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

    PubMed

    2013-06-19

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

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

    PubMed

    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 < 0.01). Total hours of physical therapy and occupational therapy services per patient day were 1.2 in skilled nursing facilities and 2.0 in 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 < 0.01). Patients in 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.

  8. The Rehabilitation Medicine Scientist Training Program

    PubMed Central

    Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn

    2016-01-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining NIH funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe, and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program (RMSTP) was funded by a K12 grant from the National Center of Medical Rehabilitation Research (NCMRR), as one strategy for increasing the number of research-productive physiatrists. The RMSTP's structure was revised in 2001 to improve the level of preparation of incoming trainees, and to provide a stronger central mentorship support network. Here we describe the original and revised structure of the RMSTP and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that RMSTP trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 years of training. PMID:19847126

  9. Attendance and graduation patterns in a group-model health maintenance organization alternative cardiac rehabilitation program.

    PubMed

    Ratchford, Andria M; Hamman, Richard F; Regensteiner, Judith G; Magid, David J; Gallagher, Stacy Brennan; Merenich, John A

    2004-01-01

    Poor rates of participation in cardiac rehabilitation programs are well documented, especially among women and older patients. The Colorado Kaiser Permanente Cardiac Rehabilitation (KPCR) program is a home-based, case-managed, goal-oriented program with an active recruitment process and unlimited program length. This study evaluated the participation rates for the program and the predictors of attendance and graduation. Patients hospitalized with acute myocardial infarction, coronary artery bypass graft, and percutaneous coronary intervention from June 1999 to May 2000 (n = 1030) were identified from the administrative database, and the proportion captured by the KPCR staff was determined. Subsequent attendance and graduation patterns were evaluated. Nearly 94% of patients with one of the three aforementioned conditions were identified by the rehabilitation staff, and 41% of all patients attended the KPCR program. More than 75% of the patients who participated went on to graduate from the program. Gender comparisons showed no difference in participation between men (66.8%) and women (59.7%) (P =.07). Participation rates were inversely associated with age, yet age was not associated with graduation from the program. Surgical interventions and two or more events experienced within the first 4 weeks of the index event were the strongest predictors of attendance and graduation from the KPCR program. Innovative approaches for the capture and retention of patients in cardiac rehabilitation programs are urgently needed. The alternative program evaluated in this study showed little difference in participation between men and women, yet participation among older patients remained poor. Overall, patients who underwent surgical interventions or multiple events were more likely to attend and graduate from the program.

  10. Dance program for physical rehabilitation and participation in children with cerebral palsy.

    PubMed

    López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

    2012-02-01

    Objective : This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods : The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children ( n  = 16), parents ( n  = 16), and therapists ( n  = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results : Main results were that the children reported high enjoyment level ( p  < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit ( p  < .0001); and the therapists viewed the class as a positive adjunct to therapy ( p  < .0001). Conclusions : The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP.

  11. Dance program for physical rehabilitation and participation in children with cerebral palsy

    PubMed Central

    López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

    2012-01-01

    Objective: This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods: The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children (n = 16), parents (n = 16), and therapists (n = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results: Main results were that the children reported high enjoyment level (p < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit (p < .0001); and the therapists viewed the class as a positive adjunct to therapy (p < .0001). Conclusions: The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP. PMID:25431617

  12. Integration of students with physical impairment in Canadian university rehabilitation sciences programs.

    PubMed

    Guitard, Paulette; Duguay, Elise; Thériault, France-Andrée; Sirois, Nathalie Julie; Lajoie, Mélissa

    2010-03-01

    The purpose of this research was two-fold. First, it sought to determine if Canadian rehabilitation science programs are equipped to admit students with physical impairments and, second, to document the experience of these students. A survey (questionnaire) conducted among all Canadian university rehabilitation science programs (n=34) and interviews with students with physical impairments (n=3) from one university help better delineate this problem. Twenty-three programs completed the survey. Of these, 21 (91%) rehabilitation science programs have admitted students with a variety of physical impairments. Programs have access to their university's Special Service Center to help answer the needs of these students. Strategies have been developed to overcome the difficulties encountered and to meet the programs' requirements. Canadian university rehabilitation science programs seem well equipped to facilitate the integration of individuals with physical impairments. Students report a positive university experience; however, they voice several recommendations to smooth the integration process. Although significant efforts have been made to facilitate the integration process of students with physical limitations, adjustments are still warranted.

  13. Successful rehabilitation program rests on service utilization.

    PubMed

    Lane, L

    1993-07-01

    An effective rehabilitation strategy is built upon three fundamentals: translating resident needs into delivered services, managing occupancy and marketing programs, and utilizing existing reimbursement mechanisms to ensure profitability of the venture.

  14. 34 CFR 390.1 - What is the Rehabilitation Short-Term Training program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false What is the Rehabilitation Short-Term Training program...-TERM TRAINING General § 390.1 What is the Rehabilitation Short-Term Training program? This program is designed for the support of special seminars, institutes, workshops, and other short-term courses in...

  15. 34 CFR 390.1 - What is the Rehabilitation Short-Term Training program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What is the Rehabilitation Short-Term Training program...-TERM TRAINING General § 390.1 What is the Rehabilitation Short-Term Training program? This program is designed for the support of special seminars, institutes, workshops, and other short-term courses in...

  16. 34 CFR 390.1 - What is the Rehabilitation Short-Term Training program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Short-Term Training program...-TERM TRAINING General § 390.1 What is the Rehabilitation Short-Term Training program? This program is designed for the support of special seminars, institutes, workshops, and other short-term courses in...

  17. 34 CFR 390.1 - What is the Rehabilitation Short-Term Training program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the Rehabilitation Short-Term Training program...-TERM TRAINING General § 390.1 What is the Rehabilitation Short-Term Training program? This program is designed for the support of special seminars, institutes, workshops, and other short-term courses in...

  18. 34 CFR 390.1 - What is the Rehabilitation Short-Term Training program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false What is the Rehabilitation Short-Term Training program...-TERM TRAINING General § 390.1 What is the Rehabilitation Short-Term Training program? This program is designed for the support of special seminars, institutes, workshops, and other short-term courses in...

  19. [Evaluation of the ICAR program--Internet communication and active rehabilitation for people with mental disorders].

    PubMed

    Załuska, Maria; Bronowski, Paweł; Panasiuk, Katarzyna; Brykalski, Jan; Paszko, Jolanta

    2008-01-01

    Prevalence of Internet use indicates, that introducing internet to people with mental disorders might have a positive impact on their social integration. There are concerns about negative effects of dealing with virtual reality on the mental health of Internet users. Evaluation of the ICAR program--"Internet communication and active rehabilitation for people with mental disorders" concerning its utility in psychiatric rehabilitation. 22 participants of the ICAR programme and 22 controls (people with mental disorders not participating in the programme) were investigated before and after the completion of the programme. There following were compared: their computer and Internet use skills, social functioning (Birchwood Scale), self-estimation of the mental health (Frankfurt Scale FBS), self-reported quality of life (WHO QOL BREV) and number of psychiatric hospitalisations during 11 months of the observation period. Among participants, their reported skills and motivation increased significantly following the programme. During 11 months of the observation there were less hospitalisations (1 fulltime and 1 daily) in the study group than in the control group (3 and 1). An increase of symptoms was observed in the Frankfurt Scale in 10 participants and 13 controls. The level of social functioning and severity of symptoms was not significantly different and did not change during observation. The self-reported quality of life increased in both groups during this period. ICAR training programme for the mentally ill, increases participants skills and motivation towards computer and Internet use, as well as their self-reported quality of life. The participation in the programme doesn't have any significant effect on the overall social functioning and number of psychiatric hospitalisations during the 11 months of observation. A positive effect of the ICAR programme on the quality of life, as well as some activating effect leading to exacerbation of the psychopatological

  20. Rehabilitation through the Arts: Impact on Participants' Engagement in Educational Programs

    ERIC Educational Resources Information Center

    Halperin, Ronnie; Kessler, Suzanne; Braunschweiger, Dana

    2012-01-01

    Educational achievement has been shown to be negatively correlated with recidivism among those released from prison (Nuttall, Hollmen, and Staley, 2003). The purpose of this study was to examine the impact of a prison art rehabilitation program, Rehabilitation Through the Arts (RTA), on inmate participation in voluntary educational programs. RTA…

  1. 76 FR 12717 - Disability and Rehabilitation Research Projects and Centers Program; Field Initiated (FI...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... DEPARTMENT OF EDUCATION Disability and Rehabilitation Research Projects and Centers Program; Field...; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Field Initiated (FI) Projects AGENCY: Office of Special Education...

  2. [The effects of psychosocial rehabilitation programs on the levels of self-efficacy for mentally disabled persons].

    PubMed

    Park, Hyun Sook; Bae, Sung-Woo; Kim, Yi Young

    2008-10-01

    This study investigated the effects of psychosocial rehabilitation programs provided by a psychosocial rehabilitation center on the levels of self-efficacy for mentally disabled persons. We followed the study subjects for 2 yr in order to examine whether the psychosocial rehabilitation programs had a positive impact on their levels of self-efficacy. There were 18 subjects in the experimental group and they received all the psychosocial rehabilitation services available at the psychosocial rehabilitation center for 2 yr. In the comparison group, there were 17 participants who voluntarily refused to participate in the psychosocial rehabilitation programs. The results indicated that the psychosocial rehabilitation programs were effective in increasing the levels of the self-efficacy total score and specific self-efficacy score. The overall study results indicated that psychosocial rehabilitation programs provided by a psychosocial rehabilitation center had a positive impact on increasing the levels of self-efficacy for mentally disabled persons.

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

    PubMed

    2013-06-14

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

  4. Relationship between cancer-related fatigue and physical activity in inpatient cancer rehabilitation.

    PubMed

    Kummer, Franziska; Catuogno, Silvio; Perseus, Josef M; Bloch, Wilhelm; Baumann, Freerk T

    2013-08-01

    Fatigue is a serious problem for the majority of patients with cancer. In this context, several studies have shown benefits of physical activity during and following treatment. However, uncertainties remain regarding the optimal type and duration of physical activity. Therefore, this study examined the relationship between cancer-related fatigue and physical activity in the course of inpatient rehabilitation. Fatigue (Multidimensional Fatigue Inventory) and physical activity (Freiburg Questionnaire of Physical Activity) were assessed in a consecutive series of 35 patients with cancer attending oncological inpatient rehabilitation during a six-month study period. The three-week rehabilitation program included daily exercise therapy consisting of aerobic endurance training, moderate resistance training, coordination exercises, relaxation training and individual physiotherapy. At discharge, a significant improvement in each dimension of cancer-related fatigue (p=0.001-0.003) and a significant increase of physical activity levels (p=0.001) were observed. A small, but significant negative correlation was found between cancer-related fatigue and the level of physical activity (R=-0.438, p=0.004). The largest effects were associated with a weekly energy expenditure of 3000 kcal through physical activity. The results support a non-linear dose-response relationship between cancer-related fatigue and physical activity. Since this is the first study providing specific exercise recommendations for an effective treatment of cancer-related fatigue in the context of inpatient rehabilitation, further research is required to validate the observed trends.

  5. Exercise through a cardiac rehabilitation program attenuates oxidative stress in patients submitted to coronary artery bypass grafting.

    PubMed

    Taty Zau, José Francisco; Costa Zeferino, Rodrigo; Sandrine Mota, Nádia; Fernandes Martins, Gerez; Manoel Serra, Salvador; Bonates da Cunha, Therezil; Medeiros Lima, Daniel; Bragança Pereira, Basilio de; Matos do Nascimento, Emília; Filho, Danilo Wilhelm; Curi Pedrosa, Rozangela; Pedrosa, Roberto Coury

    2018-12-01

    Cardiovascular disease is the main cause of morbidity and mortality in the world and oxidative stress has been implicated in the pathogenesis. Cardiac rehabilitation in patients with coronary artery disease submitted to coronary artery bypass grafting may prevent cardiovascular events probably through the attenuation of oxidative stress. The aim of this study was to evaluate the benefits of a cardiac rehabilitation program in the control of the systemic oxidative stress. The studied population consisted of 40 patients, with chronic stable coronary artery disease submitted to coronary artery bypass grafting, who attended a cardiac rehabilitation program. Biomarkers of oxidative stress were evaluated in the blood of these patients at different moments. After the onset of cardiac rehabilitation, there was a significant and progressive decrease in thiobarbituric acid reactive substances levels and protein carbonyls, an initial increase and subsequent decrease in superoxide dismutase, catalase and glutathione peroxidase activities. Also, a progressive increase of uric acid, while ferric reducing antioxidant power levels increased only at the end of the cardiac rehabilitation and a tendency to increase of glutathione contents. The results suggest that regular exercise through a cardiac rehabilitation program can attenuate oxidative stress in chronic coronary artery disease patients submitted to coronary artery bypass grafting.

  6. National Registry of Cardiac Rehabilitation Programs in Mexico II (RENAPREC II).

    PubMed

    Ilarraza-Lomelí, Hermes; García-Saldivia, Marianna; Rojano-Castillo, Jessica; Justiniano, Samuel; Cerón, Norma; Aranda-Ayala, Zulema-L; Rodríguez, Azucena; Hernández, Alejandro; Cassaigne, María-Elena; Cantero, Raúl; Gasca, Pablo; Hinojosa, Tania; Alonso, Jesús; Romo, Ricardo; Lara, Jorge; Pimentel, Elizabeth; Zavala, Juana; Rius-Suárez, María-Dolores; Cherebetiu, Gabriel; Cortés, Othniel; Almaraz, Alejandro; Mendoza, Pedro; Silva, Jesús; Tirado, Enrique; Martínez, Leonel

    The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  7. Effects of a Two-Year Intensive Multidisciplinary Rehabilitation Program for Patients with Huntington’s Disease: a Prospective Intervention Study

    PubMed Central

    Piira, Anu; van Walsem, Marleen R.; Mikalsen, Geir; Øie, Lars; Frich, Jan C.; Knutsen, Synnove

    2014-01-01

    Objective: To assess effects of a two year intensive, multidisciplinary rehabilitation program for patients with early- to mid-stage Huntington’s disease. Design: A prospective intervention study. Setting: One inpatient rehabilitation center in Norway. Subjects: 10 patients, with early- to mid-stage Huntington’s disease. Interventions: A two year rehabilitation program, consisting of six admissions of three weeks each, and two evaluation stays approximately three months after the third and sixth rehabilitation admission. The program focused on physical exercise, social activities, and group/teaching sessions. Main outcome measures: Standard measures for motor function, including gait and balance, cognitive function, including MMSE and UHDRS cognitive assessment, anxiety and depression, activities of daily living (ADL), health related quality of life (QoL) and Body Mass Index (BMI). Results: Six out of ten patients completed the full program. Slight, but non-significant, decline was observed for gait and balance from baseline to the evaluation stay after two years. Non-significant improvements were observed in physical QoL, anxiety and depression, and BMI. ADL-function remained stable with no significant decline. None of the cognitive measures showed a significant decline. An analysis of individual cases revealed that four out of the six participants who completed the program sustained or improved their motor function, while motor function declined in two participants. All the six patients who completed the program reported improved or stable QoL throughout the study period. Conclusion: Our findings suggest that participation in an intensive rehabilitation program is well tolerated among motivated patients with early to mid-stage HD. The findings should be interpreted with caution due to the small sample size in this study. PMID:25642382

  8. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Long-Term Training program? 386.1 Section 386.1 Education Regulations of the Offices of the Department of Education (Continued...

  9. Rehabilitation Counseling Information: Programmed Instruction for the Practitioner. Final Report.

    ERIC Educational Resources Information Center

    Phelps, William R.

    This programmed instruction rehabilitation counseling information test attempts to cover six areas as follows: testing, psychological information, medical information, counseling concepts, history of rehabilitation, and counselor-agency functioning. The information may be utilized for research purposes and/or replicated by others. (Author)

  10. Exercise-Based Oncology Rehabilitation: Leveraging the Cardiac Rehabilitation Model

    PubMed Central

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

    2014-01-01

    PURPOSE The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose is to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a cardiac rehabilitation model. METHODS We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. RESULTS Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current cardiac rehabilitation models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. CONCLUSIONS Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors. PMID:25407596

  11. 76 FR 17396 - Proposed Priorities: Disability and Rehabilitation Research Projects and Centers Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ...-science conference on its designated priority research area in the fourth year of the project period, and... Rehabilitation Research Projects and Centers Program AGENCY: Office of Special Education and Rehabilitative... and Rehabilitative Services proposes two priorities for the Disability and Rehabilitation Research...

  12. Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

    PubMed

    2013-06-11

    The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

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

    PubMed

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

    2017-09-01

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

  14. 48 CFR 853.271 - Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...

  15. 48 CFR 853.271 - Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...

  16. 48 CFR 853.271 - Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...

  17. 48 CFR 853.271 - Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...

  18. 48 CFR 853.271 - Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...

  19. The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden

    PubMed Central

    Melin-Johansson, Christina; Öhlén, Joakim; Koinberg, Ingalill; Berg, Linda; Nolbris, Margaretha Jenholt

    2015-01-01

    The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs. PMID:28462312

  20. Vocational rehabilitation case manager factors associated with vocational rehabilitation service program outcomes for people with disabilities in Taiwan - an exploratory study.

    PubMed

    Wang, Yun-Tung; Lin, Yi-Jiun

    2017-02-01

    Purpose The aim of this study is to explore whether/which vocational rehabilitation case manager (VRCMer) factors were significantly associated with the vocational rehabilitation service (VRS) program outcomes in Taiwan. Method This study used the 2011 VRS Program for People with Disabilities Database in a metropolitan city in Taiwan (N = 466) to do a secondary data analysis using hierarchical logistic regression. Results This study found that the employment rate and stable employment rate created by the 2011 VRS program in a metropolitan city in Taiwan were 48.7% and 42.1%, respectively. For the predictors of employment/stable employment, "occurrences of the services provided by the VRCMer" variable was definitely dominant. In addition, "level of the disability" was the second-ranking predictor, and was significantly negatively correlated with both employment and stable employment outcomes. Conclusions Vocational rehabilitation case manager factors in this study were significantly correlated with VRS program outcomes for people with disabilities in Taiwan after controlling for the clients' socio-demographic variables. The results indicate that greater input by VRCMers for people with disabilities equates to better employment outcomes in metropolitan Taiwan. Implications for Rehabilitation This is the first study to build an inferential statistical model in attempt to explain and predict the association between vocational rehabilitation case manager factors and vocational rehabilitation service program outcomes for people with disabilities in Taiwan. In cases of severe disability, a vocational rehabilitation case manager should seek out more in-kind and in-cash resources, and choose a suitable job coach to cooperate in assisting the client to become employed. Based on the findings, government has to continue implementing opportunities for people with disabilities to attain higher and better quality educational levels, for increasing their employment rate

  1. Effect of Long-Term Physical Activity Practice after Cardiac Rehabilitation on Some Risk Factors

    ERIC Educational Resources Information Center

    Freyssin, Celine, Jr.; Blanc, Philippe; Verkindt, Chantal; Maunier, Sebastien; Prieur, Fabrice

    2011-01-01

    The objective of this study was to evaluate the effects of long-term physical activity practice after a cardiac rehabilitation program on weight, physical capacity and arterial compliance. The Dijon Physical Activity Score was used to identify two groups: sedentary and active. Weight, distance at the 6-min walk test and the small artery elasticity…

  2. 76 FR 15964 - Funding Priorities: Disability and Rehabilitation Research Projects and Centers Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... past five years, the DBTACs have published numerous journal articles, held a series of research... and Rehabilitation Research Projects and Centers Program AGENCY: Office of Special Education and... Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on...

  3. [Nutritional care in the cardiac rehabilitation program].

    PubMed

    da Vico, Letizia; Biffi, Barbara; Masini, Maria Luisa; Fattirolli, Francesco

    2007-06-01

    There is some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation: nutritional care has a relevant role in the secondary prevention of cardiovascular disease. The dietitian is the qualified sanitary professional for nutritional care. The aim of this study was to define the role of dietitians within a health care team in programs of cardiac rehabilitation. In this setting, nutritional care starts with a dietary assessment, which includes a measurement of the anthropometric parameters, and a survey of the patient knowledge and eating habits. If there is no need for change in the patient lifestyle, the patient is addressed to the normal cardiac rehabilitation program with no further nutritional intervention except one session of counseling. When lifestyle changes are needed, the dietitian defines, together with the patient, therapeutic aims and expected results. The following phase is represented by group session with patients and their relatives during which nutritional topics are discussed and nutritional education is provided Afterwards, self-monitoring sheets of eating habits are individually discussed in one visit; a last individual visit is used for a final assessment of nutritional knowledge, dietary habits, and anthropometric parameters. In case of unsatisfactory results, patients are invited to participate to three group session to be held biweekly, during which they interact with the dietitian and take part to exercises and group discussions. When the established targets are reached, the nutritional program includes individual follow up visits at six and twelve months for further assessment of medium term results.

  4. Behavior change outcomes in an outpatient cardiac rehabilitation program.

    PubMed

    Timlin, Maureen T; Shores, Kevin V; Reicks, Marla

    2002-05-01

    To evaluate the effectiveness of nutrition education within an outpatient cardiac rehabilitation program. Subjects were assigned, according to participation in cardiac rehabilitation programs in two community hospitals within an integrated healthcare system, to either a treatment (n=54), or a control group (n=50). One hundred four men and women, age range 35 to 85 years, participating in a 6-week cardiac rehabilitation program. Most were men (80%) and overweight. The majority presented with the diagnosis of myocardial infarction followed by coronary artery bypass surgery or percutaneous transluminal coronary angiography procedure. Subjects in the control group received usual nonindividualized nutrition education from cardiac rehabilitation therapists. Subjects in the treatment group attended two group nutrition education classes and one individual diet counseling session, all led by the same dietitian. Changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey; changes in cardiac diet self-efficacy; and changes in health-related quality of life. Statistical analyses performed Group-by-time analysis of variance with repeated measures, chi2 test. The treatment group had greater improvement in Restaurant and Recipes scores on the Diet Habit Survey (2.6 vs 1.0) and a greater cardiac diet self-efficacy mean score (4.3) compared with the control group (3.8), with the greatest change in items related to eating in restaurants, away from home, or when alone. From entry into the program to discharge, the cholesterol-saturated fat index decreased significantly in the control group (from 57 to 48), and in the treatment group (from 51 to 42). The percent of energy from carbohydrate increased significantly in the control group (from 51% to 55%) and in the treatment group (from 53% to 57%). There were no differences between groups over the 3 time periods (baseline, 6 weeks, and 3-month follow-up) (n=39

  5. Annual Report to the President and the Congress on Federal Activities Related to the Administration of the Rehabilitation Act of 1973, as Amended. Fiscal Year 1981. Executive Summary.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (ED), Washington, DC.

    The fiscal year 1981 annual report of the Rehabilitation Services Administration's activities under the Rehabilitation Act of 1973, as amended, is presented; program operations, program development activities, functions of the National Institute of Handicapped Research, and other provisions of the Act, are described. Program operations include:…

  6. Practice guidelines for program evaluation in community-based rehabilitation.

    PubMed

    Grandisson, Marie; Hébert, Michèle; Thibeault, Rachel

    2017-06-01

    This paper proposes practice guidelines to evaluate community-based rehabilitation (CBR) programs. These were developed through a rigorous three-phase research process including a literature review on good practices in CBR program evaluation, a field study during which a South Africa CBR program was evaluated, and a Delphi study to generate consensus among a highly credible panel of CBR experts from a wide range of backgrounds and geographical areas. The 10 guidelines developed are summarized into a practice model highlighting key features of sound CBR program evaluation. They strongly indicate that sound CBR evaluations are those that give a voice and as much control as possible to the most affected groups, embrace the challenge of diversity, and foster use of evaluation processes and findings through a rigorous, collaborative and empowering approach. The practice guidelines should facilitate CBR evaluation decisions in respect to facilitating an evaluation process, using frameworks and designing methods. Implications for rehabilitation Ten practice guidelines provide guidance to facilitate sound community-based rehabilitation (CBR) program evaluation decisions. Key indications of good practice include: • being as participatory and empowering as possible; • ensuring that all, including the most affected, have a real opportunity to share their thoughts; • highly considering mixed methods and participatory tools; • adapting to fit evaluation context, local culture and language(s); • defining evaluation questions and reporting findings using shared CBR language when possible, which the framework offered may facilitate.

  7. Informed Consumer Choice in Community Rehabilitation Programs

    ERIC Educational Resources Information Center

    Hagen-Foley, Debra L.; Rosenthal, David A.; Thomas, Dale F.

    2005-01-01

    This study investigated consumer and staff member perceptions regarding the extent of consumer choice and participatory planning in community-based rehabilitation programs (CRPs) and the relationship between these elements, satisfaction, and outcomes. Consumers reported moderate to high levels of choice in services and employment goals, and…

  8. Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review

    PubMed Central

    2013-01-01

    Background Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Methods Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Results Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved

  9. Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review.

    PubMed

    Kosse, Nienke M; Dutmer, Alisa L; Dasenbrock, Lena; Bauer, Jürgen M; Lamoth, Claudine J C

    2013-10-10

    Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after

  10. 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

    PubMed Central

    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

  11. Evaluating the "Reasoning and Rehabilitation" Program for Young Offenders

    ERIC Educational Resources Information Center

    Mitchell, Jonathan; Palmer, Emma J.

    2004-01-01

    The effectiveness of the Reasoning and Rehabilitation (R and R) program with juvenile offenders in an English prison was evaluated using reconviction and reimprisonment at eighteen months post-release as outcomes. A group of offenders who completed the program (n = 31) were compared with a group of offenders who did not receive the program (n =…

  12. Participating in life again: a mixed-method study on a goal-orientated rehabilitation program for young adult cancer survivors.

    PubMed

    Hauken, May Aasebø; Holsen, Ingrid; Fismen, Eirik; Larsen, Torill Marie Bogsnes

    2014-01-01

    Young adult cancer survivors (18-35 years old) are at risk of lifelong threats to physical and psychosocial health and decreased life participation. Research indicates lack of information about the late effects and health risks and limited follow-up and rehabilitation. The objectives of this study were to examine whether a goal-oriented rehabilitation program increased young adult cancer survivors' participation and explore the participants' descriptions and experience of the process. We used a convergent parallel design combining quantitative and qualitative methods. Sixteen young adult cancer survivors (aged 24-35 years), with different cancer diagnoses, were allocated to a 6-month rehabilitation program. The Canadian Occupational Performance Measure showed significant (P < .001) change in both performance and satisfaction from the start (T1) to the end (T4) of the program. Qualitative results indicated that increased participation was depended on building capacity and finding the balance, gaining new insight, and follow-up. Important factors of the rehabilitation program seemed to be physical activity, psychoeducation, peer-to-peer support, and follow-up over time. Results indicate that a goal-oriented rehabilitation program may increase participation by young adult cancer survivors. The goal-oriented process is not straightforward and depends on experience of coping and control, finding a balance between the different areas of life and follow-up over time. Health professionals should play an important role in the rehabilitation of young adult cancer survivors by promoting empowerment and follow-up over time. The Canadian Occupational Performance Measure seems to be a valuable instrument for setting goals and thus helps facilitate participation.

  13. Activity and heart rate-based measures for outpatient cardiac rehabilitation.

    PubMed

    Bidargaddi, N P; Sarela, A

    2008-01-01

    Derive activity and heart rate (HR) monitor-based clinically relevant measures for outpatient cardiac rehabilitation (CR). We are currently collecting activity/ECG data from patients undergoing cardiac rehabilitation over duration of six weeks. From these data sets, we a) derive various measures which can be used in assessing home-based CR patients remotely and b) investigate the usefulness of continuous ambulatory HR and heart rate variability (HRV) for various core components of CR. The information provided by these measures is interpreted according to the CR guidelines framework by American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), thus showing how these tools can be used in assessing the progress of patients' condition. The usefulness and significance of these measures from a health care professional perspective is also presented by evaluating them against the existing hospital-based measures through examples. Hospital-based CR programs, despite their clinical benefits are severely under-utilized and resource-demanding. Ambulatory monitoring technologies, which provide a means for continuous physiological monitoring of patients at home compared to hospital-based tools, can enable home-based CR. The clinically relevant measures derived from these tools not only reflect patients' condition in a similar way as conventional tools but also show the continuous status of functional capacity (FC).

  14. 77 FR 33725 - Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

    ... DEPARTMENT OF EDUCATION Applications for New Awards; Disability and Rehabilitation Research.... Overview Information National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Disability and Rehabilitation Research Projects (DRRPs...

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

    PubMed

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

    2012-01-01

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

  16. Expanding the Haitian rehabilitation workforce: employment situation and perceptions of graduates from three rehabilitation technician training programs.

    PubMed

    Descôteaux, Nancy; Chagnon, Valérie; Di Dong, Xin; Ellemo, Eric; Hamelin, Alessandra; Juste, Evans; Laplante, Xavier; Miron, Allison; Morency, Philippe; Samuel, Katherine; Charles, David; Hunt, Matthew

    2018-05-01

    This article examines the employment situation and perceptions of graduates from three rehabilitation technician (RT) programs in Haiti. In this mixed method study, 74 of 93 recent graduates completed a questionnaire, and 20 graduates participated in an in-depth qualitative interview. We analyzed survey results using descriptive statistics. We used a qualitative description approach and analyzed the interviews using constant comparative techniques. Of the 48 survey respondents who had completed their training more than six months prior to completing the questionnaire, 30 had found work in the rehabilitation sector. Most of these technicians were working in hospitals in urban settings and the patient population they treated most frequently were patients with neurological conditions. Through the interviews, we explored the participants' motivations for becoming a RT, reflections on the training program, process of finding work, current employment, and plans for the future. An analysis of qualitative and quantitative findings provides insights regarding challenges, including availability of supervision for graduated RTs and the process of seeking remunerated work. This study highlights the need for stakeholders to further engage with issues related to formal recognition of RT training, expectations for supervision of RTs, concerns for the precariousness of their employment, and uncertainty about their professional futures. Implications for Rehabilitation The availability of human resources in the rehabilitation field in Haiti has increased with the implementation of three RT training programs over the past 10 years. RTs who found work in the rehabilitation sector were more likely to work in a hospital setting, in the province where their training had taken place, to treat a diverse patient clientele, and to be employed by a non-governmental organization. The study underlines challenges related to the long-term sustainability of RT training programs, as well as the

  17. 78 FR 40458 - American Indian Vocational Rehabilitation Services Program; Notice of Tribal Consultation and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... DEPARTMENT OF EDUCATION [Docket ID ED-2013-OSERS-0083] American Indian Vocational Rehabilitation... grant under the American Indian Vocational Rehabilitation Services (AIVRS) program. Assistance to...: (1) The Department is interested in the potential effect of limiting eligibility for AVIRS program...

  18. 78 FR 35758 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... focus its activities on the Federal-State vocational rehabilitation (VR) program and its mission of... focus their research activities on topics related to the Federal-State VR program, they are not required... implementation of the Plan, NIDRR seeks to improve the health and functioning, employment, and community living...

  19. Consumer satisfaction with a rehabilitation mobile outreach program.

    PubMed

    Wilson, K G; Crupi, C D; Greene, G; Gaulin-Jones, B; Dehoux, E; Korol, C T

    1995-10-01

    Accessibility to rehabilitation services is often difficult for people with disabilities who live in rural areas. This study examined consumer satisfaction with a rehabilitation outreach approach that utilizes a mobile clinic to provide consultation services. The descriptive survey took place in fifteen rural communities in eastern and northeastern Ontario, Canada. Valid postconsultation mail surveys were completed by 143 consecutive patients with mixed diagnoses (or proxy family members) who had been seen during mobile clinic visits to their home communities (85.1% of patients approached). There were 59 men and 84 women, with an average age of 58.7 years. The main outcome measure was a consumer satisfaction scale. A high level of global satisfaction was reported, with 97.2% of respondents reporting a preference for community outreach over the alternative of traveling to an urban rehabilitation center. Enhanced accessibility was considered to be the major advantage of the outreach program, but concerns about the continuity of care were also expressed. Providing interdisciplinary rehabilitation consultation services on an outreach basis is associated with a high level of consumer satisfaction. From a consumer perspective, the outreach approach seems to be a viable way of addressing some of the rehabilitation needs of rural people with disabilities.

  20. Report on Federal Activities under the Rehabilitation Act. Annual Report, Fiscal Year 2001

    ERIC Educational Resources Information Center

    US Department of Education, 2005

    2005-01-01

    The Rehabilitation Act of 1973, as amended, provides the legislative basis for programs and activities that assist individuals with disabilities in the pursuit of gainful employment, independence, self-sufficiency and full integration into community life. This report is intended to provide a description of accomplishments and progress made under…

  1. Implicit identification with drug and alcohol use predicts retention in residential rehabilitation programs.

    PubMed

    Wolff, Nathan; von Hippel, Courtney; Brener, Loren; von Hippel, William

    2015-03-01

    Research has identified numerous factors associated with successful treatment in alcohol and drug rehabilitation programs, yet treatment completion rates are often low and subsequent relapse rates very high. We propose that people's implicit identification with drugs and alcohol may be an additional factor that impacts their ability to complete abstinence-based rehabilitation programs. In the current research, we measured implicit identification with drugs and alcohol using the Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998) among 137 members of a residential rehabilitation program for drugs and alcohol (104 men; mean age = 35 years old, 47 of whom were court-ordered to attend). Implicit identification with drugs and alcohol was measured within 1 week of arrival and again 3 weeks later, prior to the onset of the treatment phase of the program. Duration in rehabilitation was assessed 1 year later. Consistent with predictions, implicit identification with drugs and alcohol predicted the duration that people remained in residential rehabilitation even though a self-report measure of identification with drugs and alcohol did not. These results suggest that implicit identification with drugs and alcohol might be an important predictor of treatment outcomes, even among those with serious problems with drug and alcohol use. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  2. 20 CFR 416.1338 - If you are participating in an appropriate program of vocational rehabilitation services...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... carried out under an individualized program or plan; (4) An individualized education program developed... program of vocational rehabilitation services, employment services, or other support services. 416.1338... appropriate program of vocational rehabilitation services, employment services, or other support services. (a...

  3. 20 CFR 404.327 - When you are participating in an appropriate program of vocational rehabilitation services...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... carried out under an individualized program or plan; (4) An individualized education program developed... program of vocational rehabilitation services, employment services, or other support services. 404.327... When you are participating in an appropriate program of vocational rehabilitation services, employment...

  4. The Vale rangeland rehabilitation program: an evaluation.

    Treesearch

    Harold F. Heady

    1988-01-01

    This manuscript discusses the initiation, execution, and outcome of an 11-year (1962-1972) rangeland rehabilitation program in southeastern Oregon. Res. Bull. PNW-RB-070 (1977) is updated with 1986 measurements and evaluations of vegetational conditions, wildlife, recreational use, livestock grazing, and management of public rangelands. The mix of multiple uses has...

  5. Comparison of slow and accelerated rehabilitation protocol after arthroscopic rotator cuff repair: pain and functional activity.

    PubMed

    Düzgün, Irem; Baltacı, Gül; Atay, O Ahmet

    2011-01-01

    In this study, we sought to compare the effects of the slow and accelerated protocols on pain and functional activity level after arthroscopic rotator cuff repair. The study included 29 patients (3 men, 26 women) who underwent arthroscopic repair of stage 2 and 3 rotator cuff tears. Patients were randomized in two groups: the accelerated protocol group (n=13) and slow protocol group (n=16). Patients in the accelerated protocol group participated in a preoperative rehabilitation program for 4-6 weeks. Patients were evaluated preoperatively and for 24 weeks postoperatively. Pain was assessed by visual analog scale, and functional activity level was assessed by The Disabilities of The Arm Shoulder and Hand (DASH) questionnaire. The active range of motion was initiated at week 3 after surgery for the accelerated rehabilitation protocol and at week 6 for the slow protocol. The rehabilitation program was completed by the 8th week with the accelerated protocol and by the 22nd week with the slow protocol. There was no significant difference between the slow and accelerated protocols with regard to pain at rest (p>0.05). However, the accelerated protocol was associated with less pain during activity at weeks 5 and 16, and with less pain at night during week 5 (p<0.05). The accelerated protocol was superior to the slow protocol in terms of functional activity level, as determined by DASH at weeks 8, 12, and 16 after surgery (p<0.05). The accelerated protocol is recommended to physical therapists during rehabilitation after arthroscopic rotator cuff repair to prevent the negative effects of immobilization and to support rapid reintegration to daily living activities.

  6. 78 FR 34962 - American Indian Vocational Rehabilitation Services Program; Proposed Waivers and Extensions of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Vocational Rehabilitation Services (AIVRS) Program in the Rehabilitation Services Administration (RSA): eight... funds under this program. Further, if the proposed waivers and extensions are made final, RSA would not... that RSA has the authority to make an AIVRS grant effective for more than 60 months, pursuant to...

  7. Sit to stand activity during stroke rehabilitation.

    PubMed

    Kerr, Andy; Dawson, Jesse; Robertson, Chris; Rowe, Philip; Quinn, Terence J

    2017-12-01

    Objectives The sit to stand (STS) movement is key to independence and commonly affected by stroke. Repetitive practice is likely to improve STS ability during rehabilitation, however current practice levels are unknown. The objective of this study was simply to count the number of STS movements performed during the rehabilitation period of stroke patients using a physical activity monitor (PAM) and test whether being observed altered outcome. Methods Participants were medically stable patients referred for rehabilitation following stroke. Participants were randomly allocated to either wear or not wear the PAM for 14 days. STS ability and general mobility were recorded before and after. Results Sixty-one patients was recruited; aged 68.4 ± 13.15 years, weight 77.12 ± 22.73 Kg, Height 1.67 ± 0.1 m, within 9 ± 9 days of their stroke and an NIHSS score of 6.4 ± 3.3. The monitored group (n = 38) performed 25.00 ± 17.24 daily STS movements. Those requiring assistance achieved 14.29 ± 16.10 per day while those independent in the movement achieved 34.10 ± 12.44. There was an overall improvement in mobility (p = 0.002) but not STS performance (p = 0.053) neither outcome was affected by group allocation (p = 0.158). Cognition and mobility at baseline explained around 50% of daily STS variability. Discussion Low levels of STS activity were recorded during the rehabilitation period of stroke patient. The mean daily STS activity was lower than reports for frail older people receiving rehabilitation, and substantially below levels recorded by community living older adults. STS repetitions may represent general physical activity and these low levels support previous reports of sedentary behavior during rehabilitation.

  8. Designing a theory- and evidence-based tailored eHealth rehabilitation aftercare program in Germany and the Netherlands: study protocol.

    PubMed

    Reinwand, Dominique; Kuhlmann, Tim; Wienert, Julian; de Vries, Hein; Lippke, Sonia

    2013-11-19

    Cardiac rehabilitation programs aim to improve health status and to decrease the risk of further cardiac events. Persons undergoing rehabilitation often have difficulties transferring the learned health behaviors into their daily routine after returning home and maybe to work. This includes physical activity as well as fruit and vegetable consumption. Computer-based tailored interventions have been shown to be effective in increasing physical activity as well as fruit and vegetable consumption. The aim of this study is, to support people in transferring these two learned behavior changes and their antecedents into their daily life after cardiac rehabilitation. The study will have a randomized controlled design and will be conducted among German and Dutch people who participated in cardiac rehabilitation. The study will consist of one intervention group which will be compared to a waiting list control group. During the eight week duration of the intervention, participants will be invited to participate in the online after-care program once per week. The intervention encourages participants to define individual health behavior goals as well as action, and coping plans to reach these self-determined goals. The effectiveness of the program will be compared between the intervention condition and the control group in terms of behavior change, antecedents of behavior change (e.g., self-efficacy), ability to return to work and increased well-being. Further, subgroup-differences will be assessed including differences between the two countries, socioeconomic inequalities and across age groups. The present study will make a contribution to understanding how such an online-based tailored interventions enables study participants to adopt and maintain a healthy lifestyle. Implications can include how such an online program could enrich cardiac rehabilitation aftercare further. NTR 3706, NCT01909349.

  9. Sex Offender Rehabilitation Programs in State Prisons: A Nationwide Survey.

    ERIC Educational Resources Information Center

    Sapp, Allen D.; Vaughn, Michael S.

    1991-01-01

    Examined programs and strategies for rehabilitation used in adult sex offender treatment programs in state-operated adult correctional institutions. Questionnaires were completed by 73 adult sex offender treatment providers. The results revealed that incarcerated adult sex offenders were receiving comprehensive psychotherapy and behavior…

  10. Development of a home-based training program for post-ward geriatric rehabilitation patients with cognitive impairment: study protocol of a randomized-controlled trail.

    PubMed

    Bongartz, Martin; Kiss, Rainer; Ullrich, Phoebe; Eckert, Tobias; Bauer, Jürgen; Hauer, Klaus

    2017-09-12

    Geriatric patients with cognitive impairment (CI) show an increased risk for a negative rehabilitation outcome and reduced functional recovery following inpatient rehabilitation. Despite this obvious demand, evidence-based training programs at the transition from rehabilitation to the home environments are lacking. The aim of this study is to evaluate the efficacy of a feasible and cost-effective home-based training program to improve motor performance and to promote physical activity, specifically-tailored for post-ward geriatric patients with CI. A sample of 101 geriatric patients with mild to moderate stage CI following ward-based rehabilitation will be recruited for a blinded, randomized controlled trial with two arms. The intervention group will conduct a 12 week home-based training, consisting of (1) Exercises to improve strength/power, and postural control; (2) Individual walking trails to enhance physical activity; (3) Implementation of patient-specific motivational strategies to promote behavioral changes. The control group will conduct 12 weeks of unspecific flexibility exercise. Both groups will complete a baseline measurement before starting the program, at the end of the intervention, and after 24 weeks for follow-up. Sensor-based as well as questionnaire-based measures will be applied to comprehensively assess intervention effects. Primary outcomes document motor performance, assessed by the Short Physical Performance Battery, and level of physical activity (PA), as assessed by duration of active episodes (i.e., sum of standing and walking). Secondary outcomes include various medical, psycho-social, various PA and motor outcomes, including sensor-based assessment as well as cost effectiveness. Our study is among the first to provide home-based training in geriatric patients with CI at the transition from a rehabilitation unit to the home environment. The program offers several unique approaches, e.g., a comprehensive and innovative assessment

  11. Testing a Longitudinal Integrated Self-Efficacy and Self-Determination Theory Model for Physical Activity Post-Cardiac Rehabilitation

    PubMed Central

    Sweet, Shane N.; Fortier, Michelle S.; Strachan, Shaelyn M.; Blanchard, Chris M.; Boulay, Pierre

    2014-01-01

    Self-determination theory and self-efficacy theory are prominent theories in the physical activity literature, and studies have begun integrating their concepts. Sweet, Fortier, Strachan and Blanchard (2012) have integrated these two theories in a cross-sectional study. Therefore, this study sought to test a longitudinal integrated model to predict physical activity at the end of a 4-month cardiac rehabilitation program based on theory, research and Sweet et al.’s cross-sectional model. Participants from two cardiac rehabilitation programs (N=109) answered validated self-report questionnaires at baseline, two and four months. Data were analyzed using Amos to assess the path analysis and model fit. Prior to integration, perceived competence and self-efficacy were combined, and labeled as confidence. After controlling for 2-month physical activity and cardiac rehabilitation site, no motivational variables significantly predicted residual change in 4-month physical activity. Although confidence at two months did not predict residual change in 4-month physical activity, it had a strong positive relationship with 2-month physical activity (β=0.30, P<0.001). The overall model retained good fit indices. In conclusion, results diverged from theoretical predictions of physical activity, but self-determination and self-efficacy theory were still partially supported. Because the model had good fit, this study demonstrated that theoretical integration is feasible. PMID:26973926

  12. Relevance of water gymnastics in rehabilitation programs in patients with chronic heart failure or coronary artery disease with normal left ventricular function.

    PubMed

    Teffaha, Daline; Mourot, Laurent; Vernochet, Philippe; Ounissi, Fawzi; Regnard, Jacques; Monpère, Catherine; Dugué, Benoit

    2011-08-01

    Exercise training is included in cardiac rehabilitation programs to enhance physical capacity and cardiovascular function. Among the existing rehabilitation programs, exercises in water are increasingly prescribed. However, it has been questioned whether exercises in water are safe and relevant in patients with stable chronic heart failure (CHF), coronary artery disease (CAD) with normal systolic left ventricular function. The goal was to assess whether a rehabilitation program, including water-based gymnastic exercises, is safe and induces at least similar benefits as a traditional land-based training. Twenty-four male CAD patients and 24 male CHF patients with stable clinical status participated in a 3-week rehabilitation. They were randomized to either a group performing the training program totally on land (CADl, CHFl; endurance + callisthenic exercises) or partly in water (CADw, CHFw; land endurance + water callisthenic exercises). Before and after rehabilitation, left ventricular systolic and cardiorespiratory functions, hemodynamic variables and autonomic nervous activities were measured. No particular complications were associated with both of our programs. At rest, significant improvements were seen in CHF patients after both types of rehabilitation (increases in stroke volume and left ventricular ejection fraction [LVEF]) as well as a decrease in heart rate (HR) and in diastolic arterial pressure. Significant increases in peaks VO(2), HR, and power output were observed in all patients after rehabilitation in exercise test. The increase in LVEF at rest, in HR and power output at the exercise peak were slightly higher in CHFw than in CHFl. Altogether, both land and water-based programs were well tolerated and triggered improvements in cardiorespiratory function. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. 76 FR 82286 - Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... DEPARTMENT OF EDUCATION Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program--Advanced Rehabilitation Research Training (ARRT) Projects AGENCY: Office of... Research, Department of Education. ACTION: Notice. Overview Information Disability and Rehabilitation...

  14. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial

    PubMed Central

    SILDER, AMY; SHERRY, MARC A.; SANFILIPPO, JENNIFER; TUITE, MICHAEL J.; HETZEL, SCOTT J.; HEIDERSCHEIT, BRYAN C.

    2013-01-01

    STUDY DESIGN Randomized, double-blind, parallel-group clinical trial. OBJECTIVES To assess differences between a progressive agility and trunk stabilization rehabilitation program and a progressive running and eccentric strengthening rehabilitation program in recovery characteristics following an acute hamstring injury, as measured via physical examination and magnetic resonance imaging (MRI). BACKGROUND Determining the type of rehabilitation program that most effectively promotes muscle and functional recovery is essential to minimize reinjury risk and to optimize athlete performance. METHODS Individuals who sustained a recent hamstring strain injury were randomly assigned to 1 of 2 rehabilitation programs: (1) progressive agility and trunk stabilization or (2) progressive running and eccentric strengthening. MRI and physical examinations were conducted before and after completion of rehabilitation. RESULTS Thirty-one subjects were enrolled, 29 began rehabilitation, and 25 completed rehabilitation. There were few differences in clinical or morphological outcome measures between rehabilitation groups across time, and reinjury rates were low for both rehabilitation groups after return to sport (4 of 29 subjects had reinjuries). Greater craniocaudal length of injury, as measured on MRI before the start of rehabilitation, was positively correlated with longer return-to-sport time. At the time of return to sport, although all subjects showed a near-complete resolution of pain and return of muscle strength, no subject showed complete resolution of injury as assessed on MRI. CONCLUSION The 2 rehabilitation programs employed in this study yielded similar results with respect to hamstring muscle recovery and function at the time of return to sport. Evidence of continuing muscular healing is present after completion of rehabilitation, despite the appearance of normal physical strength and function on clinical examination. LEVEL OF EVIDENCE Therapy, level 1b–. J Orthop

  15. Project Rehabilitation: A Program Serving Clients Recovering from Substance Dependency.

    ERIC Educational Resources Information Center

    Weitzman, Kay; Glynn, Lorraine

    1987-01-01

    Describes a cooperative program between Rockland Community College and the Rockland County Community Mental Health Center (New York) that introduced education and retraining into the final stages of the rehabilitation process for individuals with a history of drug and substance abuse. Discusses program components, budgetary considerations, and…

  16. Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year.

    PubMed

    Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

    2017-11-01

    To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872. © 2017 Japan Geriatrics Society.

  17. Update on rehabilitation in multiple sclerosis.

    PubMed

    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.

  18. Rehabilitation After International Space Station Flights

    NASA Technical Reports Server (NTRS)

    Chauvin, S. J.; Shepherd, B. A. S.; Guilliams, M. E.; Taddeo, T.

    2003-01-01

    Rehabilitating U.S. crew members to preflight status following flights on the Russian Mir Space Station required longer than six months for full functional recovery of some of the seven crew members. Additional exercise hardware has been added on the International Space Station as well as a rehabilitative emphasis on functional fitness/agility and proprioception. The authors will describe and present the results of the rehabilitation program for ISS and evaluate rehabilitative needs for longer missions. Pre- and in-flight programs emphasize strength and aerobic conditioning. One year before launch, crew members are assigned an Astronaut Strength and Conditioning specialist. Crew members are scheduled for 2 hours, 3 days a week, for pre-flight training and 2.5 hours, six days a week, for in-flight training. Crewmembers are tested on functional fitness, agility, isokinetic strength, and submaximal cycle ergometer evaluation before and after flight. The information from these tests is used for exercise prescriptions, comparison, and evaluation of the astronaut and training programs. The rehabilitation program lasts for 45 days and is scheduled for 2 hours during each crew workday. Phase 1 of the rehabilitation program starts on landing day and places emphasis on ambulation, flexibility, and muscle strengthening. Phase 2 adds proprioceptive exercise and cardiovascular conditioning. Phase 3 (the longest phase) focuses on functional development. All programs are tailored specifically for each individual according to their test results, preferred recreational activities, and mission roles and duties. Most crew members reached or exceeded their preflight test values 45 days after flight. Some crew members subjectively indicated the need for a longer rehabilitation period. The current rehabilitation program for returning ISS crew members seems adequate in content but may need to be extended for longer expeditions.

  19. "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

    PubMed

    2017-06-01

    Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing

  20. Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

    PubMed Central

    Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

    2012-01-01

    Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

  1. Do Cardiac Rehabilitation Programs Offer Cardiopulmonary Resuscitation Training in Australia and New Zealand?

    PubMed

    Cartledge, Susie H; Bray, Janet E; Stub, Dion; Krum, Henry; Finn, Judith

    2016-06-01

    Cardiac rehabilitation may provide an ideal environment to train high-risk cardiac patients and their families in cardiopulmonary resuscitation (CPR). However, whether this training is currently offered is unknown. The aims of this study were to: 1) describe the prevalence of CPR training in cardiac rehabilitation programs in Australia and New Zealand (NZ); and 2) examine perceived barriers and attitudes of cardiac rehabilitation coordinators towards providing CPR training. We conducted a cross-sectional online survey of Australian and NZ cardiac rehabilitation coordinators. We received 253 completed surveys (46.7% response rate) (Australia n=208, NZ n=45). Cardiopulmonary resuscitation training was included in 23.9% of Australian programs and 56.6% in NZ. Common barriers to CPR training included lack of resources (49.7%) and a lack of awareness to provide CPR training for this high-risk group (33.7%). The majority of coordinators believed that lay people should be trained in CPR (96.3%) and were comfortable with recommending CPR training to this high-risk group (89.4%). While cardiac rehabilitation coordinators have positive attitudes towards CPR training, it is not currently part of most programs - particularly in Australia. Organisations formulating cardiac rehabilitation recommendations and guidelines should give consideration to include the provision of CPR training. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  2. 77 FR 34363 - Disability and Rehabilitation Research Projects and Centers Program; Traumatic Brain Injury Model...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... conducting at least one, but no more than two, site-specific research projects to test innovative approaches... DEPARTMENT OF EDUCATION Disability and Rehabilitation Research Projects and Centers Program...; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation...

  3. A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

    PubMed

    Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

    2016-07-25

    BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (p<0.001), increased ranges of motion and muscle strength, and reduced use of medicines (NASAIDs) (p<0.001). A correlation was found between the degree of degenerative deforming lesions and the effects of the treatment process (p<0.01). CONCLUSIONS 1. The rehabilitation program including water exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

  4. Donkey-assisted rehabilitation program for children: a pilot study.

    PubMed

    De Rose, Paola; Cannas, Elisabetta; Reinger Cantiello, Patrizia

    2011-01-01

    Bonding with animals grants access to the sphere of affectivity and facilitates therapeutic engagement. The methodological approach of donkey-assisted programs is based on mediation, which is characterized by multidirectional relationships (patient-donkey-therapist). The donkey is an excellent facilitator in the motivation-building process, being able to stimulate the child's development by way of active and positive forces that foster psycho-affective and psycho-cognitive development processes. Results of this study, which focused on the child's approach to the donkey, indicate that while communicating with the animal, children rely more on physical expressions than on verbal language. Donkey-assisted rehabilitative sessions can help in identifying children's strong points, on which motivation could be built.

  5. Instilling positive beliefs about disabilities: pilot testing a novel experiential learning activity for rehabilitation students.

    PubMed

    Silverman, Arielle M; Pitonyak, Jennifer S; Nelson, Ian K; Matsuda, Patricia N; Kartin, Deborah; Molton, Ivan R

    2018-05-01

    To develop and test a novel impairment simulation activity to teach beginning rehabilitation students how people adapt to physical impairments. Masters of Occupational Therapy students (n = 14) and Doctor of Physical Therapy students (n = 18) completed the study during the first month of their program. Students were randomized to the experimental or control learning activity. Experimental students learned to perform simple tasks while simulating paraplegia and hemiplegia. Control students viewed videos of others completing tasks with these impairments. Before and after the learning activities, all students estimated average self-perceived health, life satisfaction, and depression ratings among people with paraplegia and hemiplegia. Experimental students increased their estimates of self-perceived health, and decreased their estimates of depression rates, among people with paraplegia and hemiplegia after the learning activity. The control activity had no effect on these estimates. Impairment simulation can be an effective way to teach rehabilitation students about the adaptations that people make to physical impairments. Positive impairment simulations should allow students to experience success in completing activities of daily living with impairments. Impairment simulation is complementary to other pedagogical methods, such as simulated clinical encounters using standardized patients. Implication of Rehabilitation It is important for rehabilitation students to learn how people live well with disabilities. Impairment simulations can improve students' assessments of quality of life with disabilities. To be beneficial, impairment simulations must include guided exposure to effective methods for completing daily tasks with disabilities.

  6. An Annotated Bibliography of Current Literature Dealing with Stroke Education Programs in a Physical Rehabilitation Setting.

    ERIC Educational Resources Information Center

    Donohue, Ann Teresa

    This study makes available to nurses and other rehabilitation team members pertinent information to meet stroke patients' educational needs. The study was conducted to support the theory that those patients and families who actively participate in a stroke education program will more positively cope with the losses resulting from the disability…

  7. National Institute on Disability and Rehabilitation Research Program Directory, 1999.

    ERIC Educational Resources Information Center

    National Inst. on Disability and Rehabilitation Research (ED/OSERS), Washington, DC.

    This directory lists all projects funded by the National Institute of Disability and Rehabilitation Research (NIDRR) during the 1999 fiscal year. It includes summaries, funding data, and contact information for a broad range of programs. Programs are grouped into the following research priorities: (1) employment outcomes; (2) health and function;…

  8. It's About Me: Patients' Experiences of Patient Participation in the Web Behavior Change Program for Activity in Combination With Multimodal Pain Rehabilitation.

    PubMed

    Nordin, Catharina; Michaelson, Peter; Eriksson, Margareta K; Gard, Gunvor

    2017-01-18

    Patients' participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient's active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients' experiences of patient participation in Web-based interventions in clinical practice. The objective of our study was to explore patients' experiences of patient participation in a Web Behavior Change Program for Activity (Web-BCPA) in combination with multimodal rehabilitation (MMR) among patients with persistent pain in primary health care. Qualitative interviews were conducted with 15 women and 4 men, with a mean age of 45 years. Data were analyzed with qualitative content analysis. One theme, "It's about me," and 4 categories, "Take part in a flexible framework of own priority," "Acquire knowledge and insights," "Ways toward change," and "Personal and environmental conditions influencing participation," were developed. Patient participation was depicted as being confirmed in an individualized and structured rehabilitation framework of one's own choice. Being confirmed was fundamental to patient participation in the interaction with the Web-BCPA and with the health care professionals in MMR. To acquire knowledge and insights about pain and their life situation, through self-reflection in the solitary work in the Web-BCPA and through feedback from the health care professionals in MMR, was experienced as patient participation by the participants. Patient participation was described as structured ways to reach their goals of behavior change, which included analyzing resources and restrictions, problem solving, and evaluation. The individual's emotional and

  9. 34 CFR 369.44 - What wage and hour standards apply to community rehabilitation programs?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VOCATIONAL REHABILITATION SERVICE PROJECTS What Conditions Must Be Met by a Grantee? § 369.44 What wage and... hour standards must be observed in projects carried out in community rehabilitation programs...

  10. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury

    PubMed Central

    Kesler, Shelli R.; Lacayo, Norman J.; Jo, Booil

    2011-01-01

    Primary objectives Children with a history of cancer are at increased risk for cognitive impairments, particularly in executive and memory domains. Traditional, in-person cognitive rehabilitation strategies may be unavailable and/or impractical for many of these children given difficulties related to resources and health status. The feasibility and efficacy of implementing a computerized, home-based cognitive rehabilitation curriculum designed to improve executive function skills was examined in these children. Methods A one-arm open trial pilot study of an original executive function cognitive rehabilitation curriculum was conducted with 23 paediatric cancer survivors aged 7–19. Results Compliance with the cognitive rehabilitation program was 83%, similar to that of many traditional programs. Following the cognitive intervention, participants showed significantly increased processing speed, cognitive flexibility, verbal and visual declarative memory scores as well as significantly increased pre-frontal cortex activation compared to baseline. Conclusions These results suggest that a program of computerized cognitive exercises can be successfully implemented at home in young children with cancer. These exercises may be effective for improving executive and memory skills in this group, with concurrent changes in neurobiologic status. PMID:21142826

  11. Making an APPropriate Care Program for Indigenous Cardiac Disease: Customization of an Existing Cardiac Rehabilitation Program.

    PubMed

    Bradford, DanaKai; Hansen, David; Karunanithi, Mohan

    2015-01-01

    Cardiovascular disease is a major health problem for all Australians and is the leading cause of death in Aboriginal and Torres Strait Islanders. In 2010, more then 50% of all heart attack deaths were due to repeated events. Cardiac rehabilitation programs have been proven to be effective in preventing the recurrence of cardiac events and readmission to hospitals. There are however, many barriers to the use of these programs. To address these barriers, CSIRO developed an IT enabled cardiac rehabilitation program delivered by mobile phone through a smartphone app and succesfully trialed it in an urban general population. If these results can be replicated in Indigenous populations, the program has the potential to significantly improve life expectancy and help close the gap in health outcomes. The challenge described in this paper is customizing the existing cardiac health program to make it culturally relevant and suitable for Indigenous Australians living in urban and remote communities.

  12. Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

    PubMed

    2014-08-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

  13. Effects of a renal rehabilitation exercise program in patients with CKD: a randomized, controlled trial.

    PubMed

    Rossi, Ana P; Burris, Debra D; Lucas, F Leslie; Crocker, Gail A; Wasserman, James C

    2014-12-05

    Patients with CKD have a high prevalence of cardiovascular disease associated with or exacerbated by inactivity. This randomized, controlled study investigated whether a renal rehabilitation exercise program for patients with stages 3 or 4 CKD would improve their physical function and quality of life. In total, 119 adults with CKD stages 3 and 4 were randomized, and 107 of these patients proceeded to usual care or the renal rehabilitation exercise intervention consisting of usual care plus guided exercise two times per week for 12 weeks (24 sessions). Physical function was determined by three well established performance-based tests: 6-minute walk test, sit-to-stand test, and gait-speed test. Health-related quality of life was assessed by the RAND 36-Item Short Form Health Survey. At baseline, no differences in self-reported level of activity, 6-minute walk test, and sit-to-stand test scores were observed between the usual care (n=48) and renal rehabilitation exercise (n=59) groups, although baseline gait-speed test score was higher in the renal rehabilitation exercise group (P<0.001). At follow-up, the renal rehabilitation exercise group but not the usual care group showed significant improvements in the 6-minute walk test (+210.4±266.0 ft [19% improvement] versus -10±219.9 ft; P<0.001), the sit-to-stand test (+26.9±27% of age prediction [29% improvement] versus +0.7±12.1% of age prediction; P<0.001), and the RAND-36 physical measures of role functioning (P<0.01), physical functioning (P<0.01), energy/fatigue levels (P=0.01), and general health (P=0.03) and mental measure of pain scale (P=0.04). The renal rehabilitation exercise regimen was generally well tolerated. A 12-week/24-session renal rehabilitation exercise program improved physical capacity and quality of life in patients with CKD stages 3 and 4. Longer follow-up is needed to determine if these findings will translate into decreased mortality rates. Copyright © 2014 by the American Society of

  14. Effects of vitamin D receptor gene polymorphisms on low-resistance training using exercise machines: the 'Power Rehabilitation' program.

    PubMed

    Murakami, Shin-Ichiro; Otsuki, Takemi; Maeda, Megumi; Miura, Yoshie; Morii, Seiko; Kiyokane, Kenji; Hayakawa, Shin-Ichi; Maeda, Atsushi; Imakawa, Takayo; Harada, Shunpei; Handa, Torataro; Nishimura, Yasumitsu; Murakami, Shuko; Kumagai, Naoko; Hayashi, Hiroaki; Chen, Ying; Suemori, Shin-Ichiro; Fukushima, Yumiko; Nishida, Seikoh; Fukushima, Keisuke

    2009-01-01

    The enhancement and promotion of health is necessary to maintain the quality of life (QOL) of the aged population in developed nations such as Japan where the number of elderly has been increasing rapidly. For this purpose, low-resistance training using exercise machines ('Power Rehabilitation') has been established as a rehabilitation program. To investigate the individual factors which influence the effects of 'Power Rehabilitation', single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene and the ciliary neurotrophic factor (CNTF) gene were analyzed, and the relationship between SNP patterns and the effects of 'Power Rehabilitation' was evaluated. 'Power Rehabilitation' had an effect on the physiological functions involved in the activities of daily life (ADL) rather than muscle strength and size. In addition, certain SNP patterns showed better improvement of parameters associated with the effects of 'Power Rehabilitation' as analyzed by comparison between SNP patterns and factor analysis. Large scale analyses are required to ensure this tendency and to discover individual factors which may help to promote the health and QOL of the aged population.

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

    PubMed

    Krauth, Christian; Bartling, Tim

    2017-04-01

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

  16. A prospective evaluation of an interdisciplinary nutrition–rehabilitation program for patients with advanced cancer

    PubMed Central

    Gagnon, B.; Murphy, J.; Eades, M.; Lemoignan, J.; Jelowicki, M.; Carney, S.; Amdouni, S.; Di Dio, P.; Chasen, M.; MacDonald, N.

    2013-01-01

    Background Cancer can affect many dimensions of a patient’s life, and in turn, it should be targeted using a multimodal approach. We tested the extent to which an interdisciplinary nutrition–rehabilitation program can improve the well-being of patients with advanced cancer. Methods Between January 10, 2007, and September 29, 2010, 188 patients with advanced cancer enrolled in the 10–12-week program. Body weight, physical function, symptom severity, fatigue dimensions, distress level, coping ability, and overall quality of life were assessed at the start and end of the program. Results Of the enrolled patients, 70% completed the program. Patients experienced strong improvements in the physical and activity dimensions of fatigue (effect sizes: 0.8–1.1). They also experienced moderate reductions in the severity of weakness, depression, nervousness, shortness of breath, and distress (effect sizes: 0.5–0.7), and moderate improvements in Six Minute Walk Test distance, maximal gait speed, coping ability, and quality of life (effect sizes: 0.5–0.7) Furthermore, 77% of patients either maintained or increased their body weight. Conclusions Interdisciplinary nutrition–rehabilitation can be advantageous for patients with advanced cancer and should be considered an integrated part of standard palliative care. PMID:24311946

  17. 34 CFR 350.22 - What activities must a Rehabilitation Research and Training Center conduct?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... individuals with disabilities, through conferences, workshops, public education programs, in-service training... Training Center conduct? 350.22 Section 350.22 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Research and Training...

  18. 34 CFR 350.22 - What activities must a Rehabilitation Research and Training Center conduct?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... individuals with disabilities, through conferences, workshops, public education programs, in-service training... Training Center conduct? 350.22 Section 350.22 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Research and Training...

  19. 34 CFR 350.22 - What activities must a Rehabilitation Research and Training Center conduct?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... individuals with disabilities, through conferences, workshops, public education programs, in-service training... Training Center conduct? 350.22 Section 350.22 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Research and Training...

  20. 34 CFR 350.22 - What activities must a Rehabilitation Research and Training Center conduct?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... individuals with disabilities, through conferences, workshops, public education programs, in-service training... Training Center conduct? 350.22 Section 350.22 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Research and Training...

  1. Extending the Use of Spanish Computer-Assisted Anomia Rehabilitation Program (CARP-2) in People with Aphasia

    ERIC Educational Resources Information Center

    Adrian, Jose A.; Gonzalez, Mercedes; Buiza, Juan J.; Sage, Karen

    2011-01-01

    Purpose: To extend the use of the Spanish Computer-assisted Anomia Rehabilitation Program (CARP-2) for anomia from a single case to a group of 15 people with aphasia. To evaluate whether the treatment is active (Phase 1) for this group (Robey & Schultz, 1998), providing potential explanations as to why. Methods: Fifteen participants with chronic…

  2. Change in explicit and implicit motivation toward physical activity and sedentary behavior in pulmonary rehabilitation and associations with postrehabilitation behaviors.

    PubMed

    Chevance, Guillaume; Héraud, Nelly; Varray, Alain; Boiché, Julie

    2017-05-01

    The aim of this study was twofold: (a) to determine whether Theory of Planned Behavior (TPB) variables and implicit attitudes toward physical activity and sedentary behavior would change during a 5-week pulmonary rehabilitation (PR) program, and (b) to investigate the relationships between behavioral intentions, implicit attitudes, physical activity, and sedentary behavior in postrehabilitation. Out of 142 patients with respiratory disease included in this study, 119 completed 2 questionnaires measuring TPB variables with regard to physical activity and sedentary behavior, and an Implicit Association Test (IAT) measuring implicit attitudes toward physical activity in contrast to sedentary behavior. The TPB questionnaires and the IAT were administered at the beginning (Time 1) and the end of the program (Time 2). Six months after the program (Time 3), 62 patients provided self-reported measures of their recreational physical activity and screen-based, leisure-time sedentary behavior. Over the course of pulmonary rehabilitation, perceived behavioral control and intentions toward physical activity increased, as did social norms and perceived behavioral control toward sedentary behavior; implicit attitudes were also more positive toward physical activity. Implicit attitudes at the end of PR (Time 2) were significantly associated with postrehabilitation physical activity (Time 3). TPB variables toward physical activity and sedentary behavior as well as implicit attitudes were enhanced during PR. At 6 months, implicit attitudes were significantly associated with physical activity. These results suggest that motivation, particularly implicit attitudes, should be targeted in future behavioral interventions in order to optimize the effects of rehabilitation on physical activity maintenance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation: Randomized Controlled Trial

    PubMed Central

    Michaelson, Peter; Gard, Gunvor; Eriksson, Margareta K

    2016-01-01

    Background Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR). Objective The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated. Methods A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items. Results Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample

  4. Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation: Randomized Controlled Trial.

    PubMed

    Nordin, Catharina A; Michaelson, Peter; Gard, Gunvor; Eriksson, Margareta K

    2016-10-05

    Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR). The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated. A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items. Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample size of 99. The MMR+WEB intervention

  5. Musculoskeletal education in physical medicine and rehabilitation residency programs.

    PubMed

    Smith, Jay; Krabak, Brian J; Malanga, Gerard A; Moutvic, Margaret A

    2004-10-01

    To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

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

    PubMed

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

    2014-02-01

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

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

    PubMed Central

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

    2014-01-01

    The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment. PMID:24678503

  8. The Chicano Addict: An Analysis of Factors Influencing Rehabilitation in a Treatment and Prevention Program.

    ERIC Educational Resources Information Center

    Aumann, Jon; And Others

    Exploring a Phoenix, Arizona, drug rehabilitation program oriented toward the Chicano addict was the purpose of this study. The study related to 3 major variables influencing the rehabilitation process: (1) characteristics of the Chicano addict, (2) characteristic life style patterns considered in the rehabilitation process, and (3) the extent to…

  9. 76 FR 38134 - Final Priorities; Disability and Rehabilitation Research Projects and Centers Program-Disability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ...-identified research designs to generate reliable and valid findings. Changes: None. Final Priorities Priority... DEPARTMENT OF EDUCATION Final Priorities; Disability and Rehabilitation Research Projects and Centers Program--Disability Rehabilitation Research Projects, etc. AGENCY: Office of Special Education and...

  10. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... vocational rehabilitation unit personnel in program areas essential to the effective management of the unit's... rehabilitation professionals; (b) To provide for succession planning; (c) To provide for leadership development...

  11. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  12. Annual Report of the Rehabilitation Services Administration to the President and the Congress on Federal Activities Related to the Administration of the Rehabilitation Act of 1973, as Amended. Fiscal Year 1980.

    ERIC Educational Resources Information Center

    Office of Special Education and Rehabilitative Services (ED), Washington, DC.

    This annual report of the Rehabilitation Services Administration for Fiscal 1980 consists of five sections. The first section, devoted to program operations, includes information on the basic vocational rehabilitation program, services to the blind, rehabilitation facilities, and three specific programs. Described in section 2 are such program…

  13. It’s About Me: Patients’ Experiences of Patient Participation in the Web Behavior Change Program for Activity in Combination With Multimodal Pain Rehabilitation

    PubMed Central

    Michaelson, Peter; Eriksson, Margareta K; Gard, Gunvor

    2017-01-01

    Background Patients’ participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient’s active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients’ experiences of patient participation in Web-based interventions in clinical practice. Objective The objective of our study was to explore patients’ experiences of patient participation in a Web Behavior Change Program for Activity (Web-BCPA) in combination with multimodal rehabilitation (MMR) among patients with persistent pain in primary health care. Methods Qualitative interviews were conducted with 15 women and 4 men, with a mean age of 45 years. Data were analyzed with qualitative content analysis. Results One theme, “It’s about me,” and 4 categories, “Take part in a flexible framework of own priority,” “Acquire knowledge and insights,” “Ways toward change,” and “Personal and environmental conditions influencing participation,” were developed. Patient participation was depicted as being confirmed in an individualized and structured rehabilitation framework of one’s own choice. Being confirmed was fundamental to patient participation in the interaction with the Web-BCPA and with the health care professionals in MMR. To acquire knowledge and insights about pain and their life situation, through self-reflection in the solitary work in the Web-BCPA and through feedback from the health care professionals in MMR, was experienced as patient participation by the participants. Patient participation was described as structured ways to reach their goals of behavior change, which included analyzing resources and restrictions

  14. Effect of individualized physical rehabilitation programs on respiratory function in women with post-mastectomy syndrome.

    PubMed

    Odinets, Tatiana; Briskin, Yuriy; Pityn, Maryan

    2018-02-26

    The purpose of this study was to determine the effectiveness of an individualized physical rehabilitation programs aimed at improving respiratory function in women with post-mastectomy syndrome. In a randomized controlled trial 50 women with post-mastectomy syndrome were enrolled in the experimental group (EG, n = 25) or the comparison group (CG, n = 25). The program for the EG included: aqua aerobics (i.e. aqua jogging, aqua building, and aqua stretching); conditional swimming; and recreational aerobics. The program for the CG included: conditional swimming and Pilates exercises. Both intervention groups attended individualized physical rehabilitation programs three times per week for 48 weeks. The primary outcome measure was spirometry of the patients measured before, 6 and 12 months after the intervention. This study demonstrated that most of the respiratory function parameters increased significantly in both groups over the year of exercise training. After the year of training the individualized physical rehabilitation program for the EG was significantly better (p < 0.01) as compared with the CG, except for inspiratory reserve volume and maximal voluntary ventilation, which were not statistically different. The results of the study suggest that individual programs of physical rehabilitation could be considered effective for the improvement of respiratory function of the patients with post-mastectomy syndrome. The results obtained could serve as a basis for more widespread clinical program development.

  15. PARTIAL ARTICULAR SUPRASPINATUS TENDON AVULSION (PASTA) LESION. CURRENT CONCEPTS IN REHABILITATION

    PubMed Central

    2016-01-01

    ABSTRACT Rotator cuff pathology can contribute to shoulder pain and may affect the performance of sport activities, work, and activities of daily living. The partial articular supraspinatus tendon avulsion (PASTA) lesion represents a very common type of rotator cuff pathology seen in rehabilitation. When conservative treatment fails, surgery is generally required. Success of recovery depends on several factors, including: repair techniques, healing process related to timing, rehabilitation programs, and patient compliance with home exercises. To date, most treatment modalities and rehabilitation programs are based on clinical experience rather than scientific evidence. Therefore, the purpose of this clinical commentary is to provide an overview on the PASTA lesion, discuss the common treatment approaches adopted to date and to propose a rehabilitation program based on the available scientific evidence. Level of Evidence 5 PMID:27274431

  16. Rehabilitation of Ankle and Foot Injuries in Athletes

    PubMed Central

    Chinn, Lisa; Hertel, Jay

    2009-01-01

    Foot and ankle injuries are extremely common among athletes and other physically active individuals. Rehabilitation programs that emphasize the use of therapeutic exercise to restore joint range of motion, muscle strength, neuromuscular coordination, and gait mechanics have been shown to have clinical success for patients suffering various foot and ankle pathologies. Rehabilitation programs are discussed for ankle sprains, plantar fasciitis, Achilles tendonitis, and turf toe. PMID:19945591

  17. A Sit-to-Stand Training Robot and Its Performance Evaluation: Dynamic Analysis in Lower Limb Rehabilitation Activities

    NASA Astrophysics Data System (ADS)

    Cao, Enguo; Inoue, Yoshio; Liu, Tao; Shibata, Kyoko

    In many countries in which the phenomenon of population aging is being experienced, motor function recovery activities have aroused much interest. In this paper, a sit-to-stand rehabilitation robot utilizing a double-rope system was developed, and the performance of the robot was evaluated by analyzing the dynamic parameters of human lower limbs. For the robot control program, an impedance control method with a training game was developed to increase the effectiveness and frequency of rehabilitation activities, and a calculation method was developed for evaluating the joint moments of hip, knee, and ankle. Test experiments were designed, and four subjects were requested to stand up from a chair with assistance from the rehabilitation robot. In the experiments, body segment rotational angles, trunk movement trajectories, rope tensile forces, ground reaction forces (GRF) and centers of pressure (COP) were measured by sensors, and the moments of ankle, knee and hip joint were real-time calculated using the sensor-measured data. The experiment results showed that the sit-to-stand rehabilitation robot with impedance control method could maintain the comfortable training postures of users, decrease the moments of limb joints, and enhance training effectiveness. Furthermore, the game control method could encourage collaboration between the brain and limbs, and allow for an increase in the frequency and intensity of rehabilitation activities.

  18. Recruiting for Rehabilitation Counselor Education Programs: Twenty Years Later

    ERIC Educational Resources Information Center

    Paul, Heidi; Brodwin, Martin G.

    2017-01-01

    Purpose: To examine changes in recruitment procedures over the past 20 years and the effect of these changes on the number of students entering rehabilitation programs at California State University, Los Angeles (CSULA). Method: The authors reviewed recruitment practices at CSULA and student enrollment of graduates and undergraduates in…

  19. Effect of Custom Orthosis and Rehabilitation Program on Outcomes Following Ankle and Subtalar Fusions.

    PubMed

    Sheean, Andrew J; Tennent, David J; Owens, Johnny G; Wilken, Jason M; Hsu, Joseph R; Stinner, Daniel J

    2016-11-01

    Fractures of the distal tibia, ankle, and foot sustained through a high-energy mechanism can be extremely debilitating, and ankle and/or subtalar fusion may be indicated if the limb is deemed salvageable. Functional outcomes among this population are often poor. The purposes of this study were to evaluate the effect of an advanced rehabilitation program combined with the use of a custom ankle-foot orthosis for patients with ankle or subtalar fusion on selected physical performance measures and patient-derived outcome measures and to determine if the response to treatment was predicated upon the type of fusion. We conducted a prospective, longitudinal, observational, cohort study composed of 23 active duty Service Members treated for lower extremity trauma. Patients were separated into 2 groups: group 1 was composed of 12 patients who underwent isolated ankle fusion or ankle fusion combined with ipsilateral subtalar fusion, group 2 was composed of 11 patients who underwent subtalar fusion only. Patient-reported outcome (PRO) measures and physical performance measures were recorded at baseline and at the conclusion of the rehabilitation program. Significant improvements in both groups were seen in each of the 4 physical performance measures. Only group 2 showed significant improvements in all domains of the Veteran's Rand 12-Item Health Survey (VR-12) and Short Musculoskeletal Function Assessment (SMFA) at all points during the course of rehabilitation. Among a subset of patients treated for severe lower extremity trauma with ankle and/or subtalar fusion, an integrated orthotic and rehabilitation initiative improved physical performance and PRO measures over an 8-week course. Level III, prospective comparative series. © The Author(s) 2016.

  20. Vocational Rehabilitation in Spinal Cord Injury: What Vocational Service Activities Are Associated with Employment Program Outcome?

    PubMed Central

    Barnett, Scott D.; Goetz, Lance L.; Toscano, Richard

    2015-01-01

    Background: Designing effective vocational programs for persons with spinal cord injury (SCI) is essential for improving return to work outcome following injury. The relationship between specific vocational services and positive employment outcome has not been empirically studied. Objective: To examine the association of specific vocational service activities as predictors of employment. Method: Secondary analysis of a randomized, controlled trial of evidence-based supported employment (EBSE) with 12-month follow-up data among 81 Veteran participants with SCI. Results: Primary activities recorded were vocational counseling (23.9%) and vocational case management (23.8%). As expected, job development and employment supports were the most time-consuming activities per appointment. Though the amount of time spent in weekly appointments did not differ by employment outcome, participants obtaining competitive employment averaged significantly more individual activities per appointment. Further, for these participants, job development or placement and employment follow-along or supports were more likely to occur and vocational counseling was less likely to occur. Community-based employment services, including job development or placement and employment follow-along or supports as part of a supported employment model, were associated with competitive employment outcomes. Office-based vocational counseling services, which are common to general models of vocational rehabilitation, were associated with a lack of employment. Conclusions: Vocational services that actively engage Veterans with SCI in job seeking and acquisition and that provide on-the-job support are more likely to lead to employment than general vocational counseling that involves only job preparation. PMID:25762858

  1. 77 FR 27035 - Rehabilitation Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ... Rehabilitation (VR) and Developing Strategies To Meet Employer Needs in Changing Economic Environments AGENCY...--Rehabilitation Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and Developing Strategies... Background The Rehabilitation Act authorizes the establishment of the State VR Services Program (VR Program...

  2. Program level evaluation of ASAP diagnosis, referral and rehabilitation efforts. Volume 3, Analysis of ASAP rehabilitation countermeasures effectiveness

    DOT National Transportation Integrated Search

    1976-09-01

    The present report describes the client flow through rehabilitation systems of the 35 NHTSA funded Alcohol Safety Action Projects (ASAPs) during the 1972-1974 period of project operations, summarizes project initiated analyses of treatment program ef...

  3. The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care.

    PubMed

    Hoekstra, Femke; Hettinga, Florentina J; Alingh, Rolinde A; Duijf, Marjo; Dekker, Rienk; van der Woude, Lucas H V; van der Schans, Cees P

    2017-01-01

    To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. The current implementation status of a sports and physical activity stimulation programme in 12 rehabilitation centres and 5 hospitals with a rehabilitation department was described by scoring fidelity and satisfaction. Seventy-one rehabilitation professionals filled out a questionnaire on how sports and physical activity, including stimulation activities, were implemented into rehabilitation care. Total fidelity scores (in %) were calculated for each organization. Professionals' satisfaction was rated on a scale from 1 to 10. In most organizations sports and physical activity were to some extent integrated during and after rehabilitation (fidelity scores: median = 54%, IQR = 23%). Physical activity stimulation was not always embedded as standard component of a rehabilitation treatment. Professionals' satisfaction rated a median value of 8.0 (IQR = 0.0) indicating high satisfaction rates. The fidelity outcome showed that activities to stimulate sports and physical activity during and after rehabilitation were integrated into rehabilitation care, but not always delivered as standardized component. These findings have emphasized the importance to focus on integrating these activities into routines of organizations. Implications for Rehabilitation Components of an evidence-based programme to stimulate sports and physical activity during and after rehabilitation can be used to measure the current status of the integration of sports and physical activity in rehabilitation care in a structural and effective way. The method described in the current study can be used to compare the content of the rehabilitation care regarding the integration of sports and physical activity among organizations both on a national and international level

  4. 42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the services on its premises. (2) Exceptions. Physical therapy, occupational therapy, and speech... rehabilitation program that includes, at a minimum, physicians' services, physical therapy services, and social... patient and the physical therapist, occupational therapist, or speech-language pathologist, as appropriate...

  5. 42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... rehabilitation program that includes, at a minimum, physicians' services, physical therapy services, and social or psychological services. These services must be furnished by personnel that meet the qualifications... the services on its premises. (2) Exceptions. Physical therapy, occupational therapy, and speech...

  6. Towards the integration of mental practice in rehabilitation programs. A critical review

    PubMed Central

    Malouin, Francine; Jackson, Philip L.; Richards, Carol L.

    2013-01-01

    Many clinical studies have investigated the use of mental practice (MP) through motor imagery (MI) to enhance functional recovery of patients with diverse physical disabilities. Although beneficial effects have been generally reported for training motor functions in persons with chronic stroke (e.g., reaching, writing, walking), attempts to integrate MP within rehabilitation programs have been met with mitigated results. These findings have stirred further questioning about the value of MP in neurological rehabilitation. In fact, despite abundant systematic reviews, which customarily focused on the methodological merits of selected studies, several questions about factors underlying observed effects remain to be addressed. This review discusses these issues in an attempt to identify factors likely to hamper the integration of MP within rehabilitation programs. First, the rationale underlying the use of MP for training motor function is briefly reviewed. Second, three modes of MI delivery are proposed based on the analysis of the research protocols from 27 studies in persons with stroke and Parkinson's disease. Third, for each mode of MI delivery, a general description of MI training is provided. Fourth, the review discusses factors influencing MI training outcomes such as: the adherence to MI training, the amount of training and the interaction between physical and mental rehearsal; the use of relaxation, the selection of reliable, valid and sensitive outcome measures, the heterogeneity of the patient groups, the selection of patients and the mental rehearsal procedures. To conclude, the review proposes a framework for integrating MP in rehabilitation programs and suggests research targets for steering the implementation of MP in the early stages of the rehabilitation process. The challenge has now shifted towards the demonstration that MI training can enhance the effects of regular therapy in persons with subacute stroke during the period of spontaneous recovery

  7. A Low Vision Rehabilitation Program for Patients with Mild Cognitive Deficits

    PubMed Central

    Whitson, Heather E.; Whitaker, Diane; Potter, Guy; McConnell, Eleanor; Tripp, Fay; Sanders, Linda L.; Muir, Kelly W.; Cohen, Harvey J.; Cousins, Scott W.

    2012-01-01

    Objective To design and pilot test a low vision rehabilitation program for patients with macular disease and cognitive deficits. Methods The Memory or Reasoning Enhanced Low Vision Rehabilitation (MORE-LVR) program was created by a team representing optometry, occupational therapy, ophthalmology, neuropsychology, and geriatrics. Key components of MORE-LVR are: 1) repetitive training with a therapist twice weekly over a 6-week period, 2) simplified training experience addressing no more than three individualized goals in a minimally distracting environment, 3) involvement of an informal companion (friend or family member). Eligible patients were recruited from an LVR clinic; measures were compared before and after the 6 week program. Results Twelve non-demented patients (mean age 84.5 years, 75% female) who screened positive for cognitive deficits completed the MORE-LVR intervention. Participants demonstrated improved scores on the National Eye Institute’s Visual Function Questionnaire (VFQ-25) composite score (47.2±16.3 to 54.8±13.8, p=0.01) and near activities score (21.5±14.0 to 41.0±23.1, p=0.02), timed performance measures (writing a grocery list [p=0.03], filling in a crossword puzzle answer [p=0.003]), a score indicating satisfaction with independence (p=0.05), and logical memory (p=0.02). All patients and companions reported progress toward at least one individualized goal; >70% reported progress toward all three goals. Conclusions This pilot study demonstrates feasibility of an LVR program for macular disease patients with mild cognitive deficits. Participants demonstrated improvements in vision-related function and cognitive measures and expressed high satisfaction. Future work is needed to determine if MORE-LVR is superior to usual outpatient LVR for persons with co-existing visual and cognitive impairments. PMID:23619914

  8. Study of High Sensitive C-Reactive Protein (HS-CRP) After Cardiac Rehabilitation Program in Patients Undergoing Isolated CABG.

    PubMed

    Johari Moghadam, Adel; Azizinejad, Saied

    2016-12-01

    Although cardiac rehabilitation is known as a tool to reduce the overall risk of cardiovascular complications, its specific role in the reduction of hs-CRP as a marker of inflammation and a proven marker of cardiovascular risk needs further investigation. The present study aims at elucidating the effects of a full course of conventional cardiac rehabilitation program for the period of eight weeks, on the levels of hs-CRP in patients who underwent isolated coronary artery bypass surgery. In this case study, 30 consecutive patients who underwent isolated coronary artery bypass surgery (isolated CABGS), and a full 8-week cardiac rehabilitation program in Tehran Heart Center, were investigated. A group of 30 similar patients, who enrolled in the same period of rehabilitation program but did not participate in practice, was considered as a control group. Serum levels of hs-CRP in both groups were measured retrospectively and in similar days before the start of rehabilitation program and at the end of it (or 8 weeks after initial registration for the control group). Levels of hs-CRP in the rehabilitation group and control group were 5.9 7.7 and 6.3 6.9 respectively before start of the program which was not statistically meaningful ( P -Value = 0.833). However, after the program, level of hs-CRP in the two tested groups changed to 2.3 5.1 and 5.7 6.1 respectively which showed a meaningful correlation ( P -Value = 0.023). These results also showed that decrease in hs-CRP level in the rehabilitated group but not in the control group was statistically meaningful (with P -Value of 0.037 and 0.0723 respectively). In patients undergoing coronary bypass surgery, participating in a full course of cardiac rehabilitation for 8 weeks has resulted in a significant reduction in hs-CRP levels as a marker of cardiovascular risk.

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

    PubMed

    2014-06-05

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Enhance Independence in Daily Living for Adults with Cognitive Impairments. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improved outcomes related to independence in daily activities in the home, community, or workplace setting for adults with cognitive impairments.

  10. The Vale rangeland rehabilitation program: the desert repaired in southeastern Oregon.

    Treesearch

    Harold F. Heady; James Bartolome

    1977-01-01

    Discusses the initiation, execution, and outcome of an 11-year program of range rehabilitation on public domain lands in southeastern Oregon. Initiated primarily to benefit the livestock industry, the investment of $10 million in range improvements also profoundly affected other multiple uses. The analysis of this large and successful program should serve as a useful...

  11. A neuropsychological rehabilitation program for patients with Multiple Sclerosis based on the model of the ICF.

    PubMed

    Pusswald, Gisela; Mildner, Christa; Zebenholzer, Karin; Auff, Eduard; Lehrner, Johann

    2014-01-01

    Forty to sixty percent of MS patients suffer from cognitive impairments. Cognitive deficits are a great burden for patients affected. In particular they may lead to a reduced quality of life, loss of work and problems with the social environment. The aim of this study was to evaluate a specific neuropsychological rehabilitation program for MS patients according to the ICF to be able to meet more properly individual requirements on the therapy level of function as well as of activities and participation. Forty patients with MS were randomised in an intervention (IG) - and a control group (CG). The outcome measure of the IG, who started an intensive computer based home training of attention and attended psychological counselling was compared to the untrained CG. In specific domains of attention (simple and cued alertness and divided attention) significant group differences between CG and IG could be found. The IG reported an improvement of mental fatigue and retardation. These findings support the idea that a neuropsychological rehabilitation program, which based on the model of ICF, could improve cognitive impairment and could also have a positive influence of activities and participation.

  12. 42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Comprehensive rehabilitation program. 485.58 Section 485.58 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION...

  13. Rehabilitation of arm function after stroke. Literature review.

    PubMed

    Oujamaa, L; Relave, I; Froger, J; Mottet, D; Pelissier, J-Y

    2009-04-01

    In the recent literature we can find many articles dealing with upper extremity rehabilitation in stroke patients. New techniques, still under evaluation, are becoming the practical applications for the concept of post-stroke brain plasticity. This literature review focuses on controlled randomized studies, reviews and meta-analyses published in the English language from 2004 to 2008. The research was conducted in MEDLINE with the following keywords: "upper limb", "stroke", "rehabilitation". We reviewed 66 studies. The main therapeutic strategies are: activation of the ipsilesional motor cortex, inhibition of the contralesional motor cortex and modulation of the sensory afferents. Keeping a cortical representation of the upper limb distal extremity could prevent the learned non-use phenomenon. The modulation of sensory afferents is then proposed: distal cutaneous electrostimulation, anesthesia of the healthy limb, mirror therapy, virtual reality. Intensifying the rehabilitation care means increasing the total hours of rehabilitation dedicated to the paretic limb (proprioceptive stimulation and repetitive movements). This specific rehabilitation is facilitated by robot-aided therapy in the active-assisted mode, neuromuscular electrostimulation and bilateral task training. Intensifying the rehabilitation training program significantly improves the arm function outcome when performed during subacute stroke rehabilitation (< six months). Ipsilesional neurostimulation as well as mental practice optimize the effect of repetitive gestures for slight motor impairments. Contralesional neurostimulation or anesthesia of the healthy hand both improve the paretic hand's dexterity via a decrease of the transcallosal inhibition. This pathophysiological mechanism could also explain the positive impact of constraint-induced movement therapy (CI therapy) in an environmental setting for chronic stroke patients. To ensure a positive functional outcome, stroke rehabilitation programs

  14. Uptake of a technology-assisted home-care cardiac rehabilitation program.

    PubMed

    Varnfield, Marlien; Karunanithi, Mohanraj K; Särelä, Antti; Garcia, Elsa; Fairfull, Anita; Oldenburg, Brian F; Walters, Darren L

    2011-02-21

    The prevalence of cardiovascular disease, a major cause of disease burden in Australia and other developed countries, is increasing due to a rapidly ageing population and environmental, biomedical and modifiable lifestyle factors. Although cardiac rehabilitation (CR) programs have been shown to be beneficial and effective, rates of referral, uptake and utilisation of traditional hospital or community centre programs are poor. Home-based CR programs have been shown to be as effective as centre-based programs, and recent advances in information and communication technologies (ICT) can be used to enhance the delivery of such programs. The Care Assessment Platform (CAP) is an integrated home-based CR model incorporating ICT (including a mobile phone and the internet) and providing all the core components of traditional CR (education, physical activity, exercise training, behaviour modification strategies and psychological counselling). The mobile phone given to patients has an integrated accelerometer and diary application for recording exercise and health information. A central database, with access to these data, allows mentors to assess patients' progress, assist in setting goals, revise targets and give weekly personal feedback. Mentors find the mobile-phone modalities practical and easy to use, and preliminary results show high usage rates and acceptance of ICT by participants. The provision of ICT-supported home-based CR programs may enable more patients in both metropolitan and remote settings to benefit from CR.

  15. Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

    PubMed

    Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

    2015-01-01

    Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

  16. 34 CFR 359.11 - What activities must each recipient carry out under this program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What activities must each recipient carry out under this program? 359.11 Section 359.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION DISABILITY AND REHABILITATION RESEARCH: SPECIAL PROJECT...

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

    PubMed

    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.

  18. [The Effect of a Movie-Based Nursing Intervention Program on Rehabilitation Motivation and Depression in Stroke Patients].

    PubMed

    Kwon, Hye Kyung; Lee, Sook Ja

    2017-06-01

    The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The moviebased nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process. © 2017 Korean Society of Nursing Science

  19. Rehabilitation Education Program for Stroke (REPS): Learning and Practice Outcomes

    ERIC Educational Resources Information Center

    McEwen, Sara; Szurek, Kristina; Polatajko, Helene J.; Rappolt, Susan

    2005-01-01

    Introduction: New research knowledge acquired from Web-based sources may have a better chance of being translated into practice when accompanied by additional educational strategies. This study was undertaken to investigate that hypothesis. Methods: The Rehabilitation Education Program for Stroke (REPS) combines a self-directed online learning…

  20. The rehabilitation plan can support clients' active engagement and facilitate the process of change - experiences from people with late effects of polio participating in a rehabilitation programme.

    PubMed

    Lexell, Eva Månsson; Lexell, Jan; Larsson-Lund, Maria

    2016-01-01

    To explore how the rehabilitation plan influences the rehabilitation process and its outcome in people with late effects of polio participating in an individualised goal-oriented interdisciplinary rehabilitation programme. Four women and two men with late effects of polio were interviewed before rehabilitation, at discharge, and at follow-up. Data were analysed according to the constant comparative method of grounded theory. The participants' experiences formed one core category: "The same starting point but different rehabilitation processes". Before rehabilitation, all participants experienced a similar starting point: Naïve understanding of rehabilitation. During rehabilitation, two separate processes followed. Four participants experienced their rehabilitation as being a mutually shared process that led to a process of change. They were actively engaged, using the rehabilitation plan, and working towards goals targeting a broad perspective of daily activities. The remaining two participants experienced their rehabilitation as a staff-directed process, with limited use of the rehabilitation plan, focusing on goals mainly related to body functions and self-care, not leading to any substantial changes. When clients experience that they develop a mutually shared rehabilitation process, based on a rehabilitation plan, they became more engaged in their rehabilitation and gained a better understanding of their participation during the process. Knowledge of the differences in how clients use the rehabilitation plan during the rehabilitation process can support their active engagement during rehabilitation. This, in turn, can promote a more holistic view among clients and professionals during the rehabilitation for people with late effects of polio. Implications for Rehabilitation Clients who experience a rehabilitation that is mutually shared with professionals, have a better understanding of their engagement during the rehabilitation process. When clients and

  1. After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review.

    PubMed

    Scrivener, Katharine; Jones, Taryn; Schurr, Karl; Graham, Petra L; Dean, Catherine M

    2015-04-01

    In adults undergoing inpatient rehabilitation, does additional after-hours rehabilitation decrease length of stay and improve functional outcome, activities of daily living performance and physical activity? Systematic review with meta-analysis of randomised trials. Adults participating in an inpatient rehabilitation program. Additional rehabilitation provided after hours (evening or weekend). Function was measured with tests such as the Motor Assessment Scale, 10-m walk test, the Timed Up and Go test, and Berg Balance Scale. Performance on activities of daily living was measured with the Barthel index or the Functional Independence Measure. Length of stay was measured in days. Physical activity levels were measured as number of steps or time spent upright. Standardised mean differences (SMD) or mean differences (MD) were used to combine these outcomes. Adverse events were summarised using relative risks (RR). Study quality was assessed using PEDro scores. Seven trials were included in the review. All trials had strong methodological quality, scoring 8/10 on the PEDro scale. Among the measures of function, only balance showed a significant effect: the MD was 14 points better (95% CI 5 to 23) with additional after-hours rehabilitation on a 0-to-56-point scale. The improvement in activities of daily living performance with additional after-hours rehabilitation was of borderline statistical significance (SMD 0.10, 95% CI 0.00 to 0.21). Hospital length of stay did not differ significantly (MD -1.8 days, 95% CI -5.1 to 1.6). Those receiving additional rehabilitation had significantly higher step counts and spent significantly more time upright. Overall, the risk of adverse events was not increased by the provision of after-hours or weekend rehabilitation (RR 0.87, 95% CI 0.70 to 1.10). Additional after-hours rehabilitation can increase physical activity and may improve activities of daily living, but does not seem to affect the hospital length of stay. PROSPERO CRD

  2. Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program: Comparison with Hospital-Based and Academic Programs.

    PubMed

    Katzenberg, Charles; Silva, Edna; Young, M Jean; Gilles, Greg

    2018-04-13

    The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population. Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program. A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m 2 , P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths). A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. An interprofessional palliative care oncology rehabilitation program: effects on function and predictors of program completion.

    PubMed

    Chasen, M R; Feldstain, A; Gravelle, D; Macdonald, N; Pereira, J

    2013-12-01

    After treatment, patients with active cancer face a considerable burden from the effects of both the disease and its treatment. The Palliative Rehabilitation Program (prp) is designed to ameliorate disease effects and to improve the patient's functioning. The present study evaluated predictors of program completion and changes in functioning, symptoms, and well-being after the program. The program received referrals for 173 patients who had finished anticancer therapy. Of those 173 patients, 116 with advanced cancer were eligible and enrolled in the 8-week interprofessional prp; 67 completed it. Measures of physical, nutritional, social, and psychological functioning were evaluated at entry to the program and at completion. Participants experienced significant improvements in physical performance (p < 0.000), nutrition (p = 0.001), symptom severity (p = 0.005 to 0.001), symptom interference with functioning (p = 0.003 to 0.001), fatigue (p = 0.001), and physical endurance, mobility, and balance or function (p = 0.001 to 0.001). Reasons that participants did not complete the prp were disease progression, geographic inaccessibility, being too well (program not challenging enough), death, and personal or unknown reasons. A normal level of C-reactive protein (<10 mg/L, p = 0.029) was a predictor of program completion. Patients living with advanced cancers who underwent the interprofessional prp experienced significant improvement in functioning across several domains. Program completion can be predicted by a normal level of C-reactive protein.

  4. 78 FR 38840 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-28

    ... Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and... Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation...

  5. "A disease of frozen feelings": ethically working on emotional worlds in a Russian Orthodox Church drug rehabilitation program.

    PubMed

    Zigon, Jarrett

    2010-09-01

    In a Russian Orthodox Church drug rehabilitation program in St. Petersburg, drug addiction was often described as a disease of frozen feelings. This image suggests that rehabilitation is a process of thawing emotional worlds and, thus, allows the emotions to flow once again. In this article I argue that "frozen feelings" is better understood as the unsocial emotional worlds many drug users experience, and that rehabilitation in this church-run program particularly focuses on the cultivation of an emotional world that supports sociality. This is done, I argue, by means of ethically training rehabilitants to learn how to control and manage their emotional worlds, and in so doing, rehabilitants become new moral persons better able to live in the social world.

  6. 76 FR 77893 - Agency Information Collection (Request for Supplies (Chapter 31-Vocational Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... for Supplies (Chapter 31- Vocational Rehabilitation)): Activity Under OMB Review AGENCY: Veterans... for Supplies (Chapter 31--Vocational Rehabilitation), VA Form 28-1905m. OMB Control Number: 2900-0061... request supplies for veterans in rehabilitation programs. The official at the facility providing...

  7. Rehabilitation and transition after lung transplantation in children.

    PubMed

    Burton, J H; Marshall, J M; Munro, P; Moule, W; Snell, G I; Westall, G P

    2009-01-01

    We describe the key components of an outpatient pediatric recovery and rehabilitation program set up within the adult lung transplant service at the Alfred Hospital, Melbourne. Following discharge, pediatric lung transplant recipients and their families participated in an intensive 3-month outpatient rehabilitation program. Weekly sessions included education regarding transplant issues, physiotherapy, and occupational therapy sessions. The overall aim of the program was to comprehensively address physical rehabilitation and psychosocial and educational needs. Sessions tailored to meet the individual needs of the child were presented at an appropriate cognitive level. Education sessions for both the children and parents focused on medications, identification of infection and rejection, nutrition, physiotherapy/rehabilitation, occupational roles and stress management, donor issues, psychosocial readjustment, and transition issues. Physiotherapy included a progressive aerobic and strength training program, postural reeducation, and core stability. We incorporate Age-appropriate play activities: running, dancing, jumping, ball skills, and so on. Occupational therapy sessions addressed the primary roles of patient, students, and player. Transitions such as returning to school, friends, and the community were explored. Issues discussed included adjustment to new health status, strategies to manage side effects of medications, and altered body image issues. Weekly multidisciplinary team meetings were used to discuss and plan the rehabilitation progress. School liaison and visits occurred prior to school commencement with follow-up offered to review the ongoing transition process. Both patients and parents have reported a high level of satisfaction with the rehabilitation program. We plan to formally evaluate the program in the future.

  8. Pulmonary Rehabilitation

    MedlinePlus

    ... as pulmonary hypertension and interstitial lung disease can benefit as well. What is Pulmonary Rehabilitation? Pulmonary rehabilitation is a program of education and exercise that helps you manage your breathing ...

  9. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Disability and Rehabilitation Research Projects and Centers Program? 350.1 Section 350.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  10. 24 CFR 570.513 - Lump sum drawdown for financing of property rehabilitation activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... agreement to undertake activities, based on either: (i) Prior level of rehabilitation activity; or (ii... property rehabilitation activities. 570.513 Section 570.513 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING...

  11. Prison Education and Rehabilitation: Illusion or Reality? A Case Study of an Experimental Program.

    ERIC Educational Resources Information Center

    Lewis, Morgan V.; And Others

    A review of the literature, covering a variety of theories as to the causes of criminal behavior in young people and barriers to their rehabilitation, lays the groundwork for a report of an experimental program using the humanities to assist in the rehabilitation of young criminal offenders, at the State Correctional Institution at Camp Hill, Pa.…

  12. Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

    PubMed

    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.

  13. Agreement between activity-monitoring devices during home rehabilitation: a substudy of the AAA STOP trial.

    PubMed

    Myers, Jonathan; Dupain, Mandi; Vu, Andrew; Jaffe, Alyssa; Smith, Kimberly; Fonda, Holly; Dalman, Ronald

    2014-01-01

    As part of a home-based rehabilitation program, 24 older adult patients (71 ± 3 years) with abdominal aortic aneurysm (AAA) disease underwent 3 days (12 awake hr/day) of activity monitoring using an accelerometer (ACC), a pedometer, and a heart rate (HR) monitor, and recorded hourly activity logs. Subjects then underwent an interview to complete a 3-day activity recall questionnaire (3-DR). Mean energy expenditure (EE) in kcals/ day for HR, ACC, and 3-DR were 1,687 ± 458, 2,068 ± 529, and 1,974 ± 491, respectively. Differences in EE were not significant between 3-DR and ACC, but HR differed from both ACC (p < .001) and 3-DR (p < .01). ACC and 3-DR had the highest agreement, with a coefficient of variation of 7.9% and r = .86. Thus, ACC provided a reasonably accurate reflection of EE based the criterion measure, an activity recall questionnaire. ACC can be effectively used to monitor EE to achieve an appropriate training stimulus during home-based cardiac rehabilitation.

  14. Counseling Persons with Comorbid Disorders: A Quantitative Comparison of Counselor Active Rehabilitation Service and Standard Rehabilitation Counseling Approaches

    ERIC Educational Resources Information Center

    Ferdinandi, Andrew D.; Li, Ming Hui

    2007-01-01

    The purpose of this quantitative study was to investigate the effect of counselor active rehabilitation service compared with the effect of standard rehabilitation counseling in assisting individuals with coexisting psychiatric and substance abuse disorders in attaining desired life roles. This study was conducted during a 6-month period in a…

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

    PubMed Central

    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.

    2015-01-01

    Objective To describe use of Occupational Therapy (OT), Physical Therapy (PT) and Speech Therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injuries (TBI). Design Multi-site prospective observational cohort study. Setting 9 U.S. and 1 Canadian inpatient rehabilitation settings. Participants 2130 patients admitted for initial acute rehabilitation following TBI. Patients were categorized based on admission FIM cognitive scores, resulting in 5 fairly homogenous groups. Interventions Not applicable. Main Outcome Measures Percentage of patients engaged in specific activities and mean time patients engaged in the activities, per 10-hour block of time for OT, PT, and ST combined. Results Therapy activities in OT, PT, and ST across all 5 cognitive groups had a primary focus on basic activities. While 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. Conclusions The pattern of activities engaged in was both similar to and different from patterns seen in previous PBE studies with different rehabilitation diagnostic groups. PMID:26212399

  16. Guidelines for postdoctoral training in rehabilitation psychology.

    PubMed

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

    2012-11-01

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

  17. Cardiac rehabilitation

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000791.htm Cardiac rehabilitation To use the sharing features on this page, please enable JavaScript. Cardiac rehabilitation (rehab) is a program that helps you live ...

  18. Current Practices in Lumbar Surgery Perioperative Rehabilitation: A Scoping Review.

    PubMed

    Marchand, Andrée-Anne; O'Shaughnessy, Julie; Châtillon, Claude-Édouard; Sorra, Karin; Descarreaux, Martin

    The objective of this review was to identify current practices and relevant patient-reported and objective outcome measures with regard to rehabilitation protocols directed at the lumbar spine in perioperative procedure settings in order to inform clinical practice and future research. A literature search was performed in MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Central Register of Controlled Trials, PEDro (Physiotherapy Evidence Database), and PubMed using terms relevant to surgical interventions, rehabilitation, and the lumbar spine. Twenty-nine studies met the inclusion criteria, and 28 investigated postoperative forms of rehabilitation. Patient-reported outcomes typically used were pain and disability, although a wide range of objective measures based on physical capacities were often reported. Rehabilitation programs, for the most part, included some form of strengthening exercises alone or in combination with stabilization exercises, aerobic conditioning, stretching, or education. Despite most studies reporting statistically significant results between intervention groups, considering clinically significant improvement within intervention groups yielded a different portrait. A wide range of objective and subjective outcomes is used to document changes after active rehabilitation. Program components include both active and assisted interventions combined with various means of education and discussion. Multimodal rehabilitation protocols after lumbar surgery may be used to improve patient-reported and objective outcome measures such as pain, disability, and physical function. Further research should be conducted on the effects of preoperative rehabilitation programs. Copyright © 2016. Published by Elsevier Inc.

  19. 34 CFR 350.2 - What is the purpose of the Disability and Rehabilitation Research Project and Centers Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the purpose of the Disability and..., DEPARTMENT OF EDUCATION DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM General § 350.2 What is the purpose of the Disability and Rehabilitation Research Project and Centers Program? The...

  20. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability.

    PubMed

    Mattacola, Carl G; Dwyer, Maureen K

    2002-12-01

    OBJECTIVE: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. BACKGROUND: Important considerations in the rehabilitation of ankle injuries include controlling the acute inflammatory process, regaining full ankle range of motion, increasing muscle strength and power, and improving proprioceptive abilities. These goals can be achieved through various modalities, flexibility exercises, and progressive strength- and balance-training exercises. In this article, we discuss the deleterious effects of ankle injury on ankle-joint proprioception and muscular strength and how these variables can be quantifiably measured to follow progress through a rehabilitation program. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provided, along with recommendations for functional rehabilitation of ankle injuries, including a structured progression of exercises. RECOMMENDATIONS: Early functional rehabilitation of the ankle should include range-of-motion exercises and isometric and isotonic strength-training exercises. In the intermediate stage of rehabilitation, a progression of proprioception-training exercises should be incorporated. Advanced rehabilitation should focus on sport-specific activities to prepare the athlete for return to competition. Although it is important to individualize each rehabilitation program, this well-structured template for ankle rehabilitation can be adapted as needed.

  1. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

    PubMed Central

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Objective: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. Background: Important considerations in the rehabilitation of ankle injuries include controlling the acute inflammatory process, regaining full ankle range of motion, increasing muscle strength and power, and improving proprioceptive abilities. These goals can be achieved through various modalities, flexibility exercises, and progressive strength- and balance-training exercises. In this article, we discuss the deleterious effects of ankle injury on ankle-joint proprioception and muscular strength and how these variables can be quantifiably measured to follow progress through a rehabilitation program. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provided, along with recommendations for functional rehabilitation of ankle injuries, including a structured progression of exercises. Recommendations: Early functional rehabilitation of the ankle should include range-of-motion exercises and isometric and isotonic strength-training exercises. In the intermediate stage of rehabilitation, a progression of proprioception-training exercises should be incorporated. Advanced rehabilitation should focus on sport-specific activities to prepare the athlete for return to competition. Although it is important to individualize each rehabilitation program, this well-structured template for ankle rehabilitation can be adapted as needed. PMID:12937563

  2. 77 FR 8234 - National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research Projects and Centers Program, etc. AGENCY: Office of Special Education and...: National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research...

  3. The physical health of Indigenous and non-Indigenous patients participating in residential rehabilitation programs: a comparison study.

    PubMed

    Meehan, Tom; Jones, Donna; Stedman, Terry; Johnson, Dean; Suetani, Shuichi; Foreman, Emma

    2017-04-01

    To examine the differences in the physical health of Indigenous and non-Indigenous patients with severe mental illness (SMI) undergoing psychiatric rehabilitation. An audit of the physical health of patients ( n = 361) in all publicly funded residential rehabilitation programs in Queensland was carried out in late 2014. Data collection focused on clinical and lifestyle factors associated with physical health. The prevalence of smoking, substance use and type 2 diabetes in Indigenous patients was significantly higher than rates found in non-Indigenous patients. Metabolic syndrome was also significantly higher in indigenous patients, with 66% of Indigenous patients compared to 46% of non-Indigenous patients meeting criteria for metabolic syndrome. Patients with SMI in residential rehabilitation programs have poor physical health. Our findings underscore the need for clinicians to develop and evaluate interventions aimed at improving the metabolic profile of those with SMI in residential rehabilitation programs. Historical factors and cultural traditions need to be considered when designing lifestyle interventions for Indigenous patients.

  4. Effects of a 12-week mHealth program on peak VO2 and physical activity patterns after completing cardiac rehabilitation: A randomized controlled trial.

    PubMed

    Duscha, Brian D; Piner, Lucy W; Patel, Mahesh P; Craig, Karen P; Brady, Morgan; McGarrah, Robert W; Chen, Connie; Kraus, William E

    2018-05-01

    Site-based cardiac rehabilitation (CR) provides supervised exercise, education and motivation for patients. Graduates of CR have improved exercise tolerance. However, when participation in CR ceases, adherence to regular physical activity often declines, consequently leading to worsening risk factors and clinical events. Therefore, the purpose of this pilot study was to evaluate if a mHealth program could sustain the fitness and physical activity levels gained during CR. A 12-week mHealth program was implemented using physical activity trackers and health coaching. Twenty-five patients were randomized into mHealth or usual care after completing CR. The combination of a 4.7±13.8% increase in the mHealth and a 8.5±11.5% decrease in the usual care group resulted in a difference between groups (P≤.05) for absolute peak VO 2 . Usual care decreased the amount of moderate-low physical activity minutes per week (117±78 vs 50±53; P<.05) as well as moderate-high (111±87 vs 65±64; P<.05). mHealth increased moderate-high physical activity (138±113 vs 159±156; NS). The divergent changes between mHealth and usual care in moderate-high physical activity minutes/week resulted in a difference between groups (21±103 vs - 46±36; P<.05). A 12-week mHealth program of physical activity trackers and health coaching following CR graduation can sustain the gains in peak VO 2 and physical activity achieved by site-based CR. Copyright © 2018. Published by Elsevier Inc.

  5. 78 FR 42868 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority...

  6. Physical activity outside of structured therapy during inpatient spinal cord injury rehabilitation.

    PubMed

    Zbogar, Dominik; Eng, Janice J; Miller, William C; Krassioukov, Andrei V; Verrier, Mary C

    2016-11-15

    Little information exists on the content of inpatient rehabilitation stay when individuals with spinal cord injury (SCI) are not engaged in structured rehabilitation therapy sessions. Investigation of inpatient therapy content is incomplete without the context of activities outside of this time. We sought to quantify physical activity occurring outside of physical therapy (PT) and occupational therapy (OT) sessions during inpatient SCI rehabilitation and examine how this activity changes over time from admission to discharge. In this longitudinal observational study at two inpatient SCI rehabilitation centres, 95 participants were recruited through consecutive admissions. Physical activity at admission and discharge was recorded by 1) self-report (PARA-SCI questionnaire) and 2) real-time accelerometers worn on the dominant wrist, and hip if ambulatory. For analyses, we separated participants into those with paraplegia or tetraplegia, and a subgroup of those ambulatory at discharge. Wilcoxon signed rank tests (admission vs. discharge) were used for PARA-SCI minutes and accelerometry activity kilocounts. There was no change in self-report physical activity, where the majority of time was spent in leisure time sedentary activity (~4 h) and leisure time physical activity at a higher intensity had a median value of 0 min. In contrast, significant increases in physical activity outside PT and OT sessions from admission to discharge were found for wrist accelerometers for individuals with tetraplegia (i.e., upper limb activity) and hip accelerometers for ambulatory individuals (i.e., walking activity). Physical activity is low in the inpatient SCI rehabilitation setting outside of structured therapy with a substantial amount of time spent in leisure time sedentary activity. Individuals appear to have the capacity to increase their levels of physical activity over the inpatient stay.

  7. 78 FR 28543 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... priority under the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice proposes a priority...

  8. 78 FR 26560 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... priority for the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice proposes a priority...

  9. Accelerometry: A feasible method to monitor physical activity during sub-acute rehabilitation of persons with stroke.

    PubMed

    Joseph, Conran; Strömbäck, Björn; Hagströmer, Maria; Conradsson, David

    2018-05-08

    To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. Longitudinal observational study. Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and December 2016. Volume and intensity of physical activity were assessed with accelerometers throughout the rehabilitation period. Indicators of feasibility included processes (recruitment, protocol adherence and participants' experiences) and scientific feasibility, which assessed the accelerometers' ability to detect change in physical activity among stroke survivors who ambulate independently and those who are dependent on a mobility device. Twenty-seven out of 31 eligible individuals took part in this study, with 23 (85%) completing it. In total, 432 days of rehabilitation were monitored and valid physical activity data were obtained for 408 days (94%). There were no indications that the measurement interfered with participants' ability to participate in rehabilitation. Despite the subjects' ambulation status, the number of steps and time spent in moderate-to-vigorous physical activity increased significantly across the first 18 days of rehabilitation, whereas sedentary time was unchanged. This study supports the feasibility of using accelerometers to capture physical activity behaviour in survivors of stroke during inpatient rehabilitation.

  10. Patient and practitioner perspectives on reducing sedentary behavior at an exercise-based cardiac rehabilitation program.

    PubMed

    Biswas, Aviroop; Faulkner, Guy E; Oh, Paul I; Alter, David A

    2017-06-06

    To understand the awareness of sedentary behavior, as well as the perceived facilitators and barriers to reducing sedentary behaviors from the perspectives of patients undertaking an exercise-based cardiac rehabilitation program, and from staff involved in supporting patient self-management. A qualitative study was conducted at a large cardiac rehabilitation program in a metropolitan city in Canada. Guided by an ecological framework, semi-structured interviews were conducted individually with 15 patients, and in two focus groups with six staff. Transcribed interviews were analyzed by thematic analysis. Patients placed little importance on reducing sedentary behavior as they were unconvinced of the health benefits, did not perceive themselves to be sedentary, or associated such behaviors with enjoyment and relaxation. While staff were aware of the risks, they saw them as less critical than other health behaviors. Intrapersonal factors (physical and psychosocial health) and environment factors (the information environment, socio-cultural factors) within leisure time, the home, and work, influenced sedentary behavior. While these findings require further testing, future interventions may be effective if aimed at increasing awareness of the health benefits of reducing sedentary behavior, utilizing existing behavior change strategies, and using a participatory approach to tailor strategies to patients. Implications for rehabilitation Cardiac rehabilitation programs effectively use exercise promotion to improve the health of people with established cardiovascular disease. As sedentary lifestyles become more prevalent, recommendations to reduce the health risks of prolonged sedentary behavior that are specific to the characteristics and prognostic profiles of cardiac rehabilitation patients are needed. Cardiac rehabilitation programs must consider extending existing behavior change strategies utilized for exercise promotion towards addressing sedentary behaviors in order

  11. Promoting Optimal Physical Exercise for Life: An Exercise and Self-Management Program to Encourage Participation in Physical Activity after Discharge from Stroke Rehabilitation—A Feasibility Study

    PubMed Central

    Mansfield, Avril; Knorr, Svetlana; Poon, Vivien; Inness, Elizabeth L.; Middleton, Laura; Biasin, Louis; Brunton, Karen; Howe, Jo-Anne; Brooks, Dina

    2016-01-01

    People with stroke do not achieve adequate levels of physical exercise following discharge from rehabilitation. We developed a group exercise and self-management program (PROPEL), delivered during stroke rehabilitation, to promote uptake of physical activity after discharge. This study aimed to establish the feasibility of a larger study to evaluate the effect of this program on participation in self-directed physical activity. Participants with subacute stroke were recruited at discharge from one of three rehabilitation hospitals; one hospital offered the PROPEL program whereas the other two did not (comparison group; COMP). A high proportion (11/16) of eligible PROPEL program participants consented to the study. Fifteen COMP participants were also recruited. Compliance with wearing an accelerometer for 6 weeks continuously and completing physical activity questionnaires was high (>80%), whereas only 34% of daily heart rate data were available. Individuals who completed the PROPEL program seemed to have higher outcome expectations for exercise, fewer barriers to physical activity, and higher participation in physical activity than COMP participants (Hedge's g ≥ 0.5). The PROPEL program delivered during stroke rehabilitation shows promise for reducing barriers to exercise and increasing participation in physical activity after discharge. This study supports feasibility of a larger randomized trial to evaluate this program. PMID:27313948

  12. Cardiac rehabilitation programs and health-related quality of life. State of the art.

    PubMed

    Cano de la Cuerda, Roberto; Alguacil Diego, Isabel María; Alonso Martín, Joaquín Jesús; Molero Sánchez, Alberto; Miangolarra Page, Juan Carlos

    2012-01-01

    Cardiovascular disease is the main health problem in developed countries. Prevention is presented as the most effective and efficient primary care intervention, whereas cardiac rehabilitation programs are considered the most effective of secondary prevention interventions; however, these are underused. This literature review examines the effectiveness and the levels of evidence of cardiac rehabilitation programs, their components, their development and role in developed countries, applications in different fields of research and treatment, including their psychological aspects, and their application in heart failure as a paradigm of disease care under this type of intervention. It is completed by a review of the impact of such programs on measures of health-related quality of life, describing the instruments involved in studies in recent scientific literature. Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

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

    PubMed

    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.

  14. Occupational rehabilitation programs for musculoskeletal pain and common mental health disorders: study protocol of a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Long-term sick leave has considerably negative impact on the individual and society. Hence, the need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous evaluation has been performed. The described randomized controlled trial aims primarily to compare two structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual care reference group. Methods/design The study is designed as a randomized controlled trial with parallel groups. The Social Security Office performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sick leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter “untouched” control group will be monitored for future sick leave in the National Social Security Register, and 2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental training, physical training and work-related problem solving. The primary outcome is number of sick leave days. Secondary outcomes include time until full sustainable return to work, health related quality of life, health related behavior, functional status, somatic and

  15. Rehabilitation in multiple sclerosis.

    PubMed

    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.

  16. Effectiveness of a standardized back school program for patients with chronic low back pain after implementation in routine rehabilitation care.

    PubMed

    Meng, Karin; Peters, Stefan; Faller, Hermann

    2017-06-01

    To evaluate the effectiveness of a standardized, patient-oriented, biopsychosocial back school after implementation in inpatient orthopedic rehabilitation. A multi-center, quasi-experimental controlled study of patients with low back pain (n=535) was conducted. Patients in the control group received the traditional back school before implementation of the new program (usual care); patients in the intervention group received the new standardized back school after implementation into routine care. Patients' illness knowledge and conduct of back exercises (primary outcomes) and secondary self-management outcomes and treatment satisfaction were obtained at admission, discharge, and 6 and 12 months after rehabilitation. We found a significant small between-group intervention effect on patients' illness knowledge in medium- to long term (6 months: η 2 =0.015; 12 months: η 2 =0.013). There were trends for effects on conduct of back exercises among men (6 and 12 months: η 2 =0.008 both). Furthermore, significant small effects were observed for treatment satisfaction at discharge and physical activity after 6 months. The standardized back school seems to be more effective in certain outcomes than a usual care program despite heterogeneous program implementation. Further dissemination within orthopedic rehabilitation may be encouraged to foster self-management outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. NEuro COgnitive REhabilitation for Disease of Addiction (NECOREDA) Program: From Development to Trial

    PubMed Central

    Rezapour, Tara; Hatami, Javad; Farhoudian, Ali; Sofuoglu, Mehmet; Noroozi, Alireza; Daneshmand, Reza; Samiei, Ahmadreza; Ekhtiari, Hamed

    2015-01-01

    Despite extensive evidence for cognitive deficits associated with drug use and multiple publications supporting the efficacy of cognitive rehabilitation treatment (CRT) services for drug addictions, there are a few well-structured tools and organized programs to improve cognitive abilities in substance users. Most published studies on cognitive rehabilitation for drug dependent patients used rehabilitation tools, which have been previously designed for other types of brain injuries such as schizophrenia or traumatic brain injuries and not specifically designed for drug dependent patients. These studies also suffer from small sample size, lack of follow-up period assessments and or comprehensive treatment outcome measures. To address these limitations, we decided to develop and investigate the efficacy of a paper and pencil cognitive rehabilitation package called NECOREDA (Neurocognitive Rehabilitation for Disease of Addiction) to improve neurocognitive deficits associated with drug dependence particularly caused by stimulants (e.g. amphetamine type stimulants and cocaine) and opiates. To evaluate the feasibility of NECOREDA program, we conducted a pilot study with 10 opiate and methamphetamine dependent patients for 3 months in outpatient setting. NECOREDA was revised based on qualitative comments received from clients and treatment providers. Final version of NECOREDA is composed of brain training exercises called “Brain Gym” and psychoeducational modules called “Brain Treasures” which is implemented in 16 training sessions interleaved with 16 review and practice sessions. NECOREDA will be evaluated as an add-on intervention to methadone maintenance treatment in a randomized clinical trial among opiate dependent patients starting from August 2015. We discuss methodological features of NECOREDA development and evaluation in this article. PMID:26649167

  18. [Development of an integrative cognitive rehabilitation program for brain injured patients in the post-acute stage].

    PubMed

    Oh, Hyun Soo; Kim, Young Ran; Seo, Wha Sook; Seo, Yeon Ok

    2005-04-01

    This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings. A Systemic literature review design was used. Thirty-three related studies were reviewed. Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life. It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.

  19. 75 FR 21617 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ... in the public vocational rehabilitation (VR) program, including individuals from minority backgrounds... programs that are funded under the Act, as well as to improve the delivery of VR services to people with... go to work for the public VR program or related rehabilitation agencies; and (3) the number of...

  20. The application of walking training in the rehabilitation of patients after coronary artery bypass grafting

    PubMed Central

    Dylewicz, Piotr

    2015-01-01

    Walking is regarded as one of the most common and utilitarian activities of everyday life. Rehabilitation programs developed on the basis of this form of activity often constitute the primary method of rehabilitating patients after coronary artery bypass grafting. This paper provides a review of literature concerning various forms of walking training, discussing their impact on the parameters of exercise capacity and verifying the training methods with regard to the current guidelines. Attention is drawn to the diversity of the exercise protocols applied during the early and late stages of rehabilitation and pre-rehabilitation programs including: treadmill walking, walking down the corridor, treadmill walking enriched with virtual reality, and walking as an element of training sessions consisting of many different forms of activities. Exercise protocols were also analyzed in terms of their safety, especially in the case of high-intensity interval training. Despite the variety of the available rehabilitation programs, the training methodology requires constant improvement, particularly in terms of load dosage and the supervision of training sessions. PMID:26702291

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

    PubMed

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

    2013-01-01

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

  2. [Development and short-term effects of a standardized patient education program for in-patient cardiologic rehabilitation].

    PubMed

    Seekatz, B; Haug, G; Mosler, G; Schwaab, B; Altstidl, R; Worringen, U; Faller, H; Meng, K

    2013-10-01

    Patient education is an essential part in the treatment of coronary heart disease in medical rehabilitation. In the German-speaking area, no standardized and evaluated patient education program for coronary heart disease is available so far. In this paper, we demonstrate the development of a quality assured patient education program based on a health-education program of the German statutory pension insurance scheme. In a multi-level approach, an existing program was modified concerning treatment evidence, practical guidelines, theories of health and illness behavior and quality criteria for patient education as well as clinical experience and thereafter manualized. In a formative evaluation, feasibility and patient acceptance of this modified program were assessed using evaluation questionnaires of patients and trainers. Afterwards, effects of the patient education program as compared to a traditional education program were assessed on a short-term (at discharge), medium-term (6-month follow-up) and long-term (12-month follow-up) basis in a multicenter quasi-experimental control group study of patients with coronary heart disease (n=434). Results of the formative evaluation demonstrate an overall good acceptance and a good feasibility of the manualized program. Short-term results show a significant small treatment effect in the primary outcome variable patients' knowledge (p=0.001, η2 =0.028). Furthermore, small effects were also observed among some secondary outcomes, such as attitude towards medication, planning of physical activity, psychological quality of life and satisfaction with the education program. A standardized education program for patients with coronary heart disease has been developed in a systematic process based on established quality standards. Depending on the outstanding medium and long-term effects, the program may be recommended for general use in medical rehabilitation. The manual provides the prerequisites allowing for a successful

  3. Patient-Centered Goal Setting in a Hospital-Based Outpatient Stroke Rehabilitation Center.

    PubMed

    Rice, Danielle B; McIntyre, Amanda; Mirkowski, Magdalena; Janzen, Shannon; Viana, Ricardo; Britt, Eileen; Teasell, Robert

    2017-09-01

    Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001). Within an outpatient stroke rehabilitation setting, patients set

  4. The cortical activation pattern by a rehabilitation robotic hand: a functional NIRS study

    PubMed Central

    Chang, Pyung-Hun; Lee, Seung-Hee; Gu, Gwang Min; Lee, Seung-Hyun; Jin, Sang-Hyun; Yeo, Sang Seok; Seo, Jeong Pyo; Jang, Sung Ho

    2014-01-01

    Introduction: Clarification of the relationship between external stimuli and brain response has been an important topic in neuroscience and brain rehabilitation. In the current study, using functional near infrared spectroscopy (fNIRS), we attempted to investigate cortical activation patterns generated during execution of a rehabilitation robotic hand. Methods: Ten normal subjects were recruited for this study. Passive movements of the right fingers were performed using a rehabilitation robotic hand at a frequency of 0.5 Hz. We measured values of oxy-hemoglobin (HbO), deoxy-hemoglobin (HbR) and total-hemoglobin (HbT) in five regions of interest: the primary sensory-motor cortex (SM1), hand somatotopy of the contralateral SM1, supplementary motor area (SMA), premotor cortex (PMC), and prefrontal cortex (PFC). Results: HbO and HbT values indicated significant activation in the left SM1, left SMA, left PMC, and left PFC during execution of the rehabilitation robotic hand (uncorrected, p < 0.01). By contrast, HbR value indicated significant activation only in the hand somatotopic area of the left SM1 (uncorrected, p < 0.01). Conclusions: Our results appear to indicate that execution of the rehabilitation robotic hand could induce cortical activation. PMID:24570660

  5. [Attentional impairment after traumatic brain injury: assessment and rehabilitation].

    PubMed

    Ríos-Lago, M; Muñoz-Céspedes, J M; Paúl-Lapedriza, N

    Attention disorders are a major problem after traumatic brain injury underlying deficits in other cognitive functions and in everyday activities, hindering the rehabilitation process and the possibility of return to work. Functional neuroimaging and neuropsychological assessment have depicted theoretical models considering attention as a complex and non-unitary process. Although there are conceptual difficulties, it seems possible to establish a theoretical background to better define attentional impairments and to guide the rehabilitation process. The aim of the present study is to review some of the most important pieces involved in the assessment and rehabilitation of attentional impairments. We also propose an appropriate model for the design of individualized rehabilitation programs. Lastly, different approaches for the rehabilitation are reviewed. Neuropsychological assessment should provide valuable strategies to better design the cognitive rehabilitation programs. It is necessary to establish a link between basic and applied neuropsychology, in order to optimize the treatments for traumatic brain injury patients. It is also emphasized that well-defined cognitive targets and skills are required, given that an unspecific stimulation of cognitive processes (pseudorehabilitation) has been shown to be unsuccessful.

  6. Rehabilitation of traumatic brain injury in active duty military personnel and veterans: Defense and Veterans Brain Injury Center randomized controlled trial of two rehabilitation approaches.

    PubMed

    Vanderploeg, Rodney D; Schwab, Karen; Walker, William C; Fraser, Jamie A; Sigford, Barbara J; Date, Elaine S; Scott, Steven G; Curtiss, Glenn; Salazar, Andres M; Warden, Deborah L

    2008-12-01

    To determine the relative efficacy of 2 different acute traumatic brain injury (TBI) rehabilitation approaches: cognitive didactic versus functional-experiential, and secondarily to determine relative efficacy for different patient subpopulations. Randomized, controlled, intent-to-treat trial comparing 2 alternative TBI treatment approaches. Four Veterans Administration acute inpatient TBI rehabilitation programs. Adult veterans or active duty military service members (N=360) with moderate to severe TBI. One and a half to 2.5 hours of protocol-specific cognitive-didactic versus functional-experiential rehabilitation therapy integrated into interdisciplinary acute Commission for Accreditation of Rehabilitation Facilities-accredited inpatient TBI rehabilitation programs with another 2 to 2.5 hours daily of occupational and physical therapy. Duration of protocol treatment varied from 20 to 60 days depending on the clinical needs and progress of each participant. The 2 primary outcome measures were functional independence in living and return to work and/or school assessed by independent evaluators at 1-year follow-up. Secondary outcome measures consisted of the FIM, Disability Rating Scale score, and items from the Present State Exam, Apathy Evaluation Scale, and Neurobehavioral Rating Scale. The cognitive-didactic and functional-experiential treatments did not result in overall group differences in the broad 1-year primary outcomes. However, analysis of secondary outcomes found differentially better immediate posttreatment cognitive function (mean+/-SD cognitive FIM) in participants randomized to cognitive-didactic treatment (27.3+/-6.2) than to functional treatment (25.6+/-6.0, t332=2.56, P=.01). Exploratory subgroup analyses found that younger participants in the cognitive arm had a higher rate of returning to work or school than younger patients in the functional arm, whereas participants older than 30 years and those with more years of education in the functional

  7. Development and Implementation of a Mental Health Work Rehabilitation Program: Results of a Developmental Evaluation.

    PubMed

    Sylvain, Chantal; Durand, Marie-José; Velasquez Sanchez, Astrid; Lessard, Nathalie; Maillette, Pascale

    2018-05-23

    Purpose Long-term work disability due to common mental disorders (CMDs) is a growing problem. Yet optimal interventions remain unclear and little is known about implementation challenges in everyday practice. This study aimed to support and evaluate, in real time, the development and implementation of a work rehabilitation program (WRP) designed to promote post-CMD return-to-work (RTW). Methods A 2-year developmental evaluation was performed using a participatory approach. At program outset, the researchers held five work meetings to revise the program's logic model and discuss its underlying change theory with clinicians. Data collection tools used throughout the study period were structured charts of activities conducted with workers (n = 41); in-depth interviews with program clinicians and managers (n = 9); and participant observation during work meetings. Quantitative data were analyzed using descriptive statistics. Qualitative data underwent thematic analysis using a processual approach. Results Three types of activity were developed and implemented: individual and group interventions targeting workers, and joint activities targeting partners (physicians, employers, others). While worker-targeted activities were generally implemented as planned, joint activities were sporadic. Analysis of the implementation process revealed five challenges faced by clinicians. Determinants included clinicians, host organization, sociopolitical context and resources provided by the evaluation. Conclusion The program studied is original in that it is based on the best available scientific knowledge, yet adapted to contextual particularities. The identified implementation challenges highlight the need for greater importance to be placed on the external, non-program context to ensure sustainable implementation in everyday practice.

  8. Using standardized fishery data to inform rehabilitation efforts

    USGS Publications Warehouse

    Spurgeon, Jonathan J.; Stewart, Nathaniel T.; Pegg, Mark A.; Pope, Kevin L.; Porath, Mark T.

    2016-01-01

    Lakes and reservoirs progress through an aging process often accelerated by human activities, resulting in degradation or loss of ecosystem services. Resource managers thus attempt to slow or reverse the negative effects of aging using a myriad of rehabilitation strategies. Sustained monitoring programs to assess the efficacy of rehabilitation strategies are often limited; however, long-term standardized fishery surveys may be a valuable data source from which to begin evaluation. We present 3 case studies using standardized fishery survey data to assess rehabilitation efforts stemming from the Nebraska Aquatic Habitat Plan, a large-scale program with the mission to rehabilitate waterbodies within the state. The case studies highlight that biotic responses to rehabilitation efforts can be assessed, to an extent, using standardized fishery data; however, there were specific areas where minor increases in effort would clarify the effectiveness of rehabilitation techniques. Management of lakes and reservoirs can be streamlined by maximizing the utility of such datasets to work smarter, not harder. To facilitate such efforts, we stress collecting both biotic (e.g., fish lengths and weight) and abiotic (e.g., dissolved oxygen, pH, and turbidity) data during standardized fishery surveys and designing rehabilitation actions with an appropriate experimental design.

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

    PubMed

    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

  10. Comparison of Two Post-Stroke Rehabilitation Programs: A Follow-Up Study among Primary versus Specialized Health Care

    PubMed Central

    Vega-Ramírez, Francisco Antonio; Rocamora-Pérez, Patricia; Aguilar-Parra, José Manuel; Padilla-Góngora, David

    2016-01-01

    Objective To compare home-based rehabilitation (RITH) and standard outpatient rehabilitation in a hospital setting, in terms of improving the functional recovery and quality of life of stroke patients. Study Design and Setting This was a prospective cohort study in Andalusia (Spain). Participants One hundred and forty-five patients completed the outcome data. Measures Daily activities were measured by the Barthel index, Canadian Neurological Scale (to assess mental state), Tinetti scale (balance and gait), and Short Form Health Survey-36 (SF-36 to compare the quality of life). Results No statistically significant differences were found between the two groups regarding the clinical characteristics of patients in the initial measurement, except for age and mental state (younger and with greater neurological impairment in the hospital group). After physical therapy, both groups showed statistically significant improvements from baseline in each of the measures. These improvements were better in RITH patients than in the hospital patients on all functionality scales with a smaller number of sessions. Conclusions Home rehabilitation is at least as effective as the outpatient rehabilitation programs in a hospital setting, in terms of recovery of functionality in post-stroke patients. Overall quality of life is severely impaired in both groups, as stroke is a very disabling disease that radically affects patients’ lives. PMID:27835673

  11. Comparison of Brunnstrom movement therapy and Motor Relearning Program in rehabilitation of post-stroke hemiparetic hand: a randomized trial.

    PubMed

    Pandian, Shanta; Arya, Kamal Narayan; Davidson, E W Rajkumar

    2012-07-01

    Motor recovery of the hand usually plateaus in chronic stroke patients. Various conventional and contemporary approaches have been used to rehabilitate the hand post-stroke. However, the evidence for their effectiveness is still limited. To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic stroke patients. Randomized trial. Outpatients attending the occupational therapy department of a rehabilitation institute. 30 post-stroke subjects (35.06 ± 14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl-Meyer assessment: wrist and hand (FMA-WH). Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions. Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p = 0.003 to 0.004, FMA-WH; p < 0.001). However, the results were statistically significant in favor of group A undergoing BHM for FMA-WH (p < 0.004) and FMA item VIII (hand motor recovery) (p < 0.033). BHM was found to be more effective than MRP in rehabilitation of the hand in chronic post-stroke patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Should Family and Friends Be Involved in Group-Based Rehabilitation Programs for Adults with Low Vision?

    ERIC Educational Resources Information Center

    Rees, G.; Saw, C.; Larizza, M.; Lamoureux, E.; Keeffe, J.

    2007-01-01

    This qualitative study investigates the views of clients with low vision and vision rehabilitation professionals on the involvement of family and friends in group-based rehabilitation programs. Both groups outlined advantages and disadvantages to involving significant others, and it is essential that clients are given the choice. Future work is…

  13. Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation: a protocol for the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial

    PubMed Central

    Hassett, Leanne; van den Berg, Maayken; Lindley, Richard I; Crotty, Maria; McCluskey, Annie; van der Ploeg, Hidde P; Smith, Stuart T; Schurr, Karl; Killington, Maggie; Bongers, Bert; Howard, Kirsten; Heritier, Stephane; Togher, Leanne; Hackett, Maree; Treacy, Daniel; Dorsch, Simone; Wong, Siobhan; Scrivener, Katharine; Chagpar, Sakina; Weber, Heather; Pearson, Ross; Sherrington, Catherine

    2016-01-01

    Introduction People with mobility limitations can benefit from rehabilitation programmes that provide a high dose of exercise. However, since providing a high dose of exercise is logistically challenging and resource-intensive, people in rehabilitation spend most of the day inactive. This trial aims to evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation units compared to usual care alone. Methods and analysis A pragmatic, assessor blinded, parallel-group randomised trial recruiting 300 consenting rehabilitation patients with reduced mobility will be conducted. Participants will be individually randomised to intervention or control groups. The intervention group will receive technology-based exercise to target mobility and physical activity problems for 6 months. The technology will include the use of video and computer games/exercises and tablet applications as well as activity monitors. The control group will not receive any additional intervention and both groups will receive usual inpatient and outpatient rehabilitation care over the 6-month study period. The coprimary outcomes will be objectively assessed physical activity (proportion of the day spent upright) and mobility (Short Physical Performance Battery) at 6 months after randomisation. Secondary outcomes will include: self-reported and objectively assessed physical activity, mobility, cognition, activity performance and participation, utility-based quality of life, balance confidence, technology self-efficacy, falls and service utilisation. Linear models will assess the effect of group allocation for each continuously scored outcome measure with baseline scores entered as a covariate. Fall rates between groups will be compared using negative binomial regression. Primary analyses will be preplanned, conducted while masked to group allocation and use an

  14. Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation: a protocol for the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial.

    PubMed

    Hassett, Leanne; van den Berg, Maayken; Lindley, Richard I; Crotty, Maria; McCluskey, Annie; van der Ploeg, Hidde P; Smith, Stuart T; Schurr, Karl; Killington, Maggie; Bongers, Bert; Howard, Kirsten; Heritier, Stephane; Togher, Leanne; Hackett, Maree; Treacy, Daniel; Dorsch, Simone; Wong, Siobhan; Scrivener, Katharine; Chagpar, Sakina; Weber, Heather; Pearson, Ross; Sherrington, Catherine

    2016-06-06

    People with mobility limitations can benefit from rehabilitation programmes that provide a high dose of exercise. However, since providing a high dose of exercise is logistically challenging and resource-intensive, people in rehabilitation spend most of the day inactive. This trial aims to evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation units compared to usual care alone. A pragmatic, assessor blinded, parallel-group randomised trial recruiting 300 consenting rehabilitation patients with reduced mobility will be conducted. Participants will be individually randomised to intervention or control groups. The intervention group will receive technology-based exercise to target mobility and physical activity problems for 6 months. The technology will include the use of video and computer games/exercises and tablet applications as well as activity monitors. The control group will not receive any additional intervention and both groups will receive usual inpatient and outpatient rehabilitation care over the 6-month study period. The coprimary outcomes will be objectively assessed physical activity (proportion of the day spent upright) and mobility (Short Physical Performance Battery) at 6 months after randomisation. Secondary outcomes will include: self-reported and objectively assessed physical activity, mobility, cognition, activity performance and participation, utility-based quality of life, balance confidence, technology self-efficacy, falls and service utilisation. Linear models will assess the effect of group allocation for each continuously scored outcome measure with baseline scores entered as a covariate. Fall rates between groups will be compared using negative binomial regression. Primary analyses will be preplanned, conducted while masked to group allocation and use an intention-to-treat approach. The

  15. Noncompliance in an exercise rehabilitation program for men who have suffered a myocardial infarction.

    PubMed

    Oldridge, N B; Wicks, J R; Hanley, C; Sutton, J R; Jones, N L

    1978-02-18

    A group of 163 men in the Hamilton, Ont. region who had suffered a myocardial infarction were enrolled in a rehabilitation program of physical activity. These men constituted one cohort of a multicentre collaborative study designed to determine the effects of regular exercise of differing intensity on morbidity and mortality over a 4-year period.The noncompliance rate was 43% for the men who could have participated for 1 year, 46% of whom were classified as noncompliers within 1 month of entry into the program. There was no difference in overall compliance between the men exercising at high intensity and those exercising at low intensity; lack of motivation or interest was the most common reason for their leaving the program. Those leaving the program early tended to have a type A behaviour pattern (they were aggressive, ambitious and competitive, with a chronic sense of time urgency), were inactive during their leisure time, had had at least two previous infarctions and smoked. These characteristics suggest that the men leaving the program early may have been those at greatest risk for a further myocardial infarction.

  16. Posture and gait abilities in patients with myotonic dystrophy (Steinert disease). Evaluation on the short-term of a rehabilitation program.

    PubMed

    Missaoui, B; Rakotovao, E; Bendaya, S; Mane, M; Pichon, B; Faucher, M; Thoumie, P

    2010-01-01

    To evaluate the effects of a rehabilitation program in terms of balance, gait and muscle strength in a population of patients with myotonic dystrophy. Twenty patients benefited, as outpatients in a hospital setting, from a rehabilitation program with clinical and instrumental evaluations. The evaluation focused on quantitative balance measurement by clinical and stabilometer tests, gait assessed by Locometre and extensors and flexors knee muscle strength measured in isokinetic concentric mode at 60°/s. After the rehabilitation program, we observed a significant improvement in the patients' balance capacities measured with the Berg Balance Scale (BBS), fast gait speed and muscle strength. However, the instrumental evaluation did not report any gains for static balance and spontaneous gait speed after the training program. No correlation was found between the various improvements. A rehabilitation program focused on strength, gait and balance allowed for significant improvements in some parameters of myotonic dystrophy. These results attest to the relevance of a short-term rehabilitation protocol for these patients in the framework of a multidisciplinary therapeutic care. The disparity observed in the results measured for these patients suggest the contribution of cognitive involvement in the limitations felt by patients with myotonic dystrophy in the areas of gait and balance. Copyright 2010 Elsevier Masson SAS. All rights reserved.

  17. Clinical effectiveness of behavioral signs for screening chronic low-back pain patients in a work-oriented physical rehabilitation program.

    PubMed

    Werneke, M W; Harris, D E; Lichter, R L

    1993-12-01

    This prospective study investigated the relationship between behavioral sign scores (from Waddell) and the return to work status of chronic low-back pain patients who completed a work-oriented physical rehabilitation program without formal facility-related psychologic or social services. Further, the authors monitored the effect of this program on changing these scores. The program consisted of physical reconditioning through resistive exercises, flexibility and aerobic training, posture and body mechanics education, and progressive work simulation tasks and activities of daily living. One hundred eighty-three nonworking or partially disabled low-back pain patients with an average duration of 8.7 months' disability were included in the study. The presence of each of eight behavioral signs was tested for on entry and again on completion of the program. Analysis showed a significant drop in behavioral sign scores for patients who successfully returned to work. There was no significant reduction in scores for patients who did not return to work. The results suggest these signs may predict the effectiveness of treating chronic low-back pain patients in a return-to-work physical rehabilitation program. Conversely, screening for behavioral signs may identify low-back pain patients who would benefit from intensive behavioral and psychiatric testing and intervention efforts.

  18. Cardiac rehabilitation in Canada and Arab countries: comparing availability and program characteristics.

    PubMed

    Turk-Adawi, Karam I; Terzic, Carmen; Bjarnason-Wehrens, Birna; Grace, Sherry L

    2015-11-26

    Despite the high burden of cardiovascular diseases in Arab countries, little is known about cardiac rehabilitation (CR) delivery. This study assessed availability, and CR program characteristics in the Arab World, compared to Canada. A questionnaire incorporating items from 4 national / regional published CR program surveys was created for this cross-sectional study. The survey was emailed to all Arab CR program contacts that were identified through published studies, conference abstracts, a snowball sampling strategy, and other key informants from the 22 Arab countries. An online survey link was also emailed to all contacts in the Canadian Association of Cardiovascular Prevention and Rehabilitation directory. Descriptive statistics were used to describe all closed-ended items in the survey. All open-ended responses were coded using an interpretive-descriptive approach. Eight programs were identified in Arab countries, of which 5 (62.5 %) participated; 128 programs were identified in Canada, of which 39 (30.5%) participated. There was consistency in core components delivered in Arab countries and Canada; however, Arab programs more often delivered women-only classes. Lack of human resources was perceived as the greatest barrier to CR provision in all settings, with space also a barrier in Arab settings, and financial resources in Canada. The median number of patients served per program was 300 for Canada vs. 200 for Arab countries. Availability of CR programs in Arab countries is incredibly limited, despite the fact that most responses stemmed from high-income countries. Where available, CR programs in Arab countries appear to be delivered in a manner consistent with Canada.

  19. Passion for leisure activity contributes to pain experiences during rehabilitation.

    PubMed

    Courbalay, Anne; Deroche, Thomas; Brewer, Britton

    2017-03-01

    The primary aim of this study was to determine whether the levels of obsessive passion (OP) and harmonious passion for a suspended leisure activity contribute to pain catastrophizing and pain intensity in patients undergoing the rehabilitation process. The secondary aim was to examine whether the levels of passion associated with a maintained leisure activity offset the contribution of having a leisure activity suspended to pain intensity and catastrophizing. Ninety-one outpatients from functional rehabilitation units (Mage=37, SD=13.44 years) completed measures of pain catastrophizing, pain intensity, and passion about valued leisure activities (one they were prevented from practicing and one they remained able to practice). Correlation analysis showed that the level of OP for a suspended valued leisure activity was positively associated with pain catastrophizing and pain intensity. Results showed that pain catastrophizing mediated the relationship between this level of passion and pain intensity. The levels of harmonious passion and OP for a maintained valued leisure activity did not offset the contribution of OP for a suspended leisure activity to pain-related outcomes. When prevented from practicing a valued leisure activity, only OP contributes to the prediction of pain catastrophizing and pain intensity. The contribution of pain catastrophizing provides a potential explanation for why the level of OP for a suspended leisure activity is related to pain intensity ratings. The benefits of maintaining a valued leisure activity during rehabilitation do not seem sufficient to counterbalance the maladaptive effects of being prevented from the practice of a previous/another valued leisure activity.

  20. 78 FR 29237 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ..., producing observational findings, and creating other sources of research-based information. This research... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the...

  1. Therapeutic recreation treatment time during inpatient rehabilitation

    PubMed Central

    Gassaway, Julie; Dijkers, Marcel; Rider, Cecelia; Edens, Kelly; Cahow, Claire; Joyce, Joan

    2011-01-01

    Objective Following spinal cord injury (SCI), certified therapeutic recreation specialists (CTRSs) work with patients during rehabilitation to re-create leisure lifestyles. Although there is much literature available to describe the benefits of recreation, little has been written about the process of inpatient or outpatient rehabilitation therapeutic recreation (TR) programs or the effectiveness of such programs. To delineate how TR time is used during inpatient rehabilitation for SCI. Methods Six rehabilitation centers enrolled 600 patients with traumatic SCI for an observational study. CTRSs documented time spent on each of a set of specific TR activities during each patient encounter. Patterns of time use are described, for all patients and by neurologic category. Ordinary least-squares stepwise regression models are used to identify patient and injury characteristics predictive of total treatment time (overall and average per week) and time spent in TR activities. Results Ninety-four percent of patients enrolled in the SCIRehab study participated in TR. Patients received a mean total of 17.5 hours of TR; significant differences were seen in the amount of time spent in each activity among and within neurologic groups. The majority (76%) of patients participated in at least one structured therapeutic outing. Patient and injury characteristics explained little of the variation in time spent within activities. Conclusion The large amount of variability seen in TR treatment time within and among injury group categories, which is not explained well by patient and injury characteristics, sets the stage for future analyses to associate treatments with outcomes. PMID:21675356

  2. The association between rehabilitation programs and metabolic syndrome in chronic inpatients with schizophrenia.

    PubMed

    Lin, Yi-Chun; Lai, Chien-Liang; Chan, Hung-Yu

    2017-12-02

    The correlation between different rehabilitation programs and the prevalence of metabolic syndrome in people with schizophrenia is unclear. We tested the association in chronic inpatients with schizophrenia of a psychiatric hospital in Taiwan. Patients with schizophrenia and age from 20 to 65 years old were included. The criteria of metabolic syndrome were according to the adapted Adult Treatment Protocol for Asians. According to different types of rehabilitations, patients were divided into work group, occupational therapy group and daily activities group. A total of 359 chronic inpatients with schizophrenia were recruited. Participants had a mean age of 45.9 years and the prevalence of metabolic syndrome was 37.3%. There was a significantly higher prevalence of metabolic syndrome in the work group than in the daily activity group (adjusted odds ratio (aOR) = 1.91, 95% CI = 1.019-3.564, p < 0.05) after adjusted related confounders. Other factors associated with higher prevalence of metabolic syndrome included old age, female gender, low psychotic symptoms severity and clozapine user. This study identified a high prevalence of metabolic syndrome in chronic inpatients with schizophrenia especially in patients with good occupational function. Further investigation of the relationship between the occupational function and metabolic syndrome is necessary for chronic inpatients with schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. 78 FR 34261 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ..., such as observational research or research toward the development of diagnostic or outcome assessment... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the...

  4. Effects of a multidisciplinar cognitive rehabilitation program for patients with mild Alzheimer's disease

    PubMed Central

    Viola, Luciane F.; Nunes, Paula V.; Yassuda, Monica S.; Aprahamian, Ivan; Santos, Franklin S.; Santos, Glenda D.; Brum, Paula S.; Borges, Sheila M.; Oliveira, Alexandra M.; Chaves, Gisele F. S.; Ciasca, Eliane C.; Ferreira, Rita C. R.; de Paula, Vanessa J. R.; Takeda, Oswaldo H.; Mirandez, Roberta M.; Watari, Ricky; Falcão, Deusivania V. S.; Cachioni, Meire; Forlenza, Orestes V.

    2011-01-01

    OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatric symptoms in patients with mild Alzheimer's disease. METHOD: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention. INTERVENTION: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings. MEASUREMENTS: The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments. RESULTS: Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life. CONCLUSION: This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and

  5. Opioid Tapering in Fibromyalgia Patients: Experience from an Interdisciplinary Pain Rehabilitation Program.

    PubMed

    Cunningham, Julie L; Evans, Michele M; King, Susan M; Gehin, Jessica M; Loukianova, Larissa L

    2016-09-01

    Despite current guideline recommendations against the use of opioids for the treatment of fibromyalgia pain, opioid use is reported in approximately 30% of the patient population. There is a lack of information describing the process and results of tapering of chronic opioids. The purpose of this study is to describe opioid tapering and withdrawal symptoms in fibromyalgia patients on opioids. This retrospective research study included a baseline analysis of 159 patients consecutively admitted to the Mayo Clinic Pain Rehabilitation Center from 2006 through 2012 with a pain diagnosis of fibromyalgia completing a 3-week outpatient interdisciplinary pain rehabilitation program. Opioid tapering analysis included 55 (35%) patients using daily opioids. Opioid tapering was individualized to each patient based on interdisciplinary pain rehabilitation team determination. Opioid withdrawal symptoms were assessed daily, utilizing the Clinical Opioid Withdrawal Scale. Patients taking daily opioids had a morphine equivalent mean dose of 99 mg/day. Patients on < 100 mg/day were tapered off over a mean of 10 days compared with patients on > 200 mg/day over a mean of 28 days (P < 0.001). Differences in peak withdrawal symptoms were not statistically significant based on the mean equivalent dose (P = 22). Patients taking opioids for <2 years did not differ in length of tapering (P =0.63) or peak COWS score (P =0.80) compared with >2 years duration. Patients had significant improvements in pain-related measures including numeric pain scores, depression catastrophizing, health perception, interference with life, and perceived life control at program completion. Fibromyalgia patients on higher doses of opioids were tapered off over a longer period of time but no differences in withdrawal symptoms were seen based on opioid dose. Duration of opioid use did not affect the time to complete opioid taper or withdrawal symptoms. Despite opioid tapering, pain-related measures

  6. Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation

    PubMed Central

    Hardcastle, Sarah J.

    2015-01-01

    Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activity for at least two years following the cardiac rehabilitation programme. Participants were recruited from circuit training classes in East Sussex in the UK. Thematic content analysis revealed seven main themes: fear of death and ill health avoidance, critical incidents, overcoming aging, social influences, being able to enjoy life, provision of routine and structure, enjoyment and psychological well-being. Fear of death, illness avoidance, overcoming aging, and being able to enjoy life were powerful motives for continued participation in exercise. The social nature of the exercise class was also identified as a key facilitator of continued participation. Group-based exercise suited those that continued exercise participation post cardiac rehabilitation and fostered adherence. PMID:26381147

  7. [Individualization of exercise load control for inpatient cardiac rehabilitation. Development and evaluation of a HRV-based intervention program for patients with ischemic heart failure].

    PubMed

    Behrens, K; Hottenrott, K; Weippert, M; Montanus, H; Kreuzfeld, S; Rieger, A; Lübke, J; Werdan, K; Stoll, R

    2015-03-01

    The effective use of rehabilitation programs is of primary importance in order to improve the physical performance of cardiac disease patients. A modular program has been developed which is intended to structure and individualize conventional, exercise-based rehabilitation programs according to the individual needs and physical condition of each patient. The individualization of the program is based on detailed diagnostics before patients enter the program and daily measurements of heart rate variability (HRV) during cardiac rehabilitation. A total of 30 patients with ischemic heart disease were randomly assigned either to the intervention group (IG), completing the modular individualized rehabilitation program [n=15, mean age 54.4±4.2 years and mean left ventricular ejection fraction (LVEF) 28.53±6.25%) or to the control group (CG) taking part in the conventional rehabilitation program (n=15, mean age 56.4±4.4 years and mean LVEF 27.63±5.62). Before and after the intervention, cardiorespiratory fitness was assessed by measurement of maximal oxygen consumption (relative VO2max) during bicycle ergometry and the 6-minute walk test (6-MWT). Pre-post comparisons of cardiorespiratory fitness indicators were used to evaluate the effectiveness of the rehabilitation program. In addition to the results of the basic clinical investigations and the cardiorespiratory testing, results of standardized HRV measurements of 10 min at morning rest served as criteria for program individualization. The relative VO2max increased significantly (p<0.05) in the IG whereas no change was found in the CG. Similar results were found for maximum power output during bicycle ergometry (p<0.01) and for 6-MWT distance (p<0.001). Although patients in the IG completed less aerobic exercise sessions than those in the CG (p<0.001) the physical performance of the IG improved significantly. The results prove the effectiveness and efficacy of the modular individualized rehabilitation program. They

  8. Vocational Rehabilitation for Postsecondary Programs That Serve Students Who Are Deaf and Hard of Hearing. PEPNet Tipsheet

    ERIC Educational Resources Information Center

    Faver, Edward

    2011-01-01

    The public Vocational Rehabilitation (VR) program provides services to individuals with disabilities who need help to qualify for, find, or keep a job that is consistent with their strengths, resources, priorities, concerns, abilities, interests, and informed choice. This paper provides information on vocational rehabilitation for postsecondary…

  9. Increased independence and decreased vertigo after vestibular rehabilitation.

    PubMed

    Cohen, Helen S; Kimball, Kay T

    2003-01-01

    We sought to determine the effectiveness in decreasing some symptoms, such as vertigo, and increasing performance of daily life skills after vestibular rehabilitation. Patients who had chronic vertigo due to peripheral vestibular impairments were seen at a tertiary care center. They were referred for vestibular rehabilitation and were assessed on vertigo intensity and frequency with the use of the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the Vestibular Disorders Activities of Daily Living Scale, and the Dizziness Handicap Inventory. They were then randomly assigned to 1 of 3 home program treatment groups. Vertigo decreased and independence in activities of daily living improved significantly. Improvement was not affected by age, gender, or history of vertigo. For many patients a simple home program of vestibular habituation head movement exercises is related to reduction in symptoms and increasing independence in activities of daily living.

  10. Disability and rehabilitation in the dizzy patient.

    PubMed

    Cohen, Helen S

    2006-02-01

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

  11. An individual rehabilitation program: evaluation by Parkinsonian patients and their physiotherapists.

    PubMed

    Ory Magne, F; Fabre, N; Gu, C; Pastorelli, C; Tardez, S; Marchat, J-C; Marque, P; Brefel Courbon, C

    2014-11-01

    The purpose of this work was to study the feasibility of an individual Parkinson disease (PD) rehabilitation program based on each patient's prevalent symptoms and to determine the effects of this program on patient's quality of life as well as the level of patient's and physiotherapist's satisfaction with the program. In association with physiotherapists with expertise in PD, a physical medicine and rehabilitation physician, we elaborated a physical therapy program based on the core areas for physical therapy in PD: transfers; posture; balance and falls; physical capacity and inactivity. Within this program, we selected exercises tailored to each patient's main impairment and proposed this selection to their local physiotherapist for three months. Quality of life was evaluated with PDQ-39 at baseline and after three months of the individualized physical therapy program. We built an anonymous satisfaction questionnaire for patients and physiotherapists that was filled out at the end of the program. One hundred and three individuals with moderately advanced but clinically stable idiopathic PD were included. Significant improvement was found for the emotional well-being, bodily discomfort and stigma domain (P ≤ 0.05). No significant improvement was found for the other PDQ-39 domains. The mean global satisfaction figures for this program were 6.0 ± 2.4 and 7.2 ± 2.1 for patients and physiotherapists respectively. Most of the patients felt improved by the physiotherapy program and especially for transfer, balance, gait, and mobility. Our study found evidence of the potential benefits of a patient-tailored physiotherapy program. Such a program was feasible and had a favorable impact on patients' quality of life and on physiotherapists' practices for PD patients. Specific physiotherapy may be effective to limit physical mobility impairment. Our results also pointed out that physiotherapy may be efficient to confine the negative impact of social isolation, pain and

  12. Vocational Rehabilitation Act Reauthorization. Hearing on Examining Proposed Legislation Authorizing Funds for Programs of the Rehabilitation Act, Including H.R. 1385, to Consolidate, Coordinate, and Improve Employment, Training, Literacy, and Vocational Rehabilitation Programs in the United States, before the Subcommittee on Employment and Training of the Committee on Labor and Human Resources. United States Senate, One Hundred Fifth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This congressional report contains testimony pertaining to reauthorization of the Vocational Rehabilitation Act, which was drafted to authorize funds for programs covered by the act and consolidate, coordinate, and improve employment, training, literacy, and vocational rehabilitation programs in the United States. Statements were provided by three…

  13. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises.

    PubMed

    Reiman, Michael P; Bolgla, Lori A; Loudon, Janice K

    2012-05-01

    Recently, clinicians have focused much attention on the importance of hip strength for the rehabilitation of not only patients with low back pain but also lower extremity pathology. Properly designing a rehabilitation program for the gluteal muscles requires careful consideration of biomechanical principles, such as length of the external moment arm, gravity, and subject positioning. Understanding the anatomy and function of these muscles also is essential. Electromyography (EMG) provides a useful means to determine muscle activation levels during specific exercises. Descriptions of specific exercises, as they relate to the gluteal muscles, are described. The specific performance of these exercises, the reliability of such EMG measures, and descriptive figures are also detailed. Of utmost importance to practicing clinicians is the interpretation of such data and how it can be best used in exercise prescription when formulating a treatment plan.

  14. Late postacute neurologic rehabilitation: neuroscience, engineering, and clinical programs.

    PubMed

    Bach-y-Rita, Paul

    2003-08-01

    This lecture highlights my career in rehabilitation research. My principal efforts in rehabilitation have been to study (1) mechanisms of brain plasticity related to reorganization of the brain and recovery of function; (2) late postacute rehabilitation; (3) sensory substitution; and (4) rehabilitation engineering. A principal goal has been to aid in the development of a strong scientific base in rehabilitation.

  15. 75 FR 55786 - Office of Special Education Programs, Office of Special Education and Rehabilitative Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... DEPARTMENT OF EDUCATION Office of Special Education Programs, Office of Special Education and Rehabilitative Services, Department of Education; Notice of Final Extension of Project Period and Waiver for the... Transition Technical Assistance Center (NSTTAC). Currently, the Office of Special Education Programs (OSEP...

  16. Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry.

    PubMed

    Peel, Nancye M; Paul, Sanjoy K; Cameron, Ian D; Crotty, Maria; Kurrle, Susan E; Gray, Leonard C

    2016-01-01

    Low activity levels in inpatient rehabilitation are associated with adverse outcomes. The study aimed to test whether activity levels can be increased by the provision of monitored activity data to patients and clinicians in the context of explicit goal setting. A randomized controlled trial in three sites in Australia included 255 inpatients aged 60 and older who had a rehabilitation goal to become ambulant. The primary outcome was patients' walking time measured by accelerometers during the rehabilitation admission. Walking times from accelerometry were made available daily to treating therapists and intervention participants to motivate patients to improve incidental activity levels and reach set goals. For the control group, 'usual care' was followed, including the setting of mobility goals; however, for this group, neither staff nor patients received data on walking times to aid the setting of daily walking time targets. The median daily walking time in the intervention group increased from 10.3 minutes at baseline to 32.1 minutes at day 28, compared with an increase from 9.5 to 26.5 minutes per day in the control group. Subjects in the intervention group had significantly higher non-therapy walking time by about 7 minutes [mean (95% CI): 24.6 (21.7, 27.4)] compared to those in the control group [mean(95% CI): 17.3 (14.4, 20.3)] (p = 0.001). Daily feedback to patients and therapists using an accelerometer increased walking times during rehabilitation admissions. The results of this study suggest objective monitoring of activity levels could provide clinicians with information on clinically important, mobility-related activities to assist goal setting. Australian New Zealand Clinical Trials Registry ACTRN12611000034932 http://www.ANZCTR.org.au/.

  17. The relationship between physical activity and health status in patients with chronic obstructive pulmonary disease following pulmonary rehabilitation.

    PubMed

    Meshe, Oluwasomi Festus; Claydon, Leica Sarah; Bungay, Hilary; Andrew, Sharon

    2017-04-01

    To investigate the relationship between physical activity (PA) and measures of health-related quality of life (HRQoL) and hospital admissions in people with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation (PR). CINAHL, Medline, PubMed, AMED, PsycINFO and Cochrane Library (database inception to July 2014) were searched. Relevant outcomes included relationships between PA and HRQoL, lung function (forced expiratory volume in one second, FEV 1 ) and/or hospital admission. Six quantitative and 11 qualitative studies were included and Harden's method of data synthesis in a mixed-methods systematic review was applied. Six months following PR, increase activity levels was associated with improvement of 62m in 6MWD, 2.31 and 15.55 points increase in SGRQ and CRDQ total scores, respectively, 1.3% FEV 1 and reduced dyspnoea. No study reported on hospital admission. Reported relationships were facilitated by healthcare professionals, social supporters, motivation and encouragement, reduced fear and seeing benefits and hindered by changing physical health, environment, lack of motivation, fear and social isolation. The associations between increased levels of PA and quality of life, respiratory function and dyspnoea are largely based on 6MWD and PA questionnaires. Objective measurement of free living activity in exercise maintenance phase is required along with participants' views. Implications for rehabilitation Pulmonary rehabilitation (PR) is a non-therapeutic intervention in which a team of multidisciplinary health care professionals use individually tailored supervised exercise training, self-management education, psychological and social support to optimize the physical and social performance and autonomy of patients with chronic respiratory impairment. Initial benefits from PR decline after program completion. Clinical guidelines advocate increase exercise and activity in sustaining initial benefits of PR. Following PR, increased levels

  18. Patient Profile of Drop-Outs From a Pulmonary Rehabilitation Program.

    PubMed

    Almadana Pacheco, Virginia; Pavón Masa, María; Gómez-Bastero Fernández, Ana Paulina; Muñiz Rodríguez, Ana Mirian; Tallón Moreno, Rodrigo; Montemayor Rubio, Teodoro

    2017-05-01

    While the benefits of pulmonary rehabilitation programs (PR) in COPD have been demonstrated, poor adherence, related with worse clinical outcomes, is common. The purpose of this study was to examine causes for drop-out during a 12-week multidisciplinary pulmonary rehabilitation program and to investigate the characteristics of patients with poor adherence, with special emphasis on functional and clinical characteristics. A prospective study was performed between February and November 2015in 83 COPD patients enrolled in an outpatient program of 36 strength +resistance training sessions. Ambulances were provided to facilitate access to the clinic. Patients were divided into: adherent (A) (attended at least 70% of the program) or non-adherent (NA) (at least one session). A total of 83 patients were evaluated and 26 excluded; 15.7% refused to participate. The drop-out rate was 38.5%. The main causes were low motivation and transport problems. Lower forced vital capacity (NA, 58.9% vs A, 67.8%; P=.03), worse results on submaximal exercise test (NA, 6.2minutes vs A, 9.2minutes; P=.02), in total distance walked (NA, 42.6 vs A, 56.5; P=.03) and VO 2 in ml/min/kg (NA, 11.4 vs A, 13.6; P=.03) and in ml/min (NA, 839 vs A, 1020; P=.04) were found in the non-adherent group. This group also showed higher use of oral steroids (NA, 23.8% vs A, 2.9%; P=.01). More than 1/3 of patients leave programs. The main causes are related to motivation and transport. The patients who dropout are those with worse functional tests, more exacerbations, steroids and smoking habit. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Flexibility and Strength Measures in Children Participating in a Cardiac Rehabilitation Exercise Program.

    ERIC Educational Resources Information Center

    Koch, Barbara M.; And Others

    1988-01-01

    A 12-week structured rehabilitation program featuring warm-up exercises, increased aerobic exercise, cool down, and home-based continuation of exercise helped 12 children with surgically corrected congenital heart disease improve lower extremity strength and flexibility. (Author/CB)

  20. Maintenance of a physically active lifestyle after pulmonary rehabilitation in patients with COPD: a qualitative study toward motivational factors.

    PubMed

    Stewart, Kelly F J; Meis, Jessie J M; van de Bool, Coby; Janssen, Daisy J A; Kremers, Stef P J; Schols, Annemie M W J

    2014-09-01

    To explore determinants of behavior change maintenance of a physically active lifestyle in patients with chronic obstructive pulmonary disease (COPD) 8-11 months after completion of a 4-month outpatient pulmonary rehabilitation program. A qualitative descriptive study of semistructured interviews. Pulmonary rehabilitation assessment center. Patients with COPD. Semistructured interviews until data saturation, coded by 2 independent researchers. Patients were classified as responder (maintenance or improvement) or nonresponder (relapse or decrease), based on 3 quantitative variables reflecting exercise capacity (Constant Work Rate Test), health-related quality of life (Short-Form health survey [SF-36]), and self-management abilities (Self-Management Ability Scale [SMAS-30/Version 2]). Mean (SD) forced expiratory volume in the first second (FEV1) among interviewees was 52.5% (14.4%) predicted and the mean age was 63.5 years (range: 45-78). The group consisted of 15 responders and 7 nonresponders. Physical limitations reduced competence to engage in an active lifestyle and responders appeared to experience higher levels of perceived competence. Social support was found important and the experienced understanding from fellow patients made exercising together enjoyable. Particularly, responders expressed autonomous motivation and said they exercised because of the benefits they gain from it. Unexpectedly, only responders also experienced controlled motivation. Perceived competence and autonomous motivation are important determinants for maintenance of an active lifestyle in patients with COPD. In contrast to common theoretical assumptions, a certain threshold level of controlled motivation may remain important in maintaining a physically active lifestyle after a pulmonary rehabilitation program. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  1. A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture

    PubMed Central

    MacDermid, Joy C; Vincent, Joshua I; Kieffer, Leah; Kieffer, Ashley; Demaiter, Jennifer; MacIntosh, Stephanie

    2012-01-01

    Background and Purpose: Elbow fractures amount to 4.3% of all the fractures. The elbow is prone to stiffness after injury and fractures can often lead to significant functional impairment. Rehabilitation is commonly used to restore range of motion (ROM) and function. Practice patterns in elbow fracture rehabilitation have not been defined. The purpose of this study was to describe current elbow fracture rehabilitation practices; and compare those to the existing evidence base. Methods: Hand therapists (n=315) from the USA (92%) and Canada (8%) completed a web-based survey on their practice patterns and beliefs related to the acute (0-6 weeks) and functional (6-12 weeks) phases of elbow fracture rehabilitation. Results: More than 99% of respondents agreed that fracture severity, co-morbidities, time since fracture, compliance with an exercise program, psychological factors, and occupational demands are important prognostic indicators for optimal function. Strong agreement was found with the use of patient education (95%) and active ROM (86%) in the acute stage while, home exercise programs (99%), active ROM (99%), stretching (97%), strengthening (97%), functional activities (ADLs and routine tasks) (97%), passive ROM (95%), and active assisted ROM (95%) were generally used in the functional stage. The most commonly used impairment measures were goniometry (99%), Jamar dynamometry (97%), and hand held dynamometry (97%). Agreement on the use of patient-reported outcome measures was very minimal (1.3%- 35.6%). Conclusions: Exercise, education, and functional activity have high consensus as components of elbo fracture rehabilitation. Future research should focus on defining the optimal dosage and type of exercise/activity, and establish core measures to monitor outcomes of these interventions. PMID:23115603

  2. Implementation of Interdisciplinary Cancer Rehabilitation

    ERIC Educational Resources Information Center

    Cromes, G. Fred, Jr.

    1978-01-01

    Describes an interdisciplinary cancer-rehabilitation program composed of rehabilitation teams that evaluate patients and suggest or provide treatment with the goal of improved quality of life. Issues, problems, and suggested solutions are discussed with implications for other programs. (Author)

  3. Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomized controlled trial.

    PubMed

    Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie F; Said, Catherine M; Whitehead, Craig H

    2012-09-01

    To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. A single blind, multicenter, randomized controlled trial with 12-month follow-up. Participants were recruited after discharge from rehabilitation and followed up in the community. Participants (N=156) were people with stroke at risk of recurrent falls being discharged home from rehabilitation. Tailored multifactorial falls prevention program and usual care (n=71) or control (usual care, n=85). Primary outcomes were rate of falls and proportion of fallers. Secondary outcomes included injurious falls, falls risk, participation, activity, leg strength, gait speed, balance, and falls efficacy. There was no significant difference in fall rate (intervention: 1.89 falls/person-year, control: 1.76 falls/person-year, incidence rate ratio=1.10, P=.74) or the proportion of fallers between the groups (risk ratio=.83, 95% confidence interval=.60-1.14). There was no significant difference in injurious fall rate (intervention: .74 injurious falls/person-year, control: .49 injurious falls/person-year, incidence rate ratio=1.57, P=.25), and there were no significant differences between groups on any other secondary outcome. This multifactorial falls prevention program was not effective in reducing falls in people with stroke who are at risk of falls nor was it more effective than usual care in improving gait, balance, and strength in people with stroke. Further research is required to identify effective interventions for this high-risk group. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Active and Progressive Exoskeleton Rehabilitation Using Multisource Information Fusion From EMG and Force-Position EPP.

    PubMed

    Fan, Yuanjie; Yin, Yuehong

    2013-12-01

    Although exoskeletons have received enormous attention and have been widely used in gait training and walking assistance in recent years, few reports addressed their application during early poststroke rehabilitation. This paper presents a healthcare technology for active and progressive early rehabilitation using multisource information fusion from surface electromyography and force-position extended physiological proprioception. The active-compliance control based on interaction force between patient and exoskeleton is applied to accelerate the recovery of the neuromuscular function, whereby progressive treatment through timely evaluation contributes to an effective and appropriate physical rehabilitation. Moreover, a clinic-oriented rehabilitation system, wherein a lower extremity exoskeleton with active compliance is mounted on a standing bed, is designed to ensure comfortable and secure rehabilitation according to the structure and control requirements. Preliminary experiments and clinical trial demonstrate valuable information on the feasibility, safety, and effectiveness of the progressive exoskeleton-assisted training.

  5. Issues in International Rehabilitation.

    ERIC Educational Resources Information Center

    Nathanson, Jeanne H., Ed.

    1991-01-01

    Eight articles address issues and programs in international rehabilitation. The issue is introduced by a message from the Assistant Secretary of the United States Department of Education for the Office of Special Education and Rehabilitation Services, Robert R. Davila. Next, "A History of International Rehabilitation" (Nora Ellen Groce)…

  6. Facilitators and barriers to physical activity following pulmonary rehabilitation in COPD: a systematic review of qualitative studies.

    PubMed

    Robinson, Hayley; Williams, Veronika; Curtis, Ffion; Bridle, Christopher; Jones, Arwel W

    2018-06-04

    Pulmonary rehabilitation has short-term benefits on dyspnea, exercise capacity and quality of life in COPD, but evidence suggests these do not always translate to increased daily physical activity on a patient level. This is attributed to a limited understanding of the determinants of physical activity maintenance following pulmonary rehabilitation. This systematic review of qualitative research was conducted to understand COPD patients' perceived facilitators and barriers to physical activity following pulmonary rehabilitation. Electronic databases of published data, non-published data, and trial registers were searched to identify qualitative studies (interviews, focus groups) reporting the facilitators and barriers to physical activity following pulmonary rehabilitation for people with COPD. Thematic synthesis of qualitative data was adopted involving line-by-line coding of the findings of the included studies, development of descriptive themes, and generation of analytical themes. Fourteen studies including 167 COPD patients met the inclusion criteria. Seven sub-themes were identified as influential to physical activity following pulmonary rehabilitation. These included: intentions, self-efficacy, feedback of capabilities and improvements, relationship with health care professionals, peer interaction, opportunities following pulmonary rehabilitation and routine. These encapsulated the facilitators and barriers to physical activity following pulmonary rehabilitation and were identified as sub-themes within the three analytical themes, which were beliefs, social support, and the environment. The findings highlight the challenge of promoting physical activity following pulmonary rehabilitation in COPD and provide complementary evidence to aid evaluations of interventions already attempted in this area, but also adds insight into future development of interventions targeting physical activity maintenance in COPD.

  7. Rehabilitation of the Handicapped Programs, 1976. Hearings before the Subcommittee on the Handicapped of the Committee on Labor and Public Welfare, United States Senate, Ninety-Fourth Congress, Second Session on Oversight Hearings on Rehabilitation of the Handicapped Programs and the Implementation of Same by Agencies under the Rehabilitation Act of 1973. Part 1. February 20, 23, 24, 26; March 30, 1976.

    ERIC Educational Resources Information Center

    1976

    The full texts of all prepared statements and supplemental materials presented during five days of oversight hearings held on rehabilitation of the handicapped programs and implementation of these programs by agencies under the Rehabilitation Act of 1973 are contained in this document. Statements are made by (1) State and local directors and other…

  8. Noncompliance in an exercise rehabilitation program for men who have suffered a myocardial infarction

    PubMed Central

    Oldridge, N.B.; Wicks, J.R.; Hanley, C.; Sutton, J.R.; Jones, N.L.

    1978-01-01

    A group of 163 men in the Hamilton, Ont. region who had suffered a myocardial infarction were enrolled in a rehabilitation program of physical activity. These men constituted one cohort of a multicentre collaborative study designed to determine the effects of regular exercise of differing intensity on morbidity and mortality over a 4-year period. The noncompliance rate was 43% for the men who could have participated for 1 year, 46% of whom were classified as noncompliers within 1 month of entry into the program. There was no difference in overall compliance between the men exercising at high intensity and those exercising at low intensity; lack of motivation or interest was the most common reason for their leaving the program. Those leaving the program early tended to have a type A behaviour pattern (they were aggressive, ambitious and competitive, with a chronic sense of time urgency), were inactive during their leisure time, had had at least two previous infarctions and smoked. These characteristics suggest that the men leaving the program early may have been those at greatest risk for a further myocardial infarction. PMID:630495

  9. Design of active orthoses for a robotic gait rehabilitation system

    NASA Astrophysics Data System (ADS)

    Villa-Parra, A. C.; Broche, L.; Delisle-Rodríguez, D.; Sagaró, R.; Bastos, T.; Frizera-Neto, A.

    2015-09-01

    An active orthosis (AO) is a robotic device that assists both human gait and rehabilitation therapy. This work proposes portable AOs, one for the knee joint and another for the ankle joint. Both AOs will be used to complete a robotic system that improves gait rehabilitation. The requirements for actuator selection, the biomechanical considerations during the AO design, the finite element method, and a control approach based on electroencephalographic and surface electromyographic signals are reviewed. This work contributes to the design of AOs for users with foot drop and knee flexion impairment. However, the potential of the proposed AOs to be part of a robotic gait rehabilitation system that improves the quality of life of stroke survivors requires further investigation.

  10. [Adding the perspective of emotion on cognitive rehabilitation].

    PubMed

    Nakagome, Kazuyuki

    2011-01-01

    Cognitive rehabilitation has been gradually disseminated in Japan lately. Cognitive rehabilitation is distinct from other psychosocial rehabilitation methods, which aims to enhance cognitive function per se, by various training tools, using paper and pencil tasks, computer games, etc. It stands on the hypothesis that enhancing cognitive function should lead to improvement in social functioning. However, it is becoming clear that cognitive rehabilitation on its own is not strongly effective on social functioning, but rather it appears effective when combined with other methods of rehabilitation. Moreover, it does not treat the emotional problems, which is essential considering the treatment endpoint, to enhance "subjective well-being". Emotional problems arise much often at social interaction in patients with schizophrenia, which can be amended by improving their social cognition as well as social skills. Recently, one of the social cognition training programs has been developed in USA by Penn and his colleagues, named SCIT (Social Cognition and Interaction Training) . The program treats a number of factors involved in social cognition, a) emotion perception, b) attributional style, and c) theory of mind, using various techniques such as Socrates quotes. In previous studies, SCIT showed good effectiveness in various aspects of social cognition for inpatients, whereas the finding was not as clear for outpatients. It may be assumed that integrating SCIT into a cognitive rehabilitation program should alleviate emotional stress the patients often encounter at social interaction in their daily activities. Presumably the next candidate target for psychosocial treatments coming after cognition and emotion should be "intrinsic motivation".

  11. A Multimodal Communication Program for Aphasia during Inpatient Rehabilitation: A Case Study

    PubMed Central

    Wallace, Sarah E.; Purdy, Mary; Skidmore, Elizabeth

    2014-01-01

    BACKGROUND Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. OBJECTIVE The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. METHODS Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. RESULTS Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. CONCLUSIONS Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting. PMID:25227547

  12. How Prospective Physical Medicine and Rehabilitation Trainees Rank Residency Training Programs.

    PubMed

    Auriemma, Michael J; Whitehair, Curtis L

    2018-03-01

    Since the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only 2 previous studies focused on prospective physical medicine and rehabilitation (PM&R) trainees, and the most recent of these studies was published in 1993. It is unknown whether these previous studies are reflective of current prospective PM&R residents. To assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings with previous studies. An anonymous, voluntary questionnaire. A single PM&R residency program. All applicants to a single PM&R residency program. All applicants to our PM&R residency program were invited to participate in a 44-item, 5-point Likert-based questionnaire. Applicants were asked to rate the importance of various factors as they related to constructing their residency rank list. Means and standard deviations were calculated for items included in the survey. A response rate of 26% was obtained, with the responses of 98 applicants (20%) ultimately analyzed. The highest rated factors included "perceived happiness of current residents," "opportunities for hands-on procedure training," "perceived camaraderie among current residents," "perceived camaraderie among faculty and current residents," "perceived quality of current residents," and "perceived work/life balance among current residents." Although male and female respondents demonstrated similar ranking preferences, an apparent difference was detected between how genders rated the importance of "whether the program projects a favorable environment for women" and "whether the program projects a favorable environment for minorities." As compared with previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. Prospective PM&R residents highly value

  13. Socially assistive robotics for post-stroke rehabilitation

    PubMed Central

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

    2007-01-01

    Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness. Results We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context. Conclusion We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots. PMID:17309795

  14. Cardiac rehabilitation after myocardial infarction.

    PubMed

    Contractor, Aashish S

    2011-12-01

    Cardiac rehabilitation/secondary prevention programs are recognized as integral to the comprehensive care of patients with coronary heart disease (CHD), and as such are recommended as useful and effective (Class I) by the American Heart Association and the American College of Cardiology in the treatment of patients with CHD. The term cardiac rehabilitation refers to coordinated, multifaceted interventions designed to optimize a cardiac patient's physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing morbidity and mortality. Cardiac rehabilitation, aims at returning the patient back to normal functioning in a safe and effective manner and to enhance the psychosocial and vocational state of the patient. The program involves education, exercise, risk factor modification and counselling. A meta-analysis based on a review of 48 randomized trials that compared outcomes of exercise-based rehabilitation with usual medical care, showed a reduction of 20% in total mortality and 26% in cardiac mortality rates, with exercise-based rehabilitation compared with usual medical care. Risk stratification helps identify patients who are at increased risk for exercise-related cardiovascular events and who may require more intensive cardiac monitoring in addition to the medical supervision provided for all cardiac rehabilitation program participants. During exercise, the patients' ECG is continuously monitored through telemetry, which serves to optimize the exercise prescription and enhance safety. The safety of cardiac rehabilitation exercise programs is well established, and the occurrence of major cardiovascular events during supervised exercise is extremely low. As hospital stays decrease, cardiac rehabilitation is assuming an increasingly important role in secondary prevention. In contrast with its growing importance internationally, there are very few

  15. Physical medicine and rehabilitation in the elderly arthritic patient.

    PubMed

    Schutt, A H

    1977-02-01

    The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.

  16. [Clinical research on post-stroke hemiplegia treated with the optimized rehabilitation program of integrated Chinese and western medicine].

    PubMed

    Zhang, Xiao-Li; Qi, Rui; Yan, Jun-Tao

    2013-12-01

    To explore the optimized rehabilitation program in the treatment of post-stroke hemiplegia at the recovery stage. Based on the randomized controlled principle, 60 patients were randomized into an rehabilita tion + massage group (group A) and an rehabilitation + acupuncture group (group B), 30 cases in each one. Bobath sport therapy and functional training were adopted in the two groups. In the group A, the massage therapy was added. The rolling method and palm-rubbing method were used on the affected side, the pressing, kneading and plucking methods were applied to Jianliao (LI 15), Jianzhen (SI 9), Quchi (LI 11), Huantiao (GB 30), Weizhong (BL 40), Chengshan (BL 57), Zusanli (ST 36) and the other acu points; and the nipping method was adopted at the twelve Jing-well points. In the group B, acupuncture was applied to Baihui (BL 20), Jianliao (LI 15), Quchi (LI 11), Shousanli (LI 10), Huantiao (GB 30), Yanglingquan (GB 34), Jiexi (ST 41) and the other acupoints. The treatment was given once a day, 5 treatments a week in the two groups. The efficacy was evaluated in 3 weeks. Fugl-Meyer scale, Barthel index (BI) score, modified Rankin scale and stroke-specific quality of life (SS-QOL) were used to assess the limb motor function, the activity of daily life (ADL), independent activity of life and the quality of life of the patients in the two groups before and after treatment. Based on the total cost and benefit, the health economics evaluation was conducted in the patients of the two groups. The treatments all improved the limb motor function (group A: 26.00 (22) vs 37.00 (33); group B: 30.50 (21) vs 39.50 (36)), the independent activity of life, ADL (group A: 43.50 +/- 22.25 vs 57.50 +/- 22.25; group B: 52.83 +/- 16.59 vs 66.67 +/- 12.82) and the quality of life (group A: 122.23 +/- 30.00 vs 145.50 +/- 28.14; group B: 132.43 +/- 23.87 vs 151.47 +/- 22.37) in the patients of the two groups. The differences in all the indices were significant statistically before and

  17. Very short/short-term benefit of inpatient/outpatient cardiac rehabilitation programs after coronary artery bypass grafting surgery.

    PubMed

    Spiroski, Dejan; Andjić, Mojsije; Stojanović, Olivera Ilić; Lazović, Milica; Dikić, Ana Djordjević; Ostojić, Miodrag; Beleslin, Branko; Kostić, Snežana; Zdravković, Marija; Lović, Dragan

    2017-05-01

    Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters. We studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular ejection fraction 55% ± 5.81%), who participated in a 3-week clinical and 6-month outpatient cardiac rehabilitation program. The Inpatient program consisted of cycling 7 times/week and daily walking for 45 minutes. The outpatient program consisted mainly of walking 5 times/week for 45 minutes and cycling 3 times/week. All patients performed symptom-limited CPET on a bicycle ergometer with a ramp protocol of 10 W/minute at the start, for 3 weeks, and for 6 months. After 3 weeks of an exercise-based cardiac rehabilitation program, exercise tolerance improved as compared to baseline, as well as peak respiratory exchange ratio. Most importantly, peak VO 2 (16.35 ± 3.83 vs 17.88 ± 4.25 mL/kg/min, respectively, P < 0.05), peak VCO 2 (1.48 ± 0.40 vs 1.68 ± 0.43, respectively, P < 0.05), peak ventilatory exchange (44.52 ± 11.32 vs 52.56 ± 12.37 L/min, respectively, P < 0.05), and peak breathing reserve (52.00% ± 13.73% vs 45.75% ± 14.84%, respectively, P < 0.05) were also improved. The same improvement trend continued after 6 months (respectively, P < 0.001 and P < 0.0001). No major adverse cardiac events were noted during the rehabilitation program. Very short/short-term exercise training in patients with MI treated with CABG surgery is safe and improves functional capacity. © 2017 Wiley Periodicals, Inc.

  18. Psychological benefits of virtual reality for patients in rehabilitation therapy.

    PubMed

    Chen, Chih-Hung; Jeng, Ming-Chang; Fung, Chin-Ping; Doong, Ji-Liang; Chuang, Tien-Yow

    2009-05-01

    Whether virtual rehabilitation is beneficial has not been determined. To investigate the psychological benefits of virtual reality in rehabilitation. An experimental group underwent therapy with a virtual-reality-based exercise bike, and a control group underwent the therapy without virtual-reality equipment. Hospital laboratory. 30 patients suffering from spinal-cord injury. A designed rehabilitation therapy. Endurance, Borg's rating-of-perceived-exertion scale, the Activation-Deactivation Adjective Check List (AD-ACL), and the Simulator Sickness Questionnaire. The differences between the experimental and control groups were significant for AD-ACL calmness and tension. A virtual-reality-based rehabilitation program can ease patients' tension and induce calm.

  19. Effect of Rehabilitation Technology Services on Vocational Rehabilitation Outcomes of Individuals with Multiple Sclerosis

    ERIC Educational Resources Information Center

    Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran

    2015-01-01

    Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…

  20. Strategies for Community Rehabilitation Programs to Serve Consumers Who Are Deaf, Hard of Hearing, Late Deafened or Deafblind

    ERIC Educational Resources Information Center

    Faulkner, Gail; Harmon, Marguerite; Johnson, Lynnette; Knopf, Elise; Latz, Rubin; Parnes, Alan; Currie-Richardson, Diane; Sligar, Steven

    2004-01-01

    This book provides guidance for administrators and service delivery staff of Community Rehabilitation Programs to serve consumers who are deaf, hard of hearing, late deafened or deafblind. This publication follows an outline based on standards from CARF (Commission on Accreditation of Rehabilitation Facilities), the national accrediting agency for…

  1. Cognitive Rehabilitation in Alzheimer's Disease: A Controlled Intervention Trial.

    PubMed

    Brueggen, Katharina; Kasper, Elisabeth; Ochmann, Sina; Pfaff, Henrike; Webel, Steffi; Schneider, Wolfgang; Teipel, Stefan

    2017-01-01

    Cognitive Rehabilitation for Alzheimer's disease (AD) is an integrative multimodal intervention. It aims to maintain autonomy and quality of life by enhancing the patients' abilities to compensate for decreased cognitive functioning. We evaluated the feasibility of a group-based Cognitive Rehabilitation approach in mild AD dementia and assessed its effect on activities of daily living (ADL). We included 16 patients with AD dementia in a controlled partial-randomized design. We adapted the manual-guided Cognitive Rehabilitation program (CORDIAL) to a group setting. Over the course of three months, one group received the Cognitive Rehabilitation intervention (n = 8), while the other group received a standardized Cognitive Training as an active control condition (n = 8). ADL-competence was measured as primary outcome. The secondary outcome parameters included cognitive abilities related to daily living, functional cognitive state, and non-cognitive domains, e.g., quality of life. For each scale, we assessed the interaction effect 'intervention by time', i.e., from pre-to post-intervention. We found no significant interaction effect of intervention by time on the primary outcome ADL-competence. The interaction effect was significant for quality of life (Cohen's d: -1.43), showing an increase in the intervention group compared with the control group. Our study demonstrates the feasibility of a group-based Cognitive Rehabilitation program for patients with mild AD dementia. The Cognitive Rehabilitation showed no significant effect on ADL, possibly reflecting a lack of transfer between the therapy setting and real life. However, the group setting enhanced communication skills and coping mechanisms. Effects on ADL may not have reached statistical significance due to a limited sample size. Furthermore, future studies might use an extended duration of the intervention and integrate caregivers to a greater extent to increase transfer to activities of daily living.

  2. Exercise capacity before and after an 8-week multidisciplinary inpatient rehabilitation program in lung cancer patients: a pilot study.

    PubMed

    Spruit, Martijn A; Janssen, Paul P; Willemsen, Sonja C P; Hochstenbag, Monique M H; Wouters, Emiel F M

    2006-05-01

    Although lung cancer is a highly prevalent type of cancer, the effects of an inpatient multidisciplinary rehabilitation program on pulmonary function and exercise capacity have never been studied in these patients. Pulmonary function, 6-min walking distance and peak exercise capacity of 10 patients with a severely impaired pulmonary function following treatment of lung cancer were assessed in this pilot study before and after an 8-week inpatient multidisciplinary rehabilitation program. At baseline, patients had a restrictive pulmonary function and an apparent exercise intolerance (median 6-min walking distance: 63.6% predicted; median peak cycling load: 58.5% predicted). Despite the lack of change in median pulmonary function [FEV1: -0.01L, p = 0.5469], functional exercise capacity [145 m; 43.2% of the initial values, p=0.0020] and peak exercise capacity [26 W; 34.4% of the initial values, p = 0.0078] improved significantly compared to baseline. Future trials have to corroborate the present findings. Nevertheless, patients with lung cancer have a clear indication to start a comprehensive rehabilitation program following intensive treatment of their disease. In fact, based on the results of the present pilot study it appears that these patients are good candidates for pulmonary rehabilitation programs.

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

    PubMed Central

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

    2014-01-01

    This paper presents the integration of a virtual environment (BlindAid) in an orientation and mobility rehabilitation program as a training aid for people who are blind. BlindAid allows the users to interact with different virtual structures and objects through auditory and haptic feedback. This research explores if and how use of the BlindAid in conjunction with a rehabilitation program can help people who are blind train themselves in familiar and unfamiliar spaces. The study, focused on nine participants who were congenitally, adventitiously, and newly blind, during their orientation and mobility rehabilitation program at the Carroll Center for the Blind (Newton, Massachusetts, USA). The research was implemented using virtual environment (VE) exploration tasks and orientation tasks in virtual environments and real spaces. The methodology encompassed both qualitative and quantitative methods, including interviews, a questionnaire, videotape recording, and user computer logs. The results demonstrated that the BlindAid training gave participants additional time to explore the virtual environment systematically. Secondly, it helped elucidate several issues concerning the potential strengths of the BlindAid system as a training aid for orientation and mobility for both adults and teenagers who are congenitally, adventitiously, and newly blind. PMID:25284952

  4. Rehabilitation of syndesmotic (high) ankle sprains.

    PubMed

    Williams, Glenn N; Allen, Eric J

    2010-11-01

    High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program. All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryotherapy, braces, orthosis, therapeutic modalities, joint mobilization, massage, pain, pain medications, TENS (ie, transcutaneous electric nerve stimulation), acupuncture, aquatic therapy, strength, neuromuscular training, perturbation training, and outcomes. Level of evidence, 5. A 3-phase rehabilitation program is described. The acute phase is directed at protecting the joint while minimizing pain, inflammation, muscle weakness, and loss of motion. Most patients are treated with some form of immobilization and have weightbearing restrictions. A range of therapeutic modalities are used to minimize pain and inflammation. Gentle mobilization and resistance exercises are used to gain mobility and maintain muscle size and strength. The subacute phase is directed at normalizing range of motion, strength, and function in activities of daily living. Progressive mobilization and strengthening are hallmarks of this phase. Neuromuscular training is begun and becomes the central component of rehabilitation. The advanced training phase focuses on preparing the patient for return to sports participation. Perturbation of support surfaces, agility drills, plyometrics, and sport-specific training are central components of this phase. The rehabilitation guidelines discussed may assist clinicians in managing syndesmotic ankle sprains.

  5. Tennis Training Sessions as a Rehabilitation Instrument for Patients after Acute Myocardial Infarction

    PubMed Central

    García, Juan P. F.; Giraldo, Víctor M. A.; Barrado, José J. G.; Casasola, César D.

    2013-01-01

    The aims of this study were to measure the effects of a cardiac rehabilitation program based on a modification of a sport (tennis) on quality of life, on various laboratory test parameters and on an exercise stress test, and to determine if the results of this novel activity are equivalent to those of traditional programs (i.e., the use of the bicycle ergometer). The sample consisted of 79 patients with a low-risk acute coronary syndrome. They were divided into three groups: two experimental groups and one control group. One of the experimental groups used the bicycle ergometer as its main physical activity, whereas the other received training in a modified form of tennis lesson. By the end of the 3-month program, triglycerides, cholesterol LDL, cholesterol HDL, (-25 mg·dl-1 and 32.3 mg·dl-1 final, and 15.7 mg·dl-1 and 23.3 mg·dl-1 LDL final, respectively) and exercise capacity improved significantly (by 1.1 metabolic equivalents (METs) and 1.2 METs, respectively), in both experimental groups. We conclude that the application of a comprehensive cardiac rehabilitation program in patients with low-risk acute coronary syndrome based on a program of modified tennis improves exercise tolerance and metabolic parameters, as well as certain physical characteristics that reduce cardiovascular risk. Key Points Cardiac rehabilitation of low risk patients with acute coronary syndrome based on a program of modified tennis produces an improvement in quality of life, lipid profiles and in exercise tolerance A cardiac rehabilitation program based on a modification of tennis produces favourable changes in various anthropometric parameters related to the reduction of cardiovascular risk The development of programs of cardiac rehabilitation based on modified versions of various sports would advantage the adherence to physical exercise. PMID:24149811

  6. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes assessment... rehabilitation items and services are furnished. (ii) Cardiac risk factor modification, including education...

  7. A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities.

    PubMed

    Eiammanussakul, Trinnachoke; Sangveraphunsiri, Viboon

    2018-01-01

    Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

  8. 76 FR 37085 - Applications for New Awards; Rehabilitation Engineering Research Centers (RERCs)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF EDUCATION Applications for New Awards; Rehabilitation Engineering Research Centers...)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research... (Rehabilitation Act). Rehabilitation Engineering Research Centers Program (RERCs) The purpose of the RERC program...

  9. Active video game play in children with cerebral palsy: potential for physical activity promotion and rehabilitation therapies.

    PubMed

    Howcroft, Jennifer; Klejman, Sue; Fehlings, Darcy; Wright, Virginia; Zabjek, Karl; Andrysek, Jan; Biddiss, Elaine

    2012-08-01

    To evaluate the potential of active video game (AVG) play for physical activity promotion and rehabilitation therapies in children with cerebral palsy (CP) through a quantitative exploration of energy expenditure, muscle activation, and quality of movement. Single-group, experimental study. Human movement laboratory in an urban rehabilitation hospital. Children (N=17; mean age ± SD, 9.43±1.51y) with CP. Participants played 4 AVGs (bowling, tennis, boxing, and a dance game). Energy expenditure via a portable cardiopulmonary testing unit; upper limb muscle activations via single differential surface electrodes; upper limb kinematics via an optical motion capture system; and self-reported enjoyment via the Physical Activity Enjoyment Scale (PACES). Moderate levels of physical activity were achieved during the dance (metabolic equivalent for task [MET]=3.20±1.04) and boxing (MET=3.36±1.50) games. Muscle activations did not exceed maximum voluntary exertions and were greatest for the boxing AVG and for the wrist extensor bundle. Angular velocities and accelerations were significantly larger in the dominant arm than in the hemiplegic arm during bilateral play. A high level of enjoyment was reported on the PACES (4.5±0.3 out of 5). AVG play via a low-cost, commercially available system can offer an enjoyable opportunity for light to moderate physical activity in children with CP. While all games may encourage motor learning to some extent, AVGs can be strategically selected to address specific therapeutic goals (eg, targeted joints, bilateral limb use). Future research is needed to address the challenge of individual variability in movement patterns/play styles. Likewise, further study exploring home use of AVGs for physical activity promotion and rehabilitation therapies, and its functional outcomes, is warranted. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    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.

  11. CURRENT CONCEPTS IN MUSCLE STRETCHING FOR EXERCISE AND REHABILITATION

    PubMed Central

    2012-01-01

    Stretching is a common activity used by athletes, older adults, rehabilitation patients, and anyone participating in a fitness program. While the benefits of stretching are known, controversy remains about the best type of stretching for a particular goal or outcome. The purpose of this clinical commentary is to discuss the current concepts of muscle stretching interventions and summarize the evidence related to stretching as used in both exercise and rehabilitation. PMID:22319684

  12. REHABILITATION AFTER HIP ARTHROSCOPY AND LABRAL REPAIR IN A HIGH SCHOOL FOOTBALL ATHLETE

    PubMed Central

    Kolber, Morey J.

    2012-01-01

    Study Design: Case Report Background: Femoral acetabular impingement (FAI) has been implicated in the etiology of acetabular labral tears. The rehabilitation of younger athletes following arthroscopic surgery for FAI and labral tears is often complex and multifactorial. A paucity of evidence exists to describe the rehabilitation of younger athletes who have undergone arthroscopic hip surgery. Case Presentation: This case report describes a four-phase rehabilitation program for a high school football player who underwent hip arthroscopy with a labral repair and chondroplasty. Outcomes: The player returned to training for football 16 weeks later and at the 4 month follow-up was pain free with no signs of FAI. Discussion: There is little evidence regarding the rehabilitation of younger athletes who undergo arthroscopic hip surgery. This case study described a four phase rehabilitation program for a high school football player who underwent hip arthroscopy and labral repair. The patient achieved positive outcomes with a full return to athletic activity and football. The overall success of these patients depends on the appropriate surgical procedure and rehabilitation program. Key Words: Femoral acetabular impingement (FAI), hip, hip impingement Level of evidence: 4-Case report PMID:22530192

  13. Intestinal Rehabilitation Programs in the Management of Pediatric Intestinal Failure and Short Bowel Syndrome.

    PubMed

    Merritt, Russell J; Cohran, Valeria; Raphael, Bram P; Sentongo, Timothy; Volpert, Diana; Warner, Brad W; Goday, Praveen S

    2017-11-01

    Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation. These programs almost all include pediatric surgeons, pediatric gastroenterologists, specialized nurses, and dietitians; many also include a variety of other medical and allied medical specialists. Intestinal rehabilitation programs provide integrated interdisciplinary care, more discussion of patient management by involved specialists, continuity of care through various treatment interventions, close follow-up of outpatients, improved patient and family education, earlier treatment of complications, and learning from the accumulated patient databases. Quality assurance and research collaboration among centers are also goals of many of these programs. The combined and coordinated talents and skills of multiple types of health care practitioners have the potential to ameliorate the impact of intestinal failure and improve health outcomes and quality of life.

  14. Participation of children with neurodevelopmental risk factors in the early rehabilitation program in relation to the level of parental education.

    PubMed

    Mikelić, Valentina Matijević; Kosicek, Tena; Crnković, Maja; Radanović, Branko

    2011-12-01

    Many factors that have an adverse effect on fetal growth and development can manifest later in the child's development. Because of the biological basis, children born under the influence of these factors belong to the group of neurorisk children. They need special attention and prompt participation in the early rehabilitation program to encourage the use of brain plasticity. In addition to the biological influences, socioeconomic status affects a wide array of medical, cognitive and socio-emotional consequences in children, which begin before birth and continue into adulthood. This retrospective study included 50 children aged one to three years, hospitalized at Department of Pediatric Rehabilitation, University Department of Rheumatology, Physical Medicine and Rehabilitation, Sestre milosrdnice University Hospital Center in Zagreb. The aim was to determine the frequency of inclusion of children with neurodevelopmental risks in the early rehabilitation program according to the level of parental education. The results showed the highest percentage of parents of neurorisk children to have high school education, while the smallest number of parents had elementary school education. These data pointed to the lack of public awareness of the importance of the early period of life. However, they also indicated the lack of parental knowledge of their rights and opportunities for involvement of their neurorisk children in the early rehabilitation programs.

  15. Neural Coding for Effective Rehabilitation

    PubMed Central

    2014-01-01

    Successful neurological rehabilitation depends on accurate diagnosis, effective treatment, and quantitative evaluation. Neural coding, a technology for interpretation of functional and structural information of the nervous system, has contributed to the advancements in neuroimaging, brain-machine interface (BMI), and design of training devices for rehabilitation purposes. In this review, we summarized the latest breakthroughs in neuroimaging from microscale to macroscale levels with potential diagnostic applications for rehabilitation. We also reviewed the achievements in electrocorticography (ECoG) coding with both animal models and human beings for BMI design, electromyography (EMG) interpretation for interaction with external robotic systems, and robot-assisted quantitative evaluation on the progress of rehabilitation programs. Future rehabilitation would be more home-based, automatic, and self-served by patients. Further investigations and breakthroughs are mainly needed in aspects of improving the computational efficiency in neuroimaging and multichannel ECoG by selection of localized neuroinformatics, validation of the effectiveness in BMI guided rehabilitation programs, and simplification of the system operation in training devices. PMID:25258708

  16. Rehabilitation

    MedlinePlus

    ... help. A younger person who has had a heart attack may go through cardiac rehabilitation to try to return to work and normal activities. Someone with a lung disease may get pulmonary rehabilitation to be able to breathe better and improve their quality of life.

  17. Progress assessed with the Mayo-Portland Adaptability Inventory in 604 participants in 4 types of post-inpatient rehabilitation brain injury programs.

    PubMed

    Eicher, Vicki; Murphy, Mary Pat; Murphy, Thomas F; Malec, James F

    2012-01-01

    To compare progress in 4 types of post-inpatient rehabilitation brain injury programs. Quasiexperimental observational cohort study. Community and residential. Individuals (N=604) with acquired brain injury. Four program types within the Pennsylvania Association of Rehabilitation Facilities were compared: intensive outpatient and community-based rehabilitation (IRC; n=235), intensive residential rehabilitation (IRR; n=78), long-term residential supported living (SLR; n=246), and long-term community-based supported living (SLC; n=45). With the use of a commercial web-based data management system developed with federal grant support, progress was examined on 2 consecutive assessments. Mayo-Portland Adaptability Inventory (MPAI-4). Program types differed in participant age (F=10.69, P<.001), sex (χ(2)=22.38, P<.001), time from first to second assessment (F=20.71, P<.001), initial MPAI-4 score (F=6.89, P<.001), and chronicity (F=13.43, P<.001). However, only initial MPAI-4 score and chronicity were significantly associated with the second MPAI-4 rating. On average, SLR participants were 9.1 years postinjury compared with 5.1 years for IRR, 6.0 years for IRC, and 6.8 years for SLC programs. IRR participants were more severely disabled per MPAI-4 total score on admission than the other groups. Controlling for these variables, program types varied significantly on second MPAI-4 total score (F=5.14, P=.002). Both the IRR and IRC programs resulted in significant functional improvement across assessments. In contrast, both the SLR and SLC programs demonstrated relatively stable MPAI-4 scores. Results are consistent with stated goals of the programs; that is, intensive programs resulted in functional improvements, whereas supported living programs produced stable functioning. Further studies using data from this large, multiprovider measurement collaboration will potentially provide the foundation for developing outcome expectations for various types of postacute brain

  18. Defining Rehabilitation Success in Older Adults with Dementia--Results from an Inpatient Geriatric Rehabilitation Unit.

    PubMed

    Muir-Hunter, S W; Fat, G Lim; Mackenzie, R; Wells, J; Montero-Odasso, M

    2016-04-01

    To quantify the magnitude of functional recovery in older adults with and without dementia admitted to an inpatient geriatric rehabilitation program by measuring change in measures of global physical function and physical therapy treatment outcomes. Retrospective cohort study. Rehabilitation academic hospital. Consecutive subjects, with (N=65, age 81.9±6.0 y) and without (N=157, age 82.8±7.2 y) a dementia diagnosis, had assessment data at admission and discharge from inpatient geriatric rehabilitation unit. Not applicable. The Functional Independence Measure (FIM) was used to estimate level of independence on activities of daily living. The Berg Balance Scale (BBS), Timed Up and Go Test (TUG) and 2 Minute Walk Test (2MWT) were used to estimate functional mobility and endurance. The FIM (total, motor subscale, cognitive subscale scores) were used to calculate rehabilitation efficacy and efficiency scores. After controlling for confounding, there was no group difference for gains on the BBS, TUG, 2MWT; there was no group difference on rehabilitation efficacy and efficiency values based on the FIM motor subscale. The magnitude of the rehabilitation gain using the total FIM score was statistically different between groups, people with dementia having smaller gains. Older adults with a diagnosis of dementia are capable of making motor function recovery during inpatient sub-acute rehabilitation comparable to their peers without a dementia diagnosis. The metric used to evaluate functional recovery influences the determination of rehabilitation success between groups. Rehabilitation success should be defined among people with a dementia diagnosis by a change in the motor subscale of the FIM, rather than the total FIM score or the gain relative to the maximal FIM score.

  19. Basic life support training into cardiac rehabilitation programs: A chance to give back. A community intervention controlled manikin study.

    PubMed

    González-Salvado, Violeta; Abelairas-Gómez, Cristian; Peña-Gil, Carlos; Neiro-Rey, Carmen; Barcala-Furelos, Roberto; González-Juanatey, José Ramón; Rodríguez-Núñez, Antonio

    2018-03-12

    Early basic life support is crucial to enhance survival from out-of-hospital cardiac arrest but rates remain low, especially in households. High-risk groups' training has been advocated, but the optimal method is unclear. The CArdiac REhabilitation and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two basic life support educational strategies implemented in a cardiac rehabilitation program. A community intervention study including consecutive patients enrolled on an exercise-based cardiac rehabilitation program after acute coronary syndrome or revascularization was conducted. A standard basic life support training (G-Stan) and a novel approach integrating cardiopulmonary resuscitation hands-on rolling refreshers (G-CPR) were randomly assigned to each group and compared. Basic life support performance was assessed by means of simulation at baseline, following brief instruction and after the 2-month program. 114 participants were included and 108 completed the final evaluation (G-Stan:58, G-CPR:50). Basic life support performance was equally poor at baseline and significantly improved following a brief instruction. A better skill retention was found after the 2-month program in G-CPR, significantly superior for safety and sending for an automated external defibrillator. Confidence and self-perceived preparation were also significantly greater in G-CPR after the program. Integrating cardiopulmonary resuscitation hands-on rolling refreshers in the training of an exercise-based cardiac rehabilitation program is feasible and improves patients' skill retention and confidence to perform a basic life support sequence, compared to conventional training. Exporting this formula to other programs may result in increased numbers of trained citizens, enhanced social awareness and bystander resuscitation. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network

    PubMed Central

    Dinesen, Birthe; Seeman, Janne; Gustafsson, Jeppe

    2011-01-01

    Introduction The aim of the Telekat project is to prevent re-admissions of patients with chronic obstructive pulmonary disease (COPD) by developing a preventive program of tele-rehabilitation across sectors for COPD patients. The development of the program is based on a co-innovation process between COPD patients, relatives, healthcare professionals and representatives from private firms and universities. This paper discusses the obstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients. Theory Network and innovation theory. Methods The case study was applied. A triangulation of data collection techniques was used: documents, observations (123 hours), qualitative interviews (n=32) and action research. Findings Obstacles were identified in the network context; these obstacles included the mindset of the healthcare professionals, inter-professionals relations, views of technology as a tool and competing visions for the goals of tele-rehabilitation. Conclusion We have identified obstacles that emerge in the co-innovation process when developing a programme for tele-rehabilitation of COPD patients in an inter-organizational context. Action research has been carried out and can have helped to facilitate the co-innovation process. PMID:21637709

  1. Spinal cord injury in the emergency context: review of program outcomes of a spinal cord injury rehabilitation program in Sri Lanka

    PubMed Central

    2014-01-01

    Background The final months of the conflict in Sri Lanka in 2009 resulted in massive displacement of the civilian population and a high volume of orthopedic trauma including spinal cord injury. In response to this need, Médecins Sans Frontières implemented a multidisciplinary rehabilitation program. Methods Patients were admitted to the program if they had a spinal cord injury, a stable spine and absence of a high-grade pressure ulcer. All patients were assessed on admission with a standardized functional scale the Spinal Cord Independence Measure II (SCIM) and the American Spinal Injury Association Impairment Scale (ASIA). A multidisciplinary team provided nursing care, physiotherapy, bowel and bladder training, mental health care, and vocational rehabilitation. Patients were discharged from the program when medically stable and able to perform activities of daily living independently or with assistance of a caregiver. The primary outcome measures were discharge to the community, and change in SCIM score on discharge. Secondary outcome measures were measured at 6-12 weeks post-discharge, and included SCIM score and presence of complications (pressure ulcers, urinary tract infections and bowel problems). Results 89 patients were admitted. The majority of injuries were to the thoracic region or higher (89%). The injuries were classified as ASIA grade A in 37 (43%), grade B in 17(20%), grade C in 15 (17%) and grade D in 17(20%). 83.2% met the criteria for discharge, with a further 7.9% patients requiring transfer to hospital for surgical care of pressure ulcers. There was a significant change in SCIM score from 55 on admission to 71 on discharge (p < 0.01). 79.8% and 66.7% achieved a clinically significant and substantially significant SCIM score improvement, respectively. Amongst those with follow up data, there was a reduction in post spinal cord injury complications from those experienced either at or during admission. A further 79% of SCIM scores were

  2. Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts.

    PubMed

    Middleton, Addie; Graham, James E; Krishnan, Shilpa; Ottenbacher, Kenneth J

    2016-11-01

    The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

  3. Program interruptions and short-stay transfers represent potential targets for inpatient rehabilitation care-improvement efforts

    PubMed Central

    Middleton, Addie; Graham, James E.; Krishnan, Shilpa; Ottenbacher, Kenneth J.

    2016-01-01

    Objective To present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation following stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Design Retrospective cohort study of Medicare beneficiaries with any of the three conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012 and November 15, 2013. Results In the final sample (stroke: n=71 769; TBI: n=7109; SCI: n=659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI). 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke, 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Conclusions Broad healthcare policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions. PMID:27631389

  4. Study protocol: Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer (RESPECT).

    PubMed

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Hasle, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis; Wehner, Peder Skov; Schmiegelow, Kjeld; Larsen, Hanne Baekgaard

    2013-11-14

    During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the

  5. Analyzing Sensor-Based Time Series Data to Track Changes in Physical Activity during Inpatient Rehabilitation.

    PubMed

    Sprint, Gina; Cook, Diane; Weeks, Douglas; Dahmen, Jordana; La Fleur, Alyssa

    2017-09-27

    Time series data collected from sensors can be analyzed to monitor changes in physical activity as an individual makes a substantial lifestyle change, such as recovering from an injury or illness. In an inpatient rehabilitation setting, approaches to detect and explain changes in longitudinal physical activity data collected from wearable sensors can provide value as a monitoring, research, and motivating tool. We adapt and expand our Physical Activity Change Detection (PACD) approach to analyze changes in patient activity in such a setting. We use Fitbit Charge Heart Rate devices with two separate populations to continuously record data to evaluate PACD, nine participants in a hospitalized inpatient rehabilitation group and eight in a healthy control group. We apply PACD to minute-by-minute Fitbit data to quantify changes within and between the groups. The inpatient rehabilitation group exhibited greater variability in change throughout inpatient rehabilitation for both step count and heart rate, with the greatest change occurring at the end of the inpatient hospital stay, which exceeded day-to-day changes of the control group. Our additions to PACD support effective change analysis of wearable sensor data collected in an inpatient rehabilitation setting and provide insight to patients, clinicians, and researchers.

  6. Motivational factors of adherence to cardiac rehabilitation.

    PubMed

    Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

    2012-05-01

    Main suggested theories about patients' adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients' adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients' participation and compliance to cardiac rehabilitation by recognizing and understanding the nature of patients' experiences. The participants were selected among the patients with cardiac diseases who were referred to cardiac rehabilitation in Isfahan Cardiovascular Research Center, Iran. The purposive sampling method was used and data saturation achieved after 8 semi-structured interviews. The three main concepts obtained from this study are "beliefs", "supporters" and "group cohesion". In cardiac rehabilitation programs, emphasis on motivational factors affects the patient's adherence. It is suggested that in cardiac rehabilitation programs more attention should be paid to patients' beliefs, the role of patients' supporters and the role of group-based rehabilitation.

  7. Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

    PubMed Central

    2014-01-01

    Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and

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

    PubMed

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

    2016-09-01

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

  9. Effectiveness of individualized fall prevention program in geriatric rehabilitation hospital setting: a cluster randomized trial.

    PubMed

    Aizen, Efraim; Lutsyk, Galina; Wainer, Lea; Carmeli, Sarit

    2015-10-01

    There is no conclusive evidence that hospital fall prevention programs can reduce the number of falls. We aimed to investigate the effect of a targeted individualized falls prevention program in a geriatric rehabilitation hospital. This was a two-stage cluster-controlled trial carried out in five geriatric rehabilitation wards. Participants were 752 patients with mean age 83.2 years. The intervention was a two-phase targeted intervention falls prevention program. The intervention included an assessment of patient's risk by a risk assessment tool and an individual management that includes medical, behavioral, cognitive and environmental modifications. Patients with moderate risk received additionally orientation guidance, and mobility restriction. Patients determined as high risk were additionally placed under permanent personal supervision. Outcome measures were falls during hospital stay. In both stages of the trial, intervention and control wards were almost similar at baseline for individual patient characteristics. Overall, 37 falls occurred during the study. No significant difference was found in fall rates during follow-up between intervention and control wards: 1.306 falls per 1000 bed days in the intervention groups and 1.763-1.826 falls per 1000 bed days in the control groups. The adjusted hazard ratio for falls in the intervention groups was 1.36 (95 % confidence interval 0.89-1.77) (P = 0.08) in the first stage and 1.27 (95 % confidence interval 0.92-1.67) (P = 0.12) in the second stage. These results suggest that in a geriatric rehabilitation hospital a targeted individualized intervention falls prevention program is not effective in reducing falls.

  10. An Internet- and mobile-based tailored intervention to enhance maintenance of physical activity after cardiac rehabilitation: short-term results of a randomized controlled trial.

    PubMed

    Antypas, Konstantinos; Wangberg, Silje C

    2014-03-11

    An increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual. Our trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version. The study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program. Included in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant

  11. Making Connections That Work: Partnerships between Vocational Rehabilitation and Chemical Dependency Treatment Programs.

    ERIC Educational Resources Information Center

    Hitchen, Sheila R.

    2001-01-01

    Clients in recovery from substance abuse are eligible for and can benefit from vocational rehabilitation (VR) services. VR, its history, its case management format, and American Indian tribal VR programs are discussed. A partnership between an American Indian substance abuse treatment center and Oregon state VR services is described, and…

  12. A Combined Early Cognitive and Physical Rehabilitation Program for People Who Are Critically Ill: The Activity and Cognitive Therapy in the Intensive Care Unit (ACT-ICU) Trial

    PubMed Central

    Jackson, James C.; Girard, Timothy D.; Pandharipande, Pratik P.; Schiro, Elena; Work, Brittany; Pun, Brenda T.; Boehm, Leanne; Gill, Thomas M.; Ely, E. Wesley

    2012-01-01

    -number sequences, pattern recognition). Daily physical rehabilitation sessions will advance patients from passive range of motion exercises through ambulation. Patients with cognitive or physical impairment at discharge will undergo a 12-week, in-home cognitive rehabilitation program. Measurements A battery of neurocognitive and functional outcomes will be measured 3 and 12 months after hospital discharge. Conclusions If feasible, these interventions will lay the groundwork for a larger, multicenter trial to determine their efficacy. PMID:22577067

  13. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.

    PubMed

    Abdel-Aziem, Amr Almaz; Soliman, Elsadat Saad; Mosaad, Dalia Mohammed; Draz, Amira Hussin

    2018-02-01

    [Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

  14. Functioning, coping and work status three years after participating in an interdisciplinary, occupational rehabilitation program.

    PubMed

    Øyeflaten, Irene; Midtgarden, Inger Johanne; Maeland, Silje; Eriksen, Hege R; Magnussen, Liv Heide

    2014-07-01

    The aim of this study was to explore how functional ability, coping and health were related to work and benefit status three years after participating in a four-week inpatient interdisciplinary occupational rehabilitation program. The cohort consisted of 338 individuals (75% females, mean age 51 years (SD=8.6)) who three years earlier had participated in a comprehensive inpatient interdisciplinary occupational rehabilitation program, due to long-term sick leave. The participants answered standardised questionnaires about subjective health complaints, functional ability, coping, and current work and benefit status. The relationships between these variables were analysed using logistic regression analyses. At the time of the survey, 59% of the participants worked at least 50% of a full working day. Twenty-five percent received at least 50% disability pension and 16% received other benefits. Poor functional ability (OR 4.8; CI 3.0-7.6), poor general health (OR 3.8; CI 2.3-6.1), high level of subjective health complaints (OR 3.3; CI 2.1-5.2), low coping (OR 2.8; CI 1.7-4.4), poor physical fitness (OR 2.8; CI 1.7-4.6) and poor sleep quality (OR 2.4; CI 1.5-3.7) were associated with receiving allowances. In a fully adjusted model, only poor functional ability and low coping were associated with receiving allowances three years after occupational rehabilitation. Functional ability and coping were the variables most strongly associated with not having returned to work. More attention should therefore be paid to enhance these factors in occupational rehabilitation programs. Part-time work may be a feasible way to integrate individuals with reduced workability in working life, if the alternative is complete absence from work. © 2014 the Nordic Societies of Public Health.

  15. Rehabilitation Needs Assessment for Vocational Rehabilitation Agencies. Volume II. Needs Assessment Topics Identified in the Rehabilitation Act: Issues and Resources.

    ERIC Educational Resources Information Center

    Wisconsin Univ.-Stout, Menomonie. Stout Vocational Rehabilitation Inst.

    This guide was developed to help Wisconsin agency assessment, evaluation, and planning personnel to develop a perspective on how needs assessment fits into their state's vocational rehabilitation program planning. Volume II provides state agency personnel with tools for conducting rehabilitation needs assessment. The first three chapters consider…

  16. Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation.

    PubMed

    Leijendekkers, Ruud A; van Hinte, Gerben; Nijhuis-van der Sanden, Maria Wg; Staal, J Bart

    2017-02-01

    In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis - EEFP]. A 13-week physiotherapy program. Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At one-year follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.

  17. The uniform data system for medical rehabilitation: report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010.

    PubMed

    Granger, Carl V; Karmarkar, Amol M; Graham, James E; Deutsch, Anne; Niewczyk, Paulette; Divita, Margaret A; Ottenbacher, Kenneth J

    2012-04-01

    This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points). National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings

  18. Humanoid assessing rehabilitative exercises.

    PubMed

    Simonov, M; Delconte, G

    2015-01-01

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

  19. Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study.

    PubMed

    Chung, Heewon; Ko, Hoon; Thap, Tharoeun; Jeong, Changwon; Noh, Se-Eung; Yoon, Kwon-Ha; Lee, Jinseok

    2016-01-01

    We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone's built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient's HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis.

  20. Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study

    PubMed Central

    Chung, Heewon; Yoon, Kwon-Ha; Lee, Jinseok

    2016-01-01

    We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone’s built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone’s built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient’s HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis. PMID:27551969

  1. Rehabilitation Medicine Approaches to Pain Management.

    PubMed

    Cheville, Andrea L; Smith, Sean R; Basford, Jeffrey R

    2018-06-01

    Rehabilitation medicine offers strategies that reduce musculoskeletal pain, targeted approaches to alleviate movement-related pain, and interventions to optimize patients' function despite the persistence of pain. These approaches fall into four categories: modulating nociception, stabilizing and unloading painful structures, influencing pain perception, and alleviating soft tissue musculotendinous pain. Incorporating these interventions into individualized, comprehensive pain management programs offers the potential to empower patients and limit pain associated with mobility and required daily activities. Rehabilitative approach may be particularly helpful for patients with refractory movement-associated pain and functional vulnerability, and for those who do not wish for, or cannot, tolerate pharmacoanalgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2014-01-01

    Air pollution in Japan caused respiratory disease, such as chronic bronchitis and asthma, in many individuals in the 1960s. Although air pollution has decreased, many victims of air pollution-related respiratory disease are limited in their activities of daily living because of respiratory symptoms. The purpose of this study was to evaluate the efficacy of pulmonary rehabilitation in victims of air pollution-related chronic bronchitis or asthma. Subjects were enrolled in a 12-week (2-week inpatient followed by 10-week outpatient) pulmonary rehabilitation program. The program comprised conditioning, strength training, endurance training, and patient education. We assessed the Modified Medical Research Council (MMRC) dyspnea grade, pulmonary function, peripheral muscle force, incremental shuttle walk distance (ISWD), and physical activity at baseline and immediately after the program. Twenty-nine subjects (mean age 74.2 ± 10.1 years, 11 males) completed the program, including 11 subjects with COPD and 18 subjects with asthma. Following rehabilitation, the participants (n = 29) showed significant improvements in MMRC dyspnea grade, vital capacity % predicted, quadriceps force and ISWD (all P < 0.05). Sub-group analyses revealed that all these variables were significantly improved in subjects with asthma. In contrast, subjects with COPD showed significant improvements only in quadriceps force and ISWD (both P < 0.05). Thus, pulmonary rehabilitation is an effective method of improving exercise capacity and dyspnea in officially acknowledged victims of air pollution-related asthma. In conclusion, we recommend that patients with chronic bronchitis or asthma, resulting from exposure to air pollution, are referred for pulmonary rehabilitation.

  3. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    NASA Astrophysics Data System (ADS)

    Kikuchi, T.; Jin, Y.; Fukushima, K.; Akai, H.; Furusho, J.

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named "Hybrid-PLEMO" in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  4. Factors Contributing to Dropout in a Psychosocial Rehabilitation Program for the Chronically Emotionally Disabled.

    ERIC Educational Resources Information Center

    Sultan, Faye E.; Johnson, Peter

    Deinstitutionalization refers to the provision of care for psychiatrically-disabled individuals within the community, rather than in institutions. Thus far, evaluation of vocationally oriented psychosocial rehabilitation programs developed to substitute for institutions have failed to assess reasons for dropping out of or refusing to participate…

  5. Developing a Virtual Reality-Based Vocational Rehabilitation Training Program for Patients with Schizophrenia.

    PubMed

    Sohn, Bo Kyung; Hwang, Jae Yeon; Park, Su Mi; Choi, Jung-Seok; Lee, Jun-Young; Lee, Ji Yeuon; Jung, Hee-Yeon

    2016-11-01

    Maintaining employment is difficult for patients with schizophrenia because of deterioration of psychosocial and cognitive functions. Such patients usually require vocational rehabilitation training, which is both demanding and costly. In this study, we developed a virtual reality-based vocational rehabilitation training program (VR-VRTP) for such patients and evaluated its feasibility as an alternative to traditional rehabilitation programs. We developed the VR-VRTP to include various situations commonly encountered in two types of occupations: convenience store employee and supermarket clerk. We developed practical situations, as well as a system for providing feedback, to ensure patients would not lose interest during training. Nine participants each performed the VR-VRTP repeatedly per week for a total of 8 weeks. At baseline and after training, all participants were evaluated using the following clinical and neuropsychological tests: Manchester Scale, Clinical Global Impression, Personal and Social Performance Scale (PSP), Hamilton Depression Rating Scale, Zung Depression Rating Scale, Beck Anxiety Inventory, Wisconsin Card Sorting Test, Stroop Test, Rey-Osterrieth Complex Figure Test (RCFT), and Auditory Verbal Learning Test (AVLT). After training, patient scores improved on the PSP, general symptoms on the Manchester Scale, AVLT, and delayed recall on the RCFT. The Manchester positive symptom score showed a trend of improvement. No significant changes were observed for other measures. The VR-VRTP may improve general psychosocial function and memory, potentially influencing real-world vocational performance. These findings provide preliminary evidence regarding the utility of the VR-VRTP in patients with schizophrenia.

  6. Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis.

    PubMed

    Smania, Nicola; Picelli, Alessandro; Romano, Michele; Negrini, Stefano

    2008-01-01

    Knowledge on mechanisms of neurophysiological control of trunk movement and posture could help in the development of rehabilitation programs and brace treatment in adolescent idiopathic scoliosis (AIS). Reviewing up-to-date research on neurophysiology of movement and posture control with the aim of providing basis for new researches in the field of AIS rehabilitation and background understanding for clinicians engaged in management of AIS. Review of literature. We considered several neurophysiological issues relevant for AIS rehabilitation, namely, the peculiar organization of patterns of trunk muscle recruitment, the structure of the neural hardware subserving axial and arm muscle control, and the relevance of cognitive systems allowing mapping of spatial coordinates and building of body schema. We made clear the reason why trunk control is generally carried out by means of very fast, feedforward or feedback driven patterns of muscle activation which are deeply rooted in our neural control system and very difficult to modify by training. We hypothesized that augmented sensory feedback and strength exercises could be an important stage in a rehabilitation program aimed at hindering, or possibly reversing, scoliosis progression. In this context we considered bracing not only as a corrective biomechanical device but also as a tool for continuous sensory stimulation that could help awareness of body misalignment. Future research aimed at developing strategies of trunk postural control learning is essential in the rehabilitation of adolescent idiopathic scoliosis.

  7. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    PubMed

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  8. [Gait, balance and independence rehabilitation program in elderly adults in a primary care unit].

    PubMed

    Espinosa-Cuervo, Gisela; López-Roldán, Verónica Miriam; Escobar-Rodríguez, David Alvaro; Conde-Embarcadero, Margarita; Trejo-León, Gerardo; González-Carmona, Beatriz

    2013-01-01

    to evaluate the effect of a supervised rehabilitation program to improve gait, balance and independence in elderly patients attending a family medicine unit. we conducted a quasi-experimental study over a period of four weeks in a group of 72 patients older than 65 years. a supervised program regarding the risk factors for falling, and balance, gait, coordination and oculovestibular system, the modalities to be done two or three times a week in the primary care unit or at home. An analysis of both tests was performed by "up and go," Tinetti scale and the Katz index. "intention to treat" and "by protocol." mean age was 72 ± 5 years, 67.8% were female and 81.9% of the patients completed the program. A significant clinical improvement with statistical level were evident for gait and balance (p = 0.001), independence showed only clinical improvement (p = 0.083). The efficacy for periodicity (two or three times/week) and performance place showed same clinical improvement and statistical level for gait and balance (p = 0.001 to 0.003) and independence showed only clinical improvement (p = 0.317 to 0.991). an integral rehabilitation program improved gait, balance and clinical independence significantly. The supervised program is applicable and can be reproduced at primary care unit or home for geriatric care and preventive actions.

  9. Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

    PubMed

    Parry, Selina M; Knight, Laura D; Connolly, Bronwen; Baldwin, Claire; Puthucheary, Zudin; Morris, Peter; Mortimore, Jessica; Hart, Nicholas; Denehy, Linda; Granger, Catherine L

    2017-04-01

    To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454. Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment. The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

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

    PubMed

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

    2016-02-01

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

  11. [Implementation and evaluation of an ambulatory exercise therapy based rehabilitation program for breast cancer patients].

    PubMed

    Schulz, K H; Szlovák, C; Schulz, H; Gold, S; Brechtel, L; Braumann, M; Koch, U

    1998-01-01

    Physical exercise does not only have positive effects on physical fitness but also on mental health. However, there has been little empirical study on effects of rehabilitation programmes based on physical exercise in cancer patients. We conducted a study to examine the interrelation between the participation of breast cancer patients in an exercise rehabilitation training and aspects of quality of life and physical fitness. 28 patients with not metastasized mamma carcinoma participated in a structured exercise rehabilitation program twice a week for ten weeks. Before and after the intervention the patients were asked to fill in questionnaires to assess their quality of life. At the same instants they underwent physical examination and a bicycle ergometry as well as a blood drawing. The training was aimed at changes at the social, emotional, as well as the motor physical level. Pre-post comparisons demonstrated an improvement in quality of life, such as decreased levels of depression and anxiety. Furthermore the women proved to show an obvious increase in physical fitness. Present results support an implementation of an exercise rehabilitation training for breast cancer outpatients.

  12. Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

    PubMed

    Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

    2012-01-01

    Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

  13. Rehabilitation Program for the Quality of Life for Individuals on Highly Active Antiretroviral Therapy in KwaZulu-Natal, South Africa: A Short Report

    ERIC Educational Resources Information Center

    Maharaj, Sonill S.; Chetty, Verusia

    2011-01-01

    Patients on highly active antiretroviral therapy (HAART) spend less time on vigorous activities due to lower aerobic capacity with functional limitations that can be attributed to a detraining effect, resulting in a poor quality of life (QoL). The overall aims of rehabilitation are to restore, to maintain, and to enhance the QoL and this…

  14. Effects of a brief, pedometer-based behavioral intervention for individuals with COPD during inpatient pulmonary rehabilitation on 6-week and 6-month objectively measured physical activity: study protocol for a randomized controlled trial.

    PubMed

    Geidl, Wolfgang; Semrau, Jana; Streber, René; Lehbert, Nicola; Wingart, Silke; Tallner, Alexander; Wittmann, Michael; Wagner, Rupert; Schultz, Konrad; Pfeifer, Klaus

    2017-08-29

    Pulmonary rehabilitation programs often fail to substantially enhance long-term physical activity in patients with chronic obstructive pulmonary disease (COPD). The reasons for successful physical activity changes in patients with COPD are not well understood. The need to better understand the determinants of physical activity in patients with COPD and effective rehabilitation strategies to improve physical activity is evident. The STAR study (Stay Active after Rehabilitation) investigates, in a randomized controlled trial, the additional effect of a pedometer-based behavior-change intervention during inpatient pulmonary rehabilitation on objectively measured physical activity 6 weeks and 6 months post rehabilitation. The intervention uses the behavior-change techniques (1) instruction on how, where and when to perform the behavior, (2) prompt goal setting for physical activity, (3) prompt self-monitoring of behavior, and (4) feedback on behavior. The primary outcome of physical activity will be measured using a physical activity monitor (Actigraph wGT3X-BT) for a period of 7 days, firstly 2 weeks before rehabilitation begins (t0) as well as 6 weeks and 6 months after rehabilitation (t3, t4). Additionally, to predict physical activity progression after rehabilitation, a complex personal diagnostics battery, including questionnaires as well as functional assessments, is to be carried out at the start and end of rehabilitation (t1, t2). This battery is based on the foundational ideas of the Physical Activity-Related health Competence model. Five hundred and two patients with COPD, aged 18 years or older and admitted for an approved pulmonary rehabilitation, will be enrolled in the STAR study. The STAR study is designed as a randomized controlled trial to gain a better understanding of the personal determinants of physical activity in patients with COPD and to evaluate a pedometer-based physical activity-change intervention in the context of inpatient pulmonary

  15. Rehabilitation in Justice: The Prisoner's Perspective.

    ERIC Educational Resources Information Center

    Erez, Edna

    1987-01-01

    Surveyed 348 prison inmates about their needs or interests in rehabilitation programs, reasons for their needs, whether they deserved treatment, and why. Results suggest that prisoners view rehabilitation and reform as the major purpose of punishment or prison sentence. Need was endorsed most often as fairest criterion for program participation.…

  16. Rehabilitation program after mesenchymal stromal cell transplantation augmented by vascularized bone grafts for idiopathic osteonecrosis of the femoral head: a preliminary study.

    PubMed

    Aoyama, Tomoki; Fujita, Yasuko; Madoba, Katsuyuki; Nankaku, Manabu; Yamada, Minoru; Tomita, Motoko; Goto, Koji; Ikeguchi, Ryosuke; Kakinoki, Ryosuke; Matsuda, Shuichi; Nakamura, Takashi; Toguchida, Junya

    2015-03-01

    To determine the feasibility and safety of implementing a 12-week rehabilitation program after mesenchymal stromal cell (MSC) transplantation augmented by vascularized bone grafting for idiopathic osteonecrosis (ION) of the femoral head. A prospective case series. University clinical research laboratory. Participants (N=10) with ION who received MSC transplantation augmented by vascularized bone grafting. A 12-week exercise program, which included range-of-motion (ROM) exercises, muscle-strengthening exercises, and aerobic training. Measures of ROM, muscle strength, Timed Up and Go test, and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were collected before surgery and again at 6 and 12 months after surgery. All participants completed the 12-week program. External rotation ROM as well as extensor and abductor muscle strength significantly improved 6 months after treatment compared with that before treatment (P<.05). Significant improvements were also seen in physical function, role physical, and bodily pain subgroup scores of the SF-36 (P<.05). No serious adverse events occurred. This study demonstrates the feasibility and safety of a multiplex rehabilitation program after MSC transplantation and provides support for further study on the benefits of rehabilitation programs in regenerative medicine. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. A bio-psycho-social exercise program (RÜCKGEWINN) for chronic low back pain in rehabilitation aftercare--study protocol for a randomised controlled trial.

    PubMed

    Hentschke, Christian; Hofmann, Jana; Pfeifer, Klaus

    2010-11-17

    There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent. This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN) in comparison to the current usual aftercare (IRENA) and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation. Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured contents, media and material for organisation assistance as

  18. Motivational counselling for physical activity in patients with coronary artery disease not participating in cardiac rehabilitation.

    PubMed

    Reid, Robert D; Morrin, Louise I; Higginson, Lyall A J; Wielgosz, Andreas; Blanchard, Chris; Beaton, Louise J; Nelson, Chantal; McDonnell, Lisa; Oldridge, Neil; Wells, George A; Pipe, Andrew L

    2012-04-01

    Many patients with coronary artery disease (CAD) fail to attend cardiac rehabilitation following acute coronary events because they lack motivation to exercise. Theory-based approaches to promote physical activity among non-participants in cardiac rehabilitation are required. A randomized trial comparing physical activity levels at baseline, 6, and 12 months between a motivational counselling (MC) intervention group and a usual care (UC) control group. One hundred and forty-one participants hospitalized with acute coronary syndromes not planning to attend cardiac rehabilitation were recruited at a single centre and randomized to either MC (n = 69) or UC (n = 72). The MC intervention, designed from an ecological perspective, included one face-to-face contact and eight telephone contacts with a trained physiotherapist over a 52-week period. The UC group received written information about starting a walking programme and brief physical activity advice from their attending cardiologist. Physical activity was measured by: 7-day physical activity recall interview; self-report questionnaire; and pedometer at baseline, 6, and 12 months after randomization. Latent growth curve analyses, which combined all three outcome measures into a single latent construct, showed that physical activity increased more over time in the MC versus the UC group (µ(add) = 0.69, p < 0.05). Patients with CAD not participating in cardiac rehabilitation receiving a theory-based motivational counselling intervention were more physically active at follow-up than those receiving usual care. This intervention may extend the reach of cardiac rehabilitation by increasing physical activity in those disinclined to participate in structured programmes.

  19. Global Mobility Task: index for evaluating motor impairment and motor rehabilitation programs in Parkinson's disease patients.

    PubMed

    Peppe, A; Ranaldi, A; Chiavalon, C; Gasbarra, A; Collepardo, A; Romeo, R; Pasqualetti, P; Caltagirone, C

    2007-09-01

    In this study, the validity of a motor task, i.e., the Global Mobility Task (GMT), was assessed in a group of Parkinson's disease (PD) patients. Fifty-eight PD patients (mean age: 68.7 years) and 18 healthy subjects (mean age: 65.8 years) were enrolled in the study. The GMT measures the ability of an adult to roll over on the floor and stand up in five steps using two parameters: 'Time' and 'Score', i.e., the time needed and the ability to perform each step of the task. As the GMT has never been evaluated before, internal consistency and concurrent and discriminative validity were considered in assessing its characteristics in a group of PD patients at the beginning and at the end of a motor rehabilitation program. To determine whether the GMT could also quantify the extrapyramidal impairment, we compared data collected using this task with data obtained using clinical scales such as the Unified Parkinson's Disease Rating Scale III (UPDRS part III) and Hoehn & Yahr's score. Results showed that the GMT had good consistency and inter-rater reproducibility, was closely related to clinical scales and was able to detect the amelioration of extrapyramidal symptoms at the end of the motor rehabilitation program. we propose the GMT as a tool for measuring impaired mobility in PD patients and for evaluating the objective effects of motor rehabilitation programs.

  20. Exercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programs.

    PubMed

    Fuchs, A R C N; Meneghelo, R S; Stefanini, E; De Paola, A V; Smanio, P E P; Mastrocolla, L E; Ferraz, A S; Buglia, S; Piegas, L S; Carvalho, A A C

    2009-03-01

    Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.

  1. Cost-effectiveness of two vocational rehabilitation programs for persons with severe mental illness.

    PubMed

    Dixon, Lisa; Hoch, Jeffrey S; Clark, Robin; Bebout, Richard; Drake, Robert; McHugo, Greg; Becker, Deborah

    2002-09-01

    This study sought to determine differences in the cost-effectiveness of two vocational programs: individual placement and support (IPS), in which employment specialists within a mental health center help patients obtain competitive jobs and provide them with ongoing support, and enhanced vocational rehabilitation (EVR), in which stepwise services that involve prevocational experiences are delivered by rehabilitation agencies. A total of 150 unemployed inner-city patients with severe mental disorders who expressed an interest in competitive employment were randomly assigned to IPS or EVR programs and were followed for 18 months. Wages from all forms of employment and the number of weeks and hours of competitive employment were tracked monthly. Estimates were made of direct mental health costs and vocational costs. Incremental cost-effectiveness ratios (ICERs) were calculated for competitive employment outcomes and total wages. No statistically significant differences were found in the overall costs of IPS and EVR. Participation in the IPS program was associated with significantly more hours and weeks of competitive employment. However, the average combined earnings-earnings from competitive and noncompetitive employment-were virtually the same both programs. The ICER estimates indicated that participants in the IPS program worked in competitive employment settings for an additional week over the 18-month period at a cost of $283 ($13 an hour). The analyses suggest that IPS participants engaged in competitive employment at a higher cost. When combined earnings were used as the outcome, data from the statistical analyses were insufficient to enable any firm conclusions to be drawn. The findings illustrate the importance of choice of outcomes in evaluations of employment programs.

  2. The Uniform Data System for Medical Rehabilitation Report of Patients with Traumatic Spinal Cord Injury Discharged from Rehabilitation Programs in 2002 – 2010

    PubMed Central

    Granger, Carl V.; Karmarkar, Amol M.; Graham, James E.; Deutsch, Anne; Niewczyk, Paulette; DiVita, Margaret A.; Ottenbacher, Kenneth J.

    2012-01-01

    Objective Provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation following a traumatic spinal cord injury. Design Analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation (UDSmr) during the period January 2002 through December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, pre-hospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, ICD-9 codes for admitting diagnosis, comorbidities), and functional status (FIM® instrument [“FIM”] ratings at admission and discharge, FIM efficiency, FIM gain). Results The final sample included 47,153 patients with traumatic spinal cord injury. Overall mean length of stay = 26.2 (±23.2) days: yearly means ranged from 29.7 (±25.4) in 2002 to 22.9 (±18.9) in 2009. FIM total admission and discharge ratings also declined over the 8-year study period: admission decreased from 60.5 (± 17.4) to 55.9 (±16.3); discharge decreased from 86.1 (±23.8) to 82.4 (±23.4). Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ±1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than persons who could walk (34.6 ±217.4 vs. 17.4 ±14.1 days) and also experienced less functional improvement (21.6 ±15.8 vs. 29.6 ±16.3 FIM points). Conclusions National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. Over seventy percent of patients were consistently discharged to community settings following inpatient

  3. Obesity treatment: results after 4 years of a Nutritional and Psycho-Physical Rehabilitation Program in an outpatient setting.

    PubMed

    Donini, Lorenzo M; Cuzzolaro, Massimo; Gnessi, Lucio; Lubrano, Carla; Migliaccio, Silvia; Aversa, Antonio; Pinto, Alessandro; Lenzi, Andrea

    2014-06-01

    Obesity is a chronic disease as well as a risk factor for cardiovascular, metabolic and osteoarticular diseases, affecting the psychosocial health and the quality of life. Recent evidence suggests that the adequate treatment of obesity should provide a multidimensional multidisciplinary approach including nutritional therapy, psycho-educational classes and physical reconditioning/motor rehabilitation. The aim of this approach should be to maintain the results over time with a positive impact on the obesity-related cardiovascular and metabolic risk. To evaluate the effectiveness of a multidisciplinary Nutritional and Psycho-Physical Reconditioning Program (NPPRP) in an outpatient setting. The observational prospective cohort study involved subjects, aged from 18 to 65 years, with a BMI >30 kg/m(2), who were followed up over 48 months. After the first nutritional and psychological examination, patients who refused NPPRP were treated according to standard nutrition procedures (SNT). Patients were followed through monthly medical examinations and then by annual telephonic structured interviews for 4 years. Changes in body weight, eating behavior, physical activity performance, and the occurrence of clinical obesity-related complications were considered as outcome measures. Of 464 enrolled patients, 161 (34.7%) took part in the follow-up. From the enrollment to the end of follow-up, weight loss was greater in the NPPRP group than in the SNP group (-8.08 ± 10 kg versus -3.0 ± 6 kg). After 4 years eating behavior improved in both groups. The percentage of patients who continued to perform physical activity was higher in the NPPRP group than in the SNT group (61.0 versus 34.1%). The SNT group reported complications more frequently than the NPPRP group: hypertension (19 versus 5.8%), dyslipidemia (19.4 versus 12.7%), and skeletal problems (26.9 versus 17.5%). The main reasons for drop-out from the rehabilitation program were logistic problems (distance or time) in both

  4. [Cardiac rehabilitation. Recent advances].

    PubMed

    Lellamo, Ferdinando; Volterrani, Maurizio

    2010-03-01

    Evidence derived from studies which support the relevance of exercise as a core component of cardiac rehabilitation programs are presented, along with the beneficial effects of exercise training in counteracting the mechanisms sustaining the atherosclerotic process and cardiovascular risk factors in the context of secundary, as well as primary, cardiovascular prevention. Practical guides to plan exercise training programs are also provided with suggestions for specific pathological conditions and advanced age. Recent advances on the benefits of exercise training in patients with heart failure are reported along with the potential of telemedicine for home rehabilitation aiming to a widespread diffusion of exercise as a cardiovascular therapy. Finally, the possible risks of exercise and practical open questions in cardiac rehabilitation are discussed.

  5. Effect of a Home-Based Exercise Program on Functional Recovery Following Rehabilitation After Hip Fracture A Randomized Clinical Trial

    PubMed Central

    Latham, Nancy K.; Harris, Bette Ann; Bean, Jonathan F.; Heeren, Timothy; Goodyear, Christine; Zawacki, Stacey; Heislein, Diane M.; Mustafa, Jabed; Pardasaney, Poonam; Giorgetti, Marie; Holt, Nicole; Goehring, Lori; Jette, Alan M.

    2015-01-01

    IMPORTANCE For many older people, long-term functional limitations persist after a hip fracture. The efficacy of a home exercise program with minimal supervision after formal hip fracture rehabilitation ends has not been established. OBJECTIVE To determine whether a home exercise program with minimal contact with a physical therapist improved function after formal hip fracture rehabilitation ended. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted from September 2008 to October 2012 in the homes of 232 functionally limited older adults who had completed traditional rehabilitation after a hip fracture. INTERVENTIONS The intervention group (n = 120) received functionally oriented exercises (such as standing from a chair, climbing a step) taught by a physical therapist and performed independently by the participants in their homes for 6 months. The attention control group (n = 112) received in-home and telephone-based cardiovascular nutrition education. MAIN OUTCOMES AND MEASURES Physical function assessed at baseline, 6 months (ie, at completion of the intervention), and 9 months by blinded assessors. The primary outcome was change in function at 6 months measured by the Short Physical Performance Battery (SPPB; range 0-12, higher score indicates better function) and the Activity Measure for Post-Acute Care (AM-PAC) mobility and daily activity (range, 23-85 and 9-101, higher score indicates better function). RESULTS Among the 232 randomized patients, 195 were followed up at 6 months and included in the primary analysis. The intervention group (n=100) showed significant improvement relative to the control group (n=95) in functional mobility (mean SPPB scores for intervention group: 6.2 [SD, 2.7] at baseline, 7.2 [SD, 3] at 6 months; control group: 6.0 [SD, 2.8] at baseline, 6.2 [SD, 3] at 6 months; and between-group differences: 0.8 [95% CI, 0.4 to 1.2], P < .001; mean AM-PAC mobility scores for intervention group: 56.2 [SD, 7.3] at baseline, 58

  6. Effect of a home-based exercise program on functional recovery following rehabilitation after hip fracture: a randomized clinical trial.

    PubMed

    Latham, Nancy K; Harris, Bette Ann; Bean, Jonathan F; Heeren, Timothy; Goodyear, Christine; Zawacki, Stacey; Heislein, Diane M; Mustafa, Jabed; Pardasaney, Poonam; Giorgetti, Marie; Holt, Nicole; Goehring, Lori; Jette, Alan M

    2014-02-19

    For many older people, long-term functional limitations persist after a hip fracture. The efficacy of a home exercise program with minimal supervision after formal hip fracture rehabilitation ends has not been established. To determine whether a home exercise program with minimal contact with a physical therapist improved function after formal hip fracture rehabilitation ended. Randomized clinical trial conducted from September 2008 to October 2012 in the homes of 232 functionally limited older adults who had completed traditional rehabilitation after a hip fracture. The intervention group (n = 120) received functionally oriented exercises (such as standing from a chair, climbing a step) taught by a physical therapist and performed independently by the participants in their homes for 6 months. The attention control group (n = 112) received in-home and telephone-based cardiovascular nutrition education. Physical function assessed at baseline, 6 months (ie, at completion of the intervention), and 9 months by blinded assessors. The primary outcome was change in function at 6 months measured by the Short Physical Performance Battery (SPPB; range 0-12, higher score indicates better function) and the Activity Measure for Post-Acute Care (AM-PAC) mobility and daily activity (range, 23-85 and 9-101, higher score indicates better function). Among the 232 randomized patients, 195 were followed up at 6 months and included in the primary analysis. The intervention group (n=100) showed significant improvement relative to the control group (n=95) in functional mobility (mean SPPB scores for intervention group: 6.2 [SD, 2.7] at baseline, 7.2 [SD, 3] at 6 months; control group: 6.0 [SD, 2.8] at baseline, 6.2 [SD, 3] at 6 months; and between-group differences: 0.8 [95% CI, 0.4 to 1.2], P < .001; mean AM-PAC mobility scores for intervention group: 56.2 [SD, 7.3] at baseline, 58.1 [SD, 7.9] at 6 months; control group: 56 [SD, 7.1] at baseline, 56.6 [SD, 8.1] at 6 months

  7. 78 FR 34901 - Final Priority; National Institute on Disability and Rehabilitation Research-Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Institute on Disability and Rehabilitation Research--Advanced Rehabilitation Research Training Program... priority for the Advanced Rehabilitation Research Training (ARRT) program under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and...

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

    PubMed

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

    2014-01-01

    To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return

  9. [Early interdisciplinary geriatric rehabilitation after hip fracture : Effective concept or just transfer of costs?].

    PubMed

    Lögters, T; Hakimi, M; Linhart, W; Kaiser, T; Briem, D; Rueger, J; Windolf, J

    2008-09-01

    Modern strategies for postoperative care of patients with hip fractures include early discharge from the acute care hospital to inpatient interdisciplinary rehabilitation facilities. Whether these programs are effective for the patients and improve their long-term outcomes or if they simply transfer costs, with a reduction of the inpatient days in the acute care hospital, is currently under discussion. This prospective study included 282 patients with hip fracture admitted to our trauma center were included into the prospective study. The mean patient age was 86+/-8 (65-110) years. All patients were treated operatively. After a mean of 12+/-9 days, the patients underwent inpatient interdisciplinary geriatric rehabilitation for a mean of 27+/-13 (4-103) days. The primary outcome measure was their activities of daily living (Barthel index) before, at the end of rehabilitation, and 1 year after trauma. In addition, patient-related variables were correlated with the Barthel index. With discharge from the acute care hospital, the Barthel index was 42+/-20 points and it increased during rehabilitation to 65+/-26 points. One year later the Barthel index was 67+/-28 points. Ninety percent of patients improved their Barthel index during rehabilitation. Within 1 year, 40% of patients deteriorated in their activities of daily living. Fifty one percent of patients were reintegrated back to their homes. Patients who lived at home before trauma and were reintegrated back to their homes had a significant higher Barthel index (75+/-24) 1 year after trauma than patients who were living in a nursing care facility before the trauma (Barthel index 52+/-27). The variables of age, level of cognition, and type of fracture had no influence on the long-term outcome. An extension of rehabilitation above the mean time period did not improve the sustainable clinical outcome. Postoperative inpatient rehabilitation programs enhance short-term activities of daily living. In particular, patients

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

    PubMed

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

    2012-11-01

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

  11. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

  12. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

  13. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

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

    PubMed

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

    2015-03-04

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

  15. Successful Geriatric Rehabilitation: Effects on Patients' Outcome of a National Program to Improve Quality of Care, the SINGER Study.

    PubMed

    Holstege, Marije S; Caljouw, Monique A A; Zekveld, Ineke G; van Balen, Romke; de Groot, Aafke J; van Haastregt, Jolanda C M; Schols, Jos M G A; Hertogh, Cees M P M; Gussekloo, Jacobijn; Achterberg, Wilco P

    2017-05-01

    To determine whether the implementation of a national program to improve quality of care in geriatric rehabilitation (GR) in the Netherlands improves successful GR in terms of independence in activities of daily living (ADL), discharge destination, and length of stay. Prospective longitudinal study, comparing 2 consecutive cohorts: at the start of implementation (n = 386) and at 1 year after implementation (n = 357) of this program. Included were 16 skilled nursing facilities, 743 patients (median age 80 years, interquartile range 72-85; 64.5% females) indicated for GR and their health care professionals (elderly care physicians, physiotherapists, and nursing staff). National program to stimulate self-organizing capacity to develop integrated care to improve GR service delivery in 4 domains: alignment with patients' (care) needs, care coordination, team cooperation, and quality of care. Data on patients' characteristics, functional outcomes at admission and discharge, length of stay, and discharge destination were collected via an online questionnaire sent to health care professionals. The primary outcome measure was successful rehabilitation defined as independence in ADL (Barthel Index ≥15), discharge home, and a short length of stay (lowest 25% per diagnostic group). Generalized estimating equation analysis was used to adjust for age, gender, and clustering effects in the total population and for the 2 largest diagnostic subgroups, traumatic injuries and stroke. In the total population, at 1 year postimplementation there was 12% more ADL independence [odds ratio (OR) 1.59, 95% confidence interval (CI) 1.00-2.54]. Although successful rehabilitation (independence in ADL, discharge home, short length of stay) was similar in the 2 cohorts, patients with traumatic injuries were more successful 1 year postimplementation (OR 1.61, 95% CI 1.01-2.54). In stroke patients, successful rehabilitation was similar between the cohorts, but with more independence in

  16. Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors.

    PubMed

    Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther; Thorne, Sally; Lomborg, Kirsten

    The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may be compromised by HCP attitudes and conduct. These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.

  17. Osteogenesis imperfecta: rehabilitation approach with infants and young children.

    PubMed

    Binder, H; Hawks, L; Graybill, G; Gerber, N L; Weintrob, J C

    1984-09-01

    A rehabilitation approach, consisting of initial handling and positioning followed by functional and formal strengthening exercises, was developed for the child with severe progressive osteogenesis imperfecta (OI). The program was developed because of the increased life expectancy for infants and children with severe progressive OI, combined with the lack of published reports dealing with their rehabilitation. The program can be followed easily by parents or therapists with regular monitoring by a psychiatrist. The goals are to improve the life span as well as the quality of life of these children by preventing the following: (1) positional contractures and deformities, (2) muscle weakness and osteoporosis, and (3) malalignment of the lower extremity joints prohibiting weight-bearing. Implementation of the program requires full cooperation of the parents. The initial results in four children between the ages of 3 and 11 years are encouraging. The benefits of increased strength and mobility leading to more age-appropriate activities and behaviors outweigh the only observed negative result, that is trauma-related lower extremity fractures in children with milder disease, and therefore greater mobility and higher activity levels.

  18. 78 FR 35009 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation... Education. ACTION: Notice. Overview Information National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering...

  19. [Guidelines for psychology activities in cardiologic rehabilitation and prevention].

    PubMed

    2003-09-01

    The purpose of these guidelines is to provide specific recommendations in regard to psychological activities in cardiac rehabilitation (CR). Based on scientific evidence and clinical experience, the present guidelines are targeted for psychologists working in the field of cardiac rehabilitation and for the core component of CR, as well as for the health care providers, insurers, policy makers and consumers. In the introduction, the framework of Italian cardiac rehabilitation and psychology as well as the methodology used are defined, in accordance with the recommendations of the National Guidelines Programme of the Italian Health Ministry. The first section illustrates the educational training and structural requirements necessary for psychologists intending to work in cardiac rehabilitation, and provides a summary of the principal models of organization. Section two describes the sequence of psychological activities based on the different phases of the process of care. The chapters devoted to selection and admission of cardiac patients define the clinical conditions for which patients should be referred to the psychologist and describe the models for the first "patient-psychologist" contact. The chapter dedicated to evaluation, which aims to identify the care needs of the patient describes the instruments available to the psychologist (interview, screening tests, clinical assessment tests, quality-of-life tests) and the areas of investigation in cardiac diseases patients. The chapter on intervention analyses the different tools including educational interventions, counselling, stress management and psychotherapy evidenced by the literature and common to the different cardiac pathologies. In the chapter on follow-up, are described tools for evaluation of patient satisfaction and for planning long-term care. Section three describes the psychological characterization and the specificity of psychological interventions in different cardiac patients populations

  20. How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR's Rehabilitation Engineering Research Centers.

    PubMed

    Reinkensmeyer, David J; Blackstone, Sarah; Bodine, Cathy; Brabyn, John; Brienza, David; Caves, Kevin; DeRuyter, Frank; Durfee, Edmund; Fatone, Stefania; Fernie, Geoff; Gard, Steven; Karg, Patricia; Kuiken, Todd A; Harris, Gerald F; Jones, Mike; Li, Yue; Maisel, Jordana; McCue, Michael; Meade, Michelle A; Mitchell, Helena; Mitzner, Tracy L; Patton, James L; Requejo, Philip S; Rimmer, James H; Rogers, Wendy A; Zev Rymer, W; Sanford, Jon A; Schneider, Lawrence; Sliker, Levin; Sprigle, Stephen; Steinfeld, Aaron; Steinfeld, Edward; Vanderheiden, Gregg; Winstein, Carolee; Zhang, Li-Qun; Corfman, Thomas

    2017-11-06

    Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a "total approach to rehabilitation", combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970's, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet

  1. A rehabilitation program based on music practice for patients with unilateral spatial neglect: a single-case study.

    PubMed

    Guilbert, Alma; Clément, Sylvain; Moroni, Christine

    2017-02-01

    Two major limitations of unilateral spatial neglect (USN) rehabilitation methods are actually reported: a lack of long-term efficiency and a lack of generalization to daily life. The aim of our case study was to underline how a multisensory method-music practice-could avoid these limitations. Mrs BV suffered from a chronic severe USN. She had rehabilitation sessions of music practice over 8 weeks. An improvement of her USN was found on paper-pencil tests but also in daily activities. Benefits subsisted 4 months after rehabilitation. Music practice seemed to avoid the major limitations of USN rehabilitations and could represent a promising tool.

  2. Rehabilitation and future participation of youth following spinal cord injury: caregiver perspectives.

    PubMed

    House, L A; Russell, H F; Kelly, E H; Gerson, A; Vogel, L C

    2009-12-01

    Cross-sectional survey. To examine caregivers' perspectives on the effectiveness of rehabilitative support experienced by youth with spinal cord injury (SCI) during acute rehabilitation and after community reintegration in terms of their community participation. Data collection took place at the three Shriners SCI hospitals: Chicago, Philadelphia, and Northern California. A total of 132 primary caregivers of youth with SCI completed a survey on what their child had experienced during and after rehabilitation to enhance their community participation. Caregivers found technical support from staff (41%), motivation and encouragement from staff (25%), and education (17%) to be the most important factors during rehabilitation for encouraging their child's future participation in school or community activities. Caregivers found involvement in activities (30%), personal resilience (22%) and interactions with others with disabilities (13%) to be important experiences since rehabilitation in terms of their child's participation in school and community activities. Caregivers who responded that something they experienced during rehabilitation was helpful to participation had children who had been injured longer and who were older at time of injury. In addition, caregivers who reported that something they have experienced since their child's rehabilitation has been helpful in terms of participation also had children who were older at time of injury. Findings from this study can be used to help professionals tailor rehabilitation programs to better meet the needs of youth with SCI and their families, thereby increasing chances of successful reintegration back into their communities.

  3. Features extraction of EMG signal using time domain analysis for arm rehabilitation device

    NASA Astrophysics Data System (ADS)

    Jali, Mohd Hafiz; Ibrahim, Iffah Masturah; Sulaima, Mohamad Fani; Bukhari, W. M.; Izzuddin, Tarmizi Ahmad; Nasir, Mohamad Na'im

    2015-05-01

    Rehabilitation device is used as an exoskeleton for people who had failure of their limb. Arm rehabilitation device may help the rehab program whom suffers from arm disability. The device that is used to facilitate the tasks of the program should improve the electrical activity in the motor unit and minimize the mental effort of the user. Electromyography (EMG) is the techniques to analyze the presence of electrical activity in musculoskeletal systems. The electrical activity in muscles of disable person is failed to contract the muscle for movements. In order to prevent the muscles from paralysis becomes spasticity, the force of movements should minimize the mental efforts. Therefore, the rehabilitation device should analyze the surface EMG signal of normal people that can be implemented to the device. The signal is collected according to procedure of surface electromyography for non-invasive assessment of muscles (SENIAM). The EMG signal is implemented to set the movements' pattern of the arm rehabilitation device. The filtered EMG signal was extracted for features of Standard Deviation (STD), Mean Absolute Value (MAV) and Root Mean Square (RMS) in time-domain. The extraction of EMG data is important to have the reduced vector in the signal features with less of error. In order to determine the best features for any movements, several trials of extraction methods are used by determining the features with less of errors. The accurate features can be use for future works of rehabilitation control in real-time.

  4. 24 CFR 572.100 - Acquisition and rehabilitation of eligible properties; rehabilitation standards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES HOPE FOR HOMEOWNERSHIP OF SINGLE FAMILY HOMES PROGRAM (HOPE 3) Homeownership Program Requirements-Implementation Grants... are unsuitable for the HOPE 3 program. (3) Rehabilitation costs must comply with the cost standards...

  5. Effectiveness of Multidimensional Cancer Survivor Rehabilitation and Cost-Effectiveness of Cancer Rehabilitation in General: A Systematic Review

    PubMed Central

    Mewes, Janne C.; IJzerman, Maarten J.; van Harten, Wim H.

    2012-01-01

    Introduction. Many cancer survivors suffer from a combination of disease- and treatment-related morbidities and complaints after primary treatment. There is a growing evidence base for the effectiveness of monodimensional rehabilitation interventions; in practice, however, patients often participate in multidimensional programs. This study systematically reviews evidence regarding effectiveness of multidimensional rehabilitation programs for cancer survivors and cost-effectiveness of cancer rehabilitation in general. Methods. The published literature was systematically reviewed. Data were extracted using standardized forms and were summarized narratively. Results. Sixteen effectiveness and six cost-effectiveness studies were included. Multidimensional rehabilitation programs were found to be effective, but not more effective than monodimensional interventions, and not on all outcome measures. Effect sizes for quality of life were in the range of −0.12 (95% confidence interval [CI], −0.45–0.20) to 0.98 (95% CI, 0.69–1.29). Incremental cost-effectiveness ratios ranged from −€16,976, indicating cost savings, to €11,057 per quality-adjusted life year. Conclusions. The evidence for multidimensional interventions and the economic impact of rehabilitation studies is scarce and dominated by breast cancer studies. Studies published so far report statistically significant benefits for multidimensional interventions over usual care, most notably for the outcomes fatigue and physical functioning. An additional benefit of multidimensional over monodimensional rehabilitation was not found, but this was also sparsely reported on. Available economic evaluations assessed very different rehabilitation interventions. Yet, despite low comparability, all showed favorable cost-effectiveness ratios. Future studies should focus their designs on the comparative effectiveness and cost-effectiveness of multidimensional programs. PMID:22982580

  6. Structures, processes and outcomes of the Aussie Heart Guide Program: A nurse mentor supported, home based cardiac rehabilitation program for rural patients with acute coronary syndrome.

    PubMed

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2018-03-01

    Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program. This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program. Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery. Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with

  7. Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences.

    PubMed

    Flick, C L

    1999-05-01

    This self-directed learning module highlights recent research in assessment of stroke outcomes and management of the psychosocial consequences of stroke. It is a part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses predictive factors for mortality and functional recovery; proposed case mix adjustment and prospective payment systems for stroke rehabilitation; continuum of care and utilization of acute, nursing home, outpatient and home health rehabilitation programs; reintegration and socialization after stroke; vocational rehabilitation of stroke patients; and management of the psychosocial effects of stroke on patients and families.

  8. Neuropsychiatric rehabilitation for persistent mental illness.

    PubMed

    Jaeger, J; Douglas, E

    1992-01-01

    The benefits of new knowledge on the psychobiology and neuropsychology of serious mental illnesses have been slow to impact on psychiatric rehabilitation technology. A literature review reveals that, at least in the case of schizophrenia, enough is known about neurobiological deficits and their impact on neurocognitive functioning to justify a more informed approach to psychiatric rehabilitation. Essential elements for a program of research are presented and preliminary data are reported examining the prevalence of executive deficits, correlations between neuropsychological deficits and social adjustment, and the nature of socially stigmatizing neuromotor deficits and their reliable assessment. In addition, early experience with the remediation of executive deficits is described and suggestions are made for future developments in this area. The authors conclude that barriers to the integration of knowledge from biological psychiatry and psychiatric rehabilitation have been largely related to academic "cultural" isolation, and that active cross fertilization of ideas is clearly justified by the present state of knowledge.

  9. Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program.

    PubMed

    Gouin, Marie-Michelle; Coutu, Marie-France; Durand, Marie-José

    2017-11-12

    Collective decision-making by stakeholders appears important to return-to-work success, yet few studies have explored the processes involved. This study aims to explore the influence of decision-making on return-to-work for workers with musculoskeletal or common mental disorders. This study is a secondary analysis using data from three earlier multiple-case studies that documented decision-making during similar and comparable work rehabilitation programs. Individual interviews were conducted at the end of the program with stakeholders, namely, the disabled workers and representatives of health care professionals, employers, unions and insurers. Verbatims were analysed inductively. The 28 decision-making processes (cases) led to 115 different decisions-making instances and included the following components: subjects of the decisions, stakeholders' concerns and powers, and types of decision-making. No differences were found in decision-making processes relative to the workers' diagnoses or return-to-work status. However, overall analysis of decision-making revealed that stakeholder agreement on a return-to-work goal and acceptance of an intervention plan in which the task demands aligned with the worker's capacities were essential for return-to-work success. These results support the possibility of return-to-work success despite conflictual decision-making processes. In addition to facilitating consensual decisions, future studies should be aimed at facilitating negotiated decisions. Implications for rehabilitation Facilitating decision-making, with the aim of obtaining agreement from all stakeholders on a return-to-work goal and their acceptance of an intervention plan that respects the worker's capacities, is important for return-to-work success. Rehabilitation professionals should constantly be on the lookout for potential conflicts, which may either complicate the reach of an agreement between the stakeholders or constrain return-to-work possibilities

  10. A novel virtual motor rehabilitation system for Guillain-Barré syndrome. Two single case studies.

    PubMed

    Albiol-Pérez, S; Forcano-García, M; Muñoz-Tomás, M T; Manzano-Fernández, P; Solsona-Hernández, S; Mashat, M A; Gil-Gómez, J A

    2015-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". For Guillain-Barré patients, motor rehabilitation programs are helpful at the onset to prevent the complications of paralysis and in cases of persistent motor impairment. Traditional motor rehabilitation programs may be tedious and monotonous, resulting in low adherence to the treatments. A Virtual Motor Rehabilitation system has been tested in Guillain-Barré patients to increase patient adherence and to improve clinical results. Two people with Guillain-Barré performed 20 rehabilitation sessions. We tested a novel system based on Motor Virtual Rehabilitation in three periods of time (baseline evaluation, final evaluation, and follow-up. In the training program, the participants carried out a specific treatment using the Active Balance Rehabilitation system (ABAR). The system is composed of customizable virtual games to perform static and dynamic balance rehabilitation. Significant improvements in clinical results were obtained by both participants, with significant results in the static balance clinical test of the Anterior Reach test in the standing position and unipedal stance time. Other significant results were found in dynamic balance clinical tests in the Berg Balance Scale test and the 30-second Sit-to-Stand test. With regard to acceptance of the system, both patients enjoyed the experience, and both patients thought that this system was helpful for their rehabilitation. The results show that Virtual Motor Rehabilitation for Guillain-Barré patients provides clinical improvements in an entertaining way.

  11. Evaluation of functional outcomes of physical rehabilitation and medical complications in spinal cord injury victims of the Sichuan earthquake.

    PubMed

    Li, Yongqiang; Reinhardt, Jan D; Gosney, James E; Zhang, Xia; Hu, Xiaorong; Chen, Sijing; Ding, Mingpu; Li, Jianan

    2012-06-01

    To characterize a spinal cord injury (SCI) population from the 2008 Sichuan earthquake in China; to evaluate functional outcomes of physical rehabilitation interventions; to assess potential determinants of rehabilitation effectiveness; and to assess medical complications and management outcomes. A total of 51 earthquake victims with SCI were enrolled and underwent rehabilitation programming. Functional rehabilitation outcomes included ambulation ability, wheelchair mobility and activities of daily living (ADL) assessed with the Modified Barthel Index at the beginning and end of rehabilitation. Effectiveness of rehabilitation and the effect of other predictors were evaluated by mixed effects regression. Outcomes of medical complication management were determined by comparison of the incidence of respective complications at the beginning and end of rehabilitation. Ambulation, wheelchair mobility and ADL were significantly improved with rehabilitation programming. Both earlier rescue and earlier onset of rehabilitation were significant positive predictors of rehabilitation effectiveness, whereas delayed onset of rehabilitation combined with prolonged time to rescue resulted in a lesser positive effect. Medical complications were managed effectively in 63% (pressure ulcers) to 85% (deep vein thrombosis) of patients during rehabilitation. Earthquake victims with SCI may achieve significantly improved functional rehabilitation functional outcomes on a formal, institutional-based physical rehabilitation programme.

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

    PubMed

    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.

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

    PubMed

    Lee, Chang Kwan

    2007-04-01

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

  14. Program Explanations: A Cooperative Effort between Special Education, Vocational Education, Vocational Rehabilitation, Eye Care Services.

    ERIC Educational Resources Information Center

    Maine State Dept. of Educational and Cultural Services, Augusta.

    Explanations are provided about Maine's special education, vocational education, vocational rehabilitation, and eye care programs and services, to assist teachers and counselors to understand better the mission, eligibility requirements, and service resources each brings to the planning process for students with handicaps. The guidelines were…

  15. Lower reinjury rate with a coach-controlled rehabilitation program in amateur male soccer: a randomized controlled trial.

    PubMed

    Hägglund, Martin; Waldén, Markus; Ekstrand, Jan

    2007-09-01

    Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury. The rate of reinjury is reduced using a coach-controlled rehabilitation program. Randomized controlled trial; Level of evidence, 1. Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups. There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16-0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11-0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%). The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.

  16. Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: a prospective randomized clinical study.

    PubMed

    Kim, Seung-Ho; Ha, Kwon-Ick; Jung, Min-Wook; Lim, Moon-Sup; Kim, Young-Min; Park, Jong-Hyuk

    2003-09-01

    Increased stress within a certain limit enhances ligament healing and improves joint function. In this prospective randomized clinical trial, we compared the clinical results of early motion versus conventional immobilization after arthroscopic Bankart repair in a selected patient population. Prospective randomized clinical trial. We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic recurrent anterior instability of the shoulder. Patients were randomized into 2 groups; group 1 (28 patients; mean age, 28 years) was managed with 3 weeks of immobilization using an abduction sling and conventional rehabilitation program, and group 2 (34 patients; mean age, 29 years) was managed with an accelerated rehabilitation program that consisted of staged range of motion and strengthening exercises from the immediate postoperative day. Selection criteria were nonathletes with recurrent anterior shoulder dislocation and a classic Bankart lesion with a robust labrum limited to 1 cm from the midglenoid notch. The patients were followed up for a mean of 31 months (range, 27 to 45 months; standard deviation, 9 months). Analysis of outcome included pain scores at 6 weeks and at final follow-up evaluation, range of motion, return to activity, recurrence rate, patient satisfaction with each rehabilitation program, and shoulder scores assessed by the American Shoulder and Elbow Surgeons Shoulder Index, the rating system of the University of California at Los Angeles, and another scoring system. The recurrence rate was not different between the 2 groups (P =.842). None of the groups developed recurrent dislocation. Two patients from each group were positive for anterior apprehension signs. Patients who underwent accelerated rehabilitation resumed functional range of motion faster (P <.001) and returned earlier to the functional level of activity (P <.001). Accelerated rehabilitation decreased postoperative pain (P =.013), and more patients were

  17. [Psychosocial rehabilitation at the dawn of the 21st century: II: Therapeutic or rehabilitative modalities and institutional disposition].

    PubMed

    Gasset, François; Orita, Alina; Spagnoli, Dany; Pomini, Valentino; Rabia, Sophie; Ducret, Michel; Veillon, Henri; Cucchia, Anne-Therèse

    2004-04-01

    The main goal of psychosocial rehabilitation is to compensate the vulnerability underlying psychiatric disorders through intermediate institutions when the persistence and recurrence of these disorders have led to social and professional exclusion. Intermediate institutions refer to services which allow transition between the state of dependence on the hospital to the state of relative autonomy in social community. Psychosocial rehabilitation is a comprehensive approach which link the type of interventions: treatment, rehabilitation and support integrated in multimodal and individualized programs. A study of the out-patients followed by the rehabilitation unit of the psychiatric department in Lausanne has shown that provision of services is divided into 60% for rehabilitation, 20% for treatment and 20% for support independently of the psychiatric disorders. The implementation of these programs necessitates institutional support from psychiatric hospital to outpatient clinics through different types of facilities in order to offer a medical and psychosocial device of rehabilitation into the community.

  18. Medical Rehabilitation in Natural Disasters: A Review.

    PubMed

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

    2015-09-01

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

  19. Short time sports exercise boosts motor imagery patterns: implications of mental practice in rehabilitation programs

    PubMed Central

    Wriessnegger, Selina C.; Steyrl, David; Koschutnig, Karl; Müller-Putz, Gernot R.

    2014-01-01

    Motor imagery (MI) is a commonly used paradigm for the study of motor learning or cognitive aspects of action control. The rationale for using MI training to promote the relearning of motor function arises from research on the functional correlates that MI shares with the execution of physical movements. While most of the previous studies investigating MI were based on simple movements in the present study a more attractive mental practice was used to investigate cortical activation during MI. We measured cerebral responses with functional magnetic resonance imaging (fMRI) in twenty three healthy volunteers as they imagined playing soccer or tennis before and after a short physical sports exercise. Our results demonstrated that only 10 min of training are enough to boost MI patterns in motor related brain regions including premotor cortex and supplementary motor area (SMA) but also fronto-parietal and subcortical structures. This supports previous findings that MI has beneficial effects especially in combination with motor execution when used in motor rehabilitation or motor learning processes. We conclude that sports MI combined with an interactive game environment could be a promising additional tool in future rehabilitation programs aiming to improve upper or lower limb functions or support neuroplasticity. PMID:25071505

  20. A Survey of Military Counseling Content and Curriculum among Council on Rehabilitation Education- and Council for Accreditation of Counseling and Related Educational Programs-Accredited Programs

    ERIC Educational Resources Information Center

    Stebnicki, Mark A.; Clemmons-James, Dominiquie; Leierer, Stephen

    2017-01-01

    Purpose: To determine the amount, frequency, and type of course content related to military counseling issues in Council on Rehabilitation Education (CORE)- and Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited master's-level counselor education programs. Methods: A questionnaire was sent to all CORE- and…

  1. What Works in Israeli Prison-Based Sex Offender Rehabilitation Programs: Program Participants' Perspective.

    PubMed

    Geiger, Brenda; Fischer, Michael

    2017-09-01

    This study invited 10 of the 22 sex offenders enrolled in a prison-based rehabilitation program in one of the prisons in Israel to engage in the two first of the 4-D ( Discover, Dream, Design, and Deliver) stages of the Appreciative Inquiry . Consistent with the responsivity principle, and the IA tenets, program participants were interviewed to Discover components to which they were responsive and Dream/envision additional ones that would increase engagement and progress. Content analysis of the interviews indicated that despite the initial decision to enrol based on external incentives, participants eventually engaged in group therapy and expressed the desire to understand and regulate their sexual behaviour. While the the modules of Cognitive Behabioral Group Therapy (CBT) were viewed as assets, the lack of sufficient recruitment criteria, the large therapy group size, and its open-ended structure were mentioned as impediments reaching therapeutic goals. Social workers/therapists were criticized for their request that they be informers, and for their accusative therapeutic style whenever sexual issues were broached. Recommendations derived from the offenders' narrative were to increase staff professionalism to create a therapeutic alliance that promotes trust and open communication. Criminal justice practitioners may then take up the challenge of the never-ending process of Appreciative Inquiry to Design and Deliver program components envisioned by the participants to increase participants' responsivity to the program and thus its effectiveness.

  2. Patients' perceptions of their roles in goal setting in a spinal cord injury regional rehabilitation program.

    PubMed

    Draaistra, Harriett; Singh, Mina D; Ireland, Sandra; Harper, Theresa

    2012-01-01

    Goal setting is a common practice in rehabilitation, yet there is a paucity of literature exploring patients' perceptions of their roles in this process. This study was conducted using a qualitative descriptive methodology to explore patients' perceptions of their roles in setting goals in a spinal cord injury regional rehabilitation program. Imogene King's theory of goal attainment was used to frame the study. Data were collected through interviews and analyzed using a content analysis. The results revealed four themes: Visioning, Redefining, Brainstorming, and Rebuilding Participants (n = 13) envisioned their roles as setting an overarching priority goal, defining detailed rehabilitation goals, sharing knowledge with the team, and rebuilding skills to attain goals. Implications for nursing practice include the need to understand patients' experiences and perceptions, share knowledge, and support effective communication to promote collaborative goal setting. A need to enhance health professionals' education to fully understand factors influencing patients' abilities to set rehabilitation goals, and future research in methods to promote patients' engagement in goal setting was also clearly indicated.

  3. Counselor Active Rehabilitation Service and the Reduction of Hopelessness in Individuals with Substance Abuse Disorders

    ERIC Educational Resources Information Center

    Ferdinandi, Andrew D.; Bethea, James S.

    2006-01-01

    The purpose of this quantitative study was to investigate the effect of Counselor Active Rehabilitation Service (CARS), compared to standard rehabilitation counseling in reducing feelings of hopelessness in individuals with substance abuse disorders. This study involved 50 inner city participants with substance abuse disorders. As determined using…

  4. Benefits of Comprehensive Rehabilitation Therapy in Thymectomy for Myasthenia Gravis: A Propensity Score Matching Analysis.

    PubMed

    Ambrogi, Vincenzo; Mineo, Tommaso Claudio

    2017-02-01

    To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching. All patients but 2 were able to complete the intended program. Eighteen patients (41%) experienced mild fatigue (>25 at MG quantitative score). Propensity score selected a group of 17 patients for the matching process. The group of patients who underwent the rehabilitation program showed significant preoperative improvement associated with a reduced operative risk, a decreased early postoperative morbidity, a lower rate of postoperative intensive care unit needed (12% vs 35%; P = 0.01) and a shorter hospital stay (3 vs 5 days; P = 0.04). After the expected perioperative decline, all major myasthenic outcomes demonstrated a significant faster recovery at 3 months. Complete stable remission did not reveal significant differences. Exercise is not necessarily a contraindication in MG, and rehabilitation can be safely performed before and after thymectomy, reducing operative risks and decreasing recovery time. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME OBJECTIVES: Upon completion of this article, the reader should be able to do the following: (1) appreciate the benefits of physical therapy in individuals with myasthenia gravis; (2) describe the benefits of physical therapy on postoperative morbidity in myasthenia gravis patients who undergo thymectomy; and (3) incorporate appropriate rehabilitation into the treatment plan of patient with myasthenia gravis. AdvancedACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation

  5. Cognitive rehabilitation for patients with schizophrenia in Korea.

    PubMed

    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.

  6. Rehabilitation in the Punitive Era: The Gap between Rhetoric and Reality in U.S. Prison Programs

    PubMed Central

    Phelps, Michelle S.

    2013-01-01

    Scholars of mass incarceration point to the 1970s as a pivotal turning point in U.S. penal history, marked by a shift towards more punitive policies and a consensus that “nothing works” in rehabilitating inmates. However, while there has been extensive research on changes in policy-makers’ rhetoric, sentencing policy, and incarceration rates, we know very little about changes in the actual practices of punishment and prisoner rehabilitation. Using nationally representative data for U.S. state prisons, this article demonstrates that there were no major changes in investments in specialized facilities, funding for inmate services-related staff, or program participation rates throughout the late 1970s and the 1980s. Not until the 1990s, more than a decade after the start of the punitive era, do we see patterns of inmate services change, as investments in programming switch from academic to reentry-related programs. These findings suggest that there is a large gap between rhetoric and reality in the case of inmate services and that since the 1990s, inmate “rehabilitation” has increasingly become equated with reentry-related life skills programs. PMID:24014890

  7. A Contest without a Loser: the Development of the Navy’s Alcohol Rehabilitation Program.

    DTIC Science & Technology

    1981-06-01

    entire HRM Program could have been cost supported on the success of the Alcohol Rehabilitation Program alone. More importantly, these figures were...later the startling results were that the use of alcohol led to 25,000 automobile related deaths and at least 800,000 automobile collisions in this...treatment of automobile accident cases, spouse or child abuse, chronic illness, etc. It was necessary to gain the support of the Medical Department to

  8. "The Whole Is Greater Than the Sum of the Parts": Prison Staff Perceptions of Domestic Violence Rehabilitation Programs.

    PubMed

    Shoham, Efrat; Zelig, Anat; Hasisi, Badi; Weisburd, David; Haviv, Noam

    2017-11-01

    This qualitative study is part of a mixed methods research project that examined the effectiveness of the primary rehabilitation program for domestic violence offenders in the Israeli Prison Services-the "House of Hope." The quantitative part of the study showed that the "House of Hope" program was effective in reducing recidivism among participating inmates. The purpose of this qualitative study was to describe the rehabilitation program according to the perspectives of the program staff. For this purpose, semistructured interviews were conducted with the department staff during the study as well as with past directors. The qualitative findings suggested that the success of the program probably stemmed from a synergistic combination of several components, for example, identifying the characteristics of domestic violence offenders and adjusting treatment programs to their needs, along with exposure to psychological treatment in varied therapies (cognitive behavioral therapy, psychoeducational, and psychodynamic) and formats (group therapy and individual therapy) during a 1-year stay in a hierarchical therapeutic community. Other components mentioned are staff professionalism, stability, and the program's location in a therapeutic-oriented prison that is architecturally designed and built to create a less stressful environment for the inmates and the staff.

  9. [Clinical application of functional near-infrared spectroscopy in rehabilitation medicine].

    PubMed

    Mihara, Masahito; Yagura, Hajime; Hatakenaka, Megumi; Hattori, Noriaki; Miyai, Ichiro

    2010-02-01

    Functional near-infrared spectroscopy (fNIRS) is an effective tool to non-invasively investigate cerebral oxygenation and hemodynamics. fNIRS as well as other functional neuroimaging techniques including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have been used for investigating the neural mechanisms of functional recovery after a stroke or a traumatic brain injury. fNIRS has several advantages over other neuroimaging techniques in terms of clinical application in the field of rehabilitation medicine. In addition to its portability and low equipment cost, fNIRS does not require strict motion restriction during measurement, unlike other functional imaging techniques. Therefore, this technique enables the examination of cortical activation during physically dynamic activities, like gait or balance perturbation. Studies using fNIRS have revealed several implications for gait recovery after stroke. These studies have shown that the medial sensorimotor cortex (SMC) and the supplementary motor area (SMA) are mainly involved in steadying gait and that the prefrontal cortex (PFC) is involved in the adjustment of walking speed. In hemiparetic patients, lateralization of SMC activation during gait is reduced, and additional cortical activations in the premotor cortex and PFC during gait became evident after focused rehabilitation for several months. The cortical activation pattern may be modified after different types of rehabilitative interventions. These results imply that fNIRS data is a potential biomarker for functional recovery and the response to rehabilitative interventions. Although further studies are required, fNIRS might provide useful information for customizing rehabilitation programs in order to enhance functional recovery.

  10. Effects of a home-based physical rehabilitation program on physical disability after hip fracture: a randomized controlled trial.

    PubMed

    Edgren, Johanna; Salpakoski, Anu; Sihvonen, Sanna E; Portegijs, Erja; Kallinen, Mauri; Arkela, Marja; Jäntti, Pirkko; Vanhatalo, Jukka; Pekkonen, Mika; Rantanen, Taina; Heinonen, Ari; Sipilä, Sarianna

    2015-04-01

    Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Randomized, controlled, parallel-group trial. Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. The year-long intervention aimed at restoring mobility. It included evaluation and modification of environmental hazards, guidance for safe walking, pain management, home exercise, physical activity counseling, and standard care. Physical disability was assessed by a questionnaire at baseline, and 3, 6, and 12 months thereafter. Sum scores were computed for basic (ADLs) and instrumental activities of daily living (IADLs). A higher score indicated more difficulty. GEE models were constructed to analyze the effect of the intervention. In the intention-to-treat analysis, no intervention effect was observed for sum scores. For the single disability items, borderline significant positive effects were observed for preparing food and handling medication (interaction P = .061 and P = .061, respectively). In the per-protocol analysis, the mean differences between groups were -0.4 points (SE 0.5), -1.7 (0.7), and -1.2 (0.7) at 3, 6, and 12 months for ADLs and -1.0 (1.2), -3.2 (1.5), and -2.5 (1.4) for IADLs, correspondingly. The current analyses suggest that home-based rehabilitation may reduce disability among older people after hip fracture. The present results need to be confirmed in a study with larger sample size. Potentially a more task-oriented rehabilitation approach might gain more benefits. Current Controlled Trials (ISRCTN53680197). Copyright © 2015 AMDA

  11. In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation.

    PubMed

    Ruivo, Jorge Manuel Arsénio Dos Santos; Karim, Kay; OʼShea, Roisin; Oliveira, Rosa Celeste Santos; Keary, Louis; OʼBrien, Claire; Gormley, John Patrick

    2017-07-01

    The application of active video games (AVGs) during cardiac rehabilitation (CR) sessions could potentially facilitate patient adherence. The feasibility, safety, and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated. A pilot, evaluator-blinded, intention-to-treat, randomized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise. Both groups experienced equal exercise loads for 6 weeks. Patients were assessed at baseline, end of the program, and after an 8-week followup. Adherence and safety-related outcomes were the primary endpoints. Secondary outcomes included change in exercise capacity, daily physical activity (PA), energy expenditure (EE), and psychometric profiling. Patients (males 81%; 60 ± 10 years) presented with typical cardiovascular risk factors and similar baseline characteristics. Participants did not perceive an increased risk of injury and were more interactive. At the end of the program, there was a lower tendency for dropping out (6% vs 19%, P > .05), a significant improvement in PA (322 vs 247 arbitrary acceleration units/min, P = .047) and related EE per body weight (13 vs 11 kcal/kg/d, P = .04) among AVG participants compared with controls. No significant differences between groups for adverse medical events, exercise capacity, affect toward exercise, anxiety, depression, or quality-of-life changes were reported. The additional use of AVGs during CR sessions is feasible, safe, and significantly improved daily PA and EE. A dropout reduction trend among its users, which needs to be confirmed in a larger trial, raises awareness to AVG supplementation as a promising strategy to increase CR adherence.

  12. Attitude toward the out-patient cardiac rehabilitation program and facilitators for maintenance of exercise behavior.

    PubMed

    Wong, Eliza M L; Zhong, Xue Bing; Sit, Janet W H; Chair, Sek Ying; Leung, Doris Y P; Leung, Carmen; Leung, K C

    2016-09-01

    This study examined the attitudes of Chinese patients with coronary heart disease (CHD) toward the outpatient cardiac rehabilitation program (OCRP), as well as their exercise behavior, intention, maintenance and related factors. A qualitative descriptive study design was used, and 22 CHD patients were recruited in Hong Kong in 2014. In-depth interviews and content analyses were conducted. The tripartite model of attitudes was adopted as research framework. Two themes were identified: (1) informant attitude (perception, affection, and practice) toward the OCRP and (2) Exercise Behavior - intention, maintenance and its related factors. Most informants showed positive perception and affection regarding the outpatient rehabilitation program, leading to regular practice of exercise in the program and at home. Peer, group dynamic, social support and Chinese culture influences on exercise behavior may serve as major facilitators to maintain exercise behavior. Positive attitude toward the OCRP enhanced the participation rate, whereas peer and social support from the family and workplace were useful to improve the maintenance of exercise behavior. Overall, this study provides insights into strategic planning for the OCRP and continual support for CHD patients in the community.

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

    PubMed

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

    2017-07-01

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

  14. 75 FR 21282 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

  15. 75 FR 2119 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

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

    PubMed

    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.

  17. Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program.

    PubMed

    Jacob, Alexandra; Kaelin, Darryl; Roach, Abbey; Ziegler, Craig; LaFaver, Kathrin

    2018-05-18

    Functional movement disorders (FMDs) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurologic practice, and prognosis is often poor. No consensus treatment guidelines have been established; however, the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. To assess outcomes of FMD patients undergoing a multidisciplinary treatment program and determine factors predictive of treatment success. Retrospective chart review. University-affiliated rehabilitation institute. Thirty-two consecutive FMD patients admitted to the MoRe program from July 2014-July 2016. Patients participated in a 1-week, multidisciplinary inpatient treatment program with daily physical, occupational, speech therapy, and psychotherapy interventions. Primary outcome measures were changes in the patient-rated Clinical Global Impression Scale (CGI) and the physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS) based on review of standardized patient videos. Measurements were taken as part of the clinical evaluation of the program. Twenty-four of the 32 patients were female with a mean age of 49.1 (±14.2) years and mean symptom duration of 7.4 (±10.8) years. Most common movement phenomenologies were abnormal gait (31.2%), hyperkinetic movements (31.2%), and dystonia (31.2%). At discharge, 86.7% of patients reported symptom improvement on the CGI, and self-reported improvement was maintained in 69.2% at the 6-month follow-up. PMDRS scores improved by 59.1% from baseline to discharge. Longer duration of symptoms, history of abuse, and comorbid psychiatric disorders were not significant predictors of treatment outcomes. The majority of FMD patients experienced improvement from a 1-week multidisciplinary inpatient rehabilitation program. Treatment outcomes

  18. Sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy: a qualitative focus group interview study.

    PubMed

    Rise, Marit B; Gismervik, Sigmund Ø; Johnsen, Roar; Fimland, Marius S

    2015-11-27

    Occupational medicine has shifted emphasis from disease treatment to disability rehabilitation and management. Hence, newly developed occupational rehabilitation programs are often generic and multicomponent, aiming to influence the sick-listed persons' perception on return to work, and thereby support the return to work process. The aim of this study was to explore sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy. Twenty-nine adults on sickness benefit or work assessment allowance due to musculoskeletal and/or common mental health disorders participated in this study. They were interviewed in focus groups at the beginning and at the end of a 3.5 week inpatient group-based occupational rehabilitation program in Central Norway. Key elements in the program were Acceptance and Commitment Therapy (ACT), physical exercise and creating a work-participation plan. The program was mainly group-based including participants with different diagnoses. Data was analyzed according to a phenomenological approach. At the start of the program most participants expressed frustration regarding being sick-listed, external anticipations as well as hindrances towards returning to work, and described hope that the program would provide them with the skills and techniques necessary to cope with health problems and being able to return to work. At the end of the program the participants described that they had embarked upon a long process of increased awareness. This process encompassed four areas; an increased awareness of what was important in life, realizing the strain from external expectations and demands, a need to balance different aspects of life, and return to work as part of a long and complex process. The occupational rehabilitation program induced a perceived meaningful reorientation encompassing several aspects of life. However, the return to work process was described as diffuse

  19. Inpatient or Outpatient Rehabilitation after Herniated Disc Surgery? – Setting-Specific Preferences, Participation and Outcome of Rehabilitation

    PubMed Central

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

    2014-01-01

    Objective To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. Methods The longitudinal observational study referred to 534 consecutive disc surgery patients (18–55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. Results The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). Conclusion The results suggest a “pre-selection” of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and

  20. Effectiveness of a family-oriented rehabilitation program on the quality of life of parents of chronically ill children.

    PubMed

    West, C A; Besier, T; Borth-Bruhns, T; Goldbeck, L

    2009-01-01

    Parents of chronically ill children face numerous burdens in daily life, which can impair their quality of life (QoL) significantly. Therefore in family-oriented rehabilitation, not only the children themselves, but also their parents receive interventions. These aim at stabilizing parents both mentally and physically to enable them to support their children in the best possible way. This study investigates the effects of an inpatient family-oriented rehabilitation program on the QoL of parents of chronically ill children. A consecutive sample of 231 mothers and 155 fathers of children suffering from cancer, cardiac diseases or cystic fibrosis participated in the study. In a prospective longitudinal study, parental QoL was repeatedly assessed using the Ulm Quality of Life Inventory for Parents (ULQIE) at three different time points: admission to the rehabilitation clinic, discharge after four weeks of inpatient treatment, and at a six-month follow-up. Parental QoL increased markedly during rehabilitation treatment (mothers eta (2)=.326, fathers eta (2)=.249). Moreover, six months after the intervention, parental quality of life was still markedly improved compared to baseline assessment (mothers eta (2)=.259, fathers eta (2)=.069). The child's diagnosis had no effect on the level and course of parental QoL. Taking part in family-oriented rehabilitation can improve the QoL of parents of children suffering from cancer, cardiac diseases or cystic fibrosis. Such programs could be expected to affect the way chronically ill children cope with their condition and this should be examined in future studies.

  1. 75 FR 21278 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... Disability and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

  2. 78 FR 69398 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving... Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Minority... the capacity of minority entities to conduct high-quality disability and rehabilitation research by...

  3. [The investigation into dynamics of depression level and the quality of life in the patients after myocardial infarction under the influence of the program of physical rehabilitation].

    PubMed

    Belikova, N A; Indyka, S Ya

    2016-01-01

    The evaluation of the psychological condition of the patients who survived myocardial infarction and its correction taking into consideration the peculiar features of the individual reaction to the disease are the indispensable components of physical rehabilitation. The present article was designed to report the results of the study on the influence of the authors' physical rehabilitation program on the prevalence of depression and the life quality characteristics of the patients treated after myocardial infarction during the follow-up period. The patients of the main group (n=30) were enrolled in the original physical rehabilitation program. Those comprising the group of comparison (n=30) were given a course of rehabilitation in accordance with the scheme that had been recommended by the leading scientists and generally accepted in the Ukraine for the patients recovering after myocardial infarction under conditions of the out-patient clinics, spa and health resort facilities or convalescent centers. The study has demonstrated that the patients of both groups exhibited positive dynamics of their clinical condition (e.g. the decrease in the number of depressed subjects); however, this tendency was more pronounced in the main group where the number of the patients experiencing depression decreased by 61% at the end of the observation period (р<0,05). The analysis of the causes of anxiety associated with this pathology in the individual patients has demonstrated that the main factors responsible for the deterioration of the quality of life were the necessity of treatment, the limitations on the everyday physical activity, and the feeling of emotional tension. Moreover, the positive dynamics of the characteristics being evaluated was documented in the patients of the main group which gives reason to conclude that the program of physical rehabilitation proposed by the authors for the treatment of the patients after myocardial infarction is highly efficient during the

  4. Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery: Data From the Clinical Outcomes Assessment Program.

    PubMed

    Beatty, Alexis L; Bradley, Steven M; Maynard, Charles; McCabe, James M

    2017-06-01

    Despite guideline recommendations that patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass surgery, or valve surgery be referred to cardiac rehabilitation, cardiac rehabilitation is underused. The objective of this study was to examine hospital-level variation in cardiac rehabilitation referral after PCI, coronary artery bypass surgery, and valve surgery. We analyzed data from the Clinical Outcomes Assessment Program, a registry of all nonfederal hospitals performing PCI and cardiac surgery in Washington State. We included eligible PCI, coronary artery bypass surgery, and valve surgery patients from 2010 to 2015. We analyzed PCI and cardiac surgery separately by performing multivariable hierarchical logistic regression for the outcome of cardiac rehabilitation referral at discharge, clustered by hospital. Patient-level covariates included age, sex, race/ethnicity, comorbidities, and procedure indication/status. Cardiac rehabilitation referral was reported in 48% (34 047/71 556) of PCI patients and 91% (21 831/23 972) of cardiac surgery patients. The hospital performing the procedure was a stronger predictor of referral than any individual patient characteristic for PCI (hospital referral range 3%-97%; median odds ratio, 5.94; 95% confidence interval, 4.10-9.49) and cardiac surgery (range 54%-100%; median odds ratio, 7.09; 95% confidence interval, 3.79-17.80). Hospitals having an outpatient cardiac rehabilitation program explained only 10% of PCI variation and 0% of cardiac surgery variation. Cardiac rehabilitation referral at discharge was less prevalent after PCI than cardiac surgery. The strongest predictor of cardiac rehabilitation referral was the hospital performing the procedure. Efforts to improve cardiac rehabilitation referral should focus on increasing referral after PCI, especially in low referral hospitals. © 2017 American Heart Association, Inc.

  5. 75 FR 27741 - National Institute on Disability and Rehabilitation Research (NIDRR); Disability and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR); Disability and Rehabilitation Research Projects and Centers Program; Rehabilitation Research and Training... Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this notice announces a...

  6. COPD online-rehabilitation versus conventional COPD rehabilitation - rationale and design for a multicenter randomized controlled trial study protocol (CORe trial).

    PubMed

    Hansen, Henrik; Bieler, Theresa; Beyer, Nina; Godtfredsen, Nina; Kallemose, Thomas; Frølich, Anne

    2017-11-16

    Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program and 30-50% drop-out before completion. The main reasons are severe symptoms, inflexible accessibility and necessity for transportation. Currently there are no well-established and evident rehabilitation alternatives. Supervised online screen rehabilitation could be a useful approach to increase accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). This study is a randomized assessor- and statistician blinded superiority multicenter trial with two parallel groups, employing 1:1 allocation to the intervention and the comparison group.On the basis of a sample size calculation, 134 patients with severe or very severe COPD and eligible to conventional hospital based outpatient COPD rehabilitation will be included and randomized from eight different hospitals. The CORe intervention group receives group supervised resistance- and endurance training and patient education, 60 min, three times/week for 10 weeks at home via online-screen. The CCRe comparison group receives group based supervised resistance- and endurance training and patient education, 90 min, two times/week for 10 weeks (two hospitals) or 12 weeks (six hospitals) in groups at the local hospital. The primary outcome is change in the 6-min walking distance after 10/12 weeks; the secondary outcomes are changes in 30 s sit-to-stand chair test, physical activity level, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline

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

    PubMed

    2014-08-19

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

  8. Consumer-Based Physical Activity Monitor as a Practical Way to Measure Walking Intensity During Inpatient Stroke Rehabilitation.

    PubMed

    Klassen, Tara D; Semrau, Jennifer A; Dukelow, Sean P; Bayley, Mark T; Hill, Michael D; Eng, Janice J

    2017-09-01

    Identifying practical ways to accurately measure exercise intensity and dose in clinical environments is essential to advancing stroke rehabilitation. This is especially relevant in monitoring walking activity during inpatient rehabilitation where recovery is greatest. This study evaluated the accuracy of a readily available consumer-based physical activity monitor during daily inpatient stroke rehabilitation physical therapy sessions. Twenty-one individuals admitted to inpatient rehabilitation were monitored for a total of 471 one-hour physical therapy sessions which consisted of walking and nonwalking therapeutic activities. Participants wore a consumer-based physical activity monitor (Fitbit One) and the gold standard for assessing step count (StepWatch Activity Monitor) during physical therapy sessions. Linear mixed modeling was used to assess the relationship of the step count of the Fitbit to the StepWatch Activity Monitor. Device accuracy is reported as the percent error of the Fitbit compared with the StepWatch Activity Monitor. A strong relationship (slope=0.99; 95% confidence interval, 0.97-1.01) was found between the number of steps captured by the Fitbit One and the StepWatch Activity Monitor. The Fitbit One had a mean error of 10.9% (5.3) for participants with walking velocities <0.4 m/s, 6.8% (3.0) for walking velocities between 0.4 and 0.8 m/s, and 4.4% (2.8) for walking velocities >0.8 m/s. This study provides preliminary evidence that the Fitbit One, when positioned on the nonparetic ankle, can accurately measure walking steps early after stroke during inpatient rehabilitation physical therapy sessions. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01915368. © 2017 American Heart Association, Inc.

  9. 24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

  10. 24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

  11. 24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

  12. 24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

  13. [Research on activity evolution of cerebral cortex and hearing rehabilitation of congenitally deaf children after cochlear implant].

    PubMed

    Wang, X J; Liang, M J; Zhang, J P; Huang, H; Zheng, Y Q

    2017-11-05

    Objective: There is a significant difference in the hearing rehabilitation between the congenitally deaf children after cochlear implant(CI). The intrinsic mechanism that affects the hearing rehabilitation in patients was discussed from the perspective of evoked EEG source activity. Method: Firstly, we collected the ERP data from 23 patients and 10 control group children during 0, 3, 6, 9 and 12 months after CI. According to the hearing rehabilitation during 12 months after CI, the patients were divided into two groups: rehabilitation of "the good" and "the poor". Then we used sLORETA to show the changes in the groups of patients' cerebral cortex and compared with the control group. Result: Cross-modal reorganization of cerebral cortex exists in the congenitally deaf children. The cross-modal reorganization gradually degraded and the activity of the relevant cortex followed by normally after CI. There was a statistically significant difference( P < 0.05) in the temporal lobe and the associated cortex around parietal lobe between "the good" and "the poor" groups after 12 months. Conclusion: The normalization of the cross-modal reorganization in patients reflects the hearing rehabilitation after CI, especially the normalization of the activity of the temporal lobe and the associated cortex around parietal lobe, which influences the rehabilitation effect of the auditory function to some extent. This research demonstrated the detection of the mechanism has important significance for the hearing recovery training and evaluation of the hearing rehabilitation after CI. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  14. Mindfulness and Rehabilitation: Teaching Yoga and Meditation to Young Men in an Alternative to Incarceration Program.

    PubMed

    Barrett, Carla J

    2017-11-01

    This study used participant/observation and open-ended interviews to understand how male participants (age 18-24 years) benefited from yoga and mindfulness training within an Alternative to Incarceration (ATI) program. Findings suggest that the male participants (age 18-24 years) benefited from the intervention through reductions in stress and improvements in emotion regulation. Several participants noted the importance of the development of an embodied practice for assisting them in managing anger and impulse control. The young men's narratives suggest that mindfulness-based interventions can contribute positively to rehabilitative outcomes within alternative to incarcerations settings, providing complementary benefit to existing ATI programs, especially for clients amenable to mindfulness training. With many jurisdictions expanding rehabilitation-focused interventions for young offenders, service providers should consider the potential positive contributions that mindfulness-based interventions can have for fostering desistance and reducing recidivism among justice system-involved populations.

  15. 78 FR 28949 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Per Diem Program as a part of the effort to increase the useful life of the facilities of grantees... grantees are required to ensure that facilities rehabilitated under this NOFA meet the Life Safety Code of the National Fire and Protection Association. Please note, typically the Life Safety Code is more...

  16. Information system for the implementation of individual rehabilitation programs for persons with disabilities in Nizhny Novgorod region.

    PubMed

    Besstrashnova, Yanina K; Shoshmin, Alexander V; Nosov, Valeriy A

    2012-01-01

    In December 2011, the first phase of the project aimed at developing an information system for the implementation of individual rehabilitation programs for persons with disabilities was finished in Nizhny Novgorod region of Russia. It included the installation of 40 workstations in the Ministry for Social Policy and 8 institutions of Nizhny Novgorod region. Accumulated data were moved to a new information system based on a distributed database. In 2012, the rest of the regional rehabilitation institutions are to join this information system. A transition to a centralized database is planned.

  17. Computer Assisted Rehabilitation Service Delivery.

    ERIC Educational Resources Information Center

    West Virginia Rehabilitation Research and Training Center, Dunbar.

    This volume consisting of state of the art reviews, suggestions and guidelines for practitioners, and program descriptions deals with the current and potential applications of computers in the delivery of services for vocational rehabilitation (VR). Discussed first are current applications of computer technology in rehabilitative service delivery.…

  18. Examining the Hospital Elder Life Program in a rehabilitation setting: a pilot feasibility study.

    PubMed

    Huson, Kelsey; Stolee, Paul; Pearce, Nancy; Bradfield, Corrie; Heckman, George A

    2016-07-18

    The Hospital Elder Life Program (HELP) has been shown to effectively prevent delirium and functional decline in older patients in acute care, but has not been examined in a rehabilitation setting. This pilot study examined potential successes and implementation factors of the HELP in a post-acute rehabilitation hospital setting. A mixed methods (quantitative and qualitative) evaluation, incorporating a repeated measures design, was used. A total of 100 patients were enrolled; 58 on the pilot intervention unit and 42 on a usual care unit. Group comparisons were made using change scores (pre-post intervention) on outcome measures between pilot unit patients and usual care patients (separate analyses compared usual care patients with pilot unit patients who did or did not receive the HELP). Qualitative data were collected using focus group and individual interviews, and analyzed using emergent coding procedures. Delirium prevalence reduced from 10.9 % (n = 6) to 2.5 % (n = 1) in the intervention group, while remaining the same in the usual care group (2.5 % at both measurement points). Those who received the HELP showed greater improvement on cognitive and functional outcomes, particularly short-term memory and recall, and a shorter average length of stay than patients who did not. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP in a rehabilitation setting. This study adds to the limited research on delirium and the effectiveness of the HELP in post-acute rehabilitation settings. The HELP was found to be feasible and have potential benefits for reduced delirium and improved outcomes among rehabilitation patients.

  19. Does participation in standardized aerobic fitness training during inpatient stroke rehabilitation promote engagement in aerobic exercise after discharge? A cohort study.

    PubMed

    Brown, Christiane; Fraser, Julia E; Inness, Elizabeth L; Wong, Jennifer S; Middleton, Laura E; Poon, Vivien; McIlroy, William E; Mansfield, Avril

    2014-01-01

    To determine whether attending an aerobic fitness program during inpatient stroke rehabilitation is associated with increased participation in physical activity after discharge. This was a prospective cohort study. Patients who received inpatient stroke rehabilitation and were discharged into the community (n = 61; mean age, 65 years) were recruited. Thirty-five participants attended a standardized aerobic fitness program during inpatient rehabilitation, whereas 26 did not. The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and adherence to the American College of Sports Medicine (ACSM) guidelines were assessed up to 6 months after discharge. Participants in the fitness group had PASIPD scores and adherence to ACSM guidelines similar to those of participants in the nonfitness group up to 6 months after discharge. There was no significant correlation between volume of exercise performed during the inpatient program and amount of physical activity after discharge. Participation in an inpatient fitness program did not increase participation in physical activity after discharge in individuals with stroke. A new model of care that encourages patients to pursue physical activity after discharge and reduces the potential barriers to participation should be developed.

  20. Geriatric rehabilitation after hip fracture. Role of body-fixed sensor measurements of physical activity.

    PubMed

    Benzinger, P; Lindemann, U; Becker, C; Aminian, K; Jamour, M; Flick, S E

    2014-04-01

    The demand for geriatric rehabilitation will drastically increase over the next years. It will be increasingly important to demonstrate the efficacy and effectiveness of geriatric rehabilitation. One component is the use of objective and valid assessment procedures. These should be understandable to patients, relevant for goal attainment, and able to document change. A number of currently used physical capacity measures have floor effects. The use of body-fixed sensor technology for monitoring physical activity is a possible supplement for the assessment during geriatric rehabilitation to overcome floor effects and directly monitor improvement of mobility as a component of geriatric rehabilitation in many patients. The observational study with a pre-post design examined 65 consecutive geriatric hip fracture inpatients. Measurements were performed on admission and 2 weeks later. The capacity measures included gait speed, chair rise time, a balance test, 2-Minute-Walk test and the Timed-Up-and-Go test. Physical activity was measured over 9 h using body-fixed sensor technology and expressed as cumulated walking and walking plus standing (time on feet). Body-fixed sensors allowed direct measurement of physical activity in all patients available for testing. Cumulated walking and standing (time on feet) increased from a median 83.6 to 102.6 min. Cumulated walking increased from a median 7.0 to 16.3 min. The comparison with the physical capacity measures demonstrated a modest to fair correlation (rs = 0.455 and 0.653). This indicates that physical capacity measures are not the same construct as physical activity. Body-fixed sensor-based assessment of physical activity was feasible even in geriatric patients with severe mobility problems and decreased the number of patients with missing data both on admission and 2 weeks later. Body-fixed sensor data documented change in activity level.

  1. Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation.

    PubMed

    Hara, Karen Walseth; Bjørngaard, Johan Håkon; Brage, Søren; Borchgrevink, Petter Christian; Halsteinli, Vidar; Stiles, Tore Charles; Johnsen, Roar; Woodhouse, Astrid

    2018-06-01

    Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.

  2. Measurement of functional capacity requirements of police officers to aid in development of an occupation-specific cardiac rehabilitation training program.

    PubMed

    Adams, Jenny; Schneider, Jonna; Hubbard, Matthew; McCullough-Shock, Tiffany; Cheng, Dunlei; Simms, Kay; Hartman, Julie; Hinton, Paul; Strauss, Danielle

    2010-01-01

    This study was designed to measure the functional capacity of healthy subjects during strenuous simulated police tasks, with the goal of developing occupation-specific training for cardiac rehabilitation of police officers. A calibrated metabolic instrument and an oxygen consumption data collection mask were used to measure the oxygen consumption and heart rates of 30 Dallas Police Academy officers and cadets as they completed an 8-event obstacle course that simulated chasing, subduing, and handcuffing a suspect. Standard target heart rates (85% of age-predicted maximum heart rate, or 0.85 x [220 - age]) and metabolic equivalents (METs) were calculated; a matched-sample t test based on differences between target and achieved heart rate and MET level was used for statistical analysis. Peak heart rates during the obstacle course simulation were significantly higher than the standard target heart rates (those at which treadmill stress tests in physicians' offices are typically stopped) (t(29) = 12.81, P < 0.001) and significantly higher than the suggested maximum of 150 beats/min during cardiac rehabilitation training (t(29) = 17.84, P < 0.001). Peak MET levels during the obstacle course simulation were also significantly higher than the goal level (8 METs) that patients typically achieve in a cardiac rehabilitation program (t(29) = 14.73, P < 0.001). We conclude that police work requires a functional capacity greater than that typically attained in traditional cardiac rehabilitation programs. Rehabilitation professionals should consider performing maximal stress tests and increasing the intensity of cardiac rehabilitation workouts to effectively train police officers who have had a cardiac event.

  3. Impact of the Northern Studies Stream and Rehabilitation Studies programs on recruitment and retention to rural and remote practice: 2002-2010.

    PubMed

    Winn, Christopher S; Chisholm, Brock A; Hummelbrunner, Jackie A; Tryssenaar, Joyce; Kandler, Liane S

    2015-01-01

    A shortage of rehabilitation practitioners in rural and/or remote (rural/remote) practice areas has a negative impact on healthcare delivery. In Northern Ontario, Canada, a shortage of rehabilitation professionals (audiology, occupational therapy, physiotherapy, speech-language pathology) has been well documented. In response to this shortage, the Northern Studies Stream (NSS) and Rehabilitation Studies (RS) programs were developed with the mandate to increase the recruitment and retention of rehabilitation professionals to Northern Ontario. However, the number of NSS or RS program graduates who choose to live and work in Northern Ontario or other rural/remote areas, and the extent to which participation in these programs or other factors contributed to their decision, is largely unknown. Between 2002 and 2010, a total of 641 individuals participated in the NSS and RS programs and were therefore eligible to participate in the study. Current contact information was obtained for 536 of these individuals (83.6%) who were eligible to participate in the study. An internet-hosted survey was administered in June of 2011. The survey consisted of 48 questions focusing on personal and professional demographics, postgraduate practice and experience, educational preparation, and factors affecting recruitment and retention decisions. A total of 280 respondents completed the survey (response rate 52%). Of these, 95 (33.9%) reported having chosen rural or remote practice following graduation. Multiple factors predictive of recruitment and retention to rural/remote practice were identified. Of particular note was that individuals raised in a rural or remote community were 3.3 times more likely to work in a rural or remote community after graduation. Recruitment was strongly associated with length of time immersed in rural/remote education settings and to participation in the NSS academic semester. Job satisfaction, professional networking opportunities, and rural lifestyle options

  4. Final priority; National Institute on Disability and Rehabilitation Research--Research Fellowships Program (also known as the Mary E. Switzer Research Fellowships). Final priority.

    PubMed

    2014-07-28

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Research Fellowships Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice announces a priority for a Distinguished Residential Disability and Rehabilitation Policy Fellowship. We take this action to focus attention on an area of national need. We intend the priority to build research capacity by providing support to highly qualified, experienced researchers, including those who are individuals with disabilities, to conduct policy research in the areas of disability and rehabilitation.

  5. The Family's Role in Rehabilitation: "Early Warning System."

    ERIC Educational Resources Information Center

    Westin, Marijo Thomas; Reiss, David

    1979-01-01

    Describes methods used in a project at George Washington University's Rehabilitation Research and Training Center to predict and classify a family's involvement in a patient's rehabilitation program. As family attitudes can enhance or damage a program's effectiveness, early identification of uncooperative families is necessary so that intervention…

  6. A retrospective study of the role of an occupational therapist in the cancer nutrition rehabilitation program.

    PubMed

    Lemoignan, Josée; Chasen, Martin; Bhargava, Ravi

    2010-12-01

    The purpose of the study was to determine how frequently each domain of activity was addressed and how frequently specific interventions were used by an occupational therapist (OT) with cancer patients who attended an 8-week Cancer Nutrition and Rehabilitation (CNR) program. Sixty-two patients with cancer were assessed. All received interventions by the OT within the CNR program. The following activity domains: (1) self-care, (2) productivity, and (3) leisure that were addressed during appointments with the OT were recorded following each visit. Seven categories of interventions were predetermined and their use was recorded using a checklist. Descriptive statistics were conducted and revealed that 36% of the therapist's time was spent assessing patients' functional capacity while 64% was spent providing interventions. The OT's interventions addressed leisure and exercise (54%), productive activities such as housework and paid employment (32%), and basic activities of daily living (14%). The frequency of specific interventions provided were as follows: 40% in teaching of energy conservation and activity management techniques, 33% in goal setting/support and counseling, 9% in cognitive retraining/stimulation, 6% in communication with community agencies, and 4% in teaching of joint and bone protection techniques, help with management of neuropathies, and education on scar management respectively. It is suggested that OTs practicing in oncology use a variety of interventions to better address productive and leisure activities. The data suggests that limitations in these areas were more prevalent than in self-care activities. Further study is needed to examine OT interventions in oncology.

  7. Current trends in rehabilitation engineering in Japan.

    PubMed

    Ohnabe, Hisaichi

    2006-01-01

    In 2005, the elderly generation comprised 20% of the Japanese population. This percentage will grow to approximately 30% in 2030, meaning that nearly one in three people in Japan will be 65 years of age or older. Japan is the first nation in the world to face this situation. This article uses the context of Japanese society to give an overview of the elderly and people with disabilities; the International Classification of Functioning, Disability, and Health model; rehabilitation engineering-related policy; and education. In addition, we examine how governmental programs and Japanese law regarding technical aids may evolve by 2030. Partner robots, intelligent powered wheelchairs, nursing robots, and other technologies are introduced as examples of rehabilitation engineering and assistive technology. We also discuss the volunteer activities of the Rehabilitation Engineering Society of Japan (RESJA) in response to the Asian tsunami disaster and the achievements of a group of students from a Japanese senior high school of industry.

  8. Rehabilitation Traumatology: A Narrative Review.

    PubMed

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

    2017-09-01

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

  9. Lean on Wii: physical rehabilitation with virtual reality Wii peripherals.

    PubMed

    Anderson, Fraser; Annett, Michelle; Bischof, Walter F

    2010-01-01

    In recent years, a growing number of occupational therapists have integrated video game technologies, such as the Nintendo Wii, into rehabilitation programs. 'Wiihabilitation', or the use of the Wii in rehabilitation, has been successful in increasing patients' motivation and encouraging full body movement. The non-rehabilitative focus of Wii applications, however, presents a number of problems: games are too difficult for patients, they mainly target upper-body gross motor functions, and they lack support for task customization, grading, and quantitative measurements. To overcome these problems, we have designed a low-cost, virtual-reality based system. Our system, Virtual Wiihab, records performance and behavioral measurements, allows for activity customization, and uses auditory, visual, and haptic elements to provide extrinsic feedback and motivation to patients.

  10. Convalescence care for seniors of lower Manhattan: an interdisciplinary outreach, rehabilitation, and education model.

    PubMed

    Moroz, Alex; Schoeb, Veronika; Fan, Grace; Vitale, Kenneth; Lee, Mathew

    2004-03-01

    The purpose of this study was to test the efficacy of an interdisciplinary geriatric outreach, rehabilitation, and education program for seniors. Community-dwelling Chinese seniors in lower Manhattan were recruited through outreach activities (17 educational workshops, three community health fairs, media interviews) and community physician referrals to offer rehabilitation services. The instrument administered at entry and exit included questions about pain intensity, quality of life, activities of daily living (ADLs), and an assessment of a variety of intrinsic and extrinsic barriers to life participation. The sample included 70 seniors (53 women) with a mean age of 70.5 +/- 7.48 years (range 60-93 years old) of whom 86% were Cantonese-speaking Chinese. The barriers-to-life participation assessment revealed cultural, communication, transportation, and physical environmental barriers as well as insufficient financial resources. Thirty-four patients who completed the program showed a significant improvement in quality of life. Patients' reports reflected a high degree of satisfaction with the program. Interdisciplinary team-oriented patient care, including a physiatrist, social worker, and rehabilitation staff, may result in good outcomes and high patient satisfaction in ambulatory community seniors.

  11. 78 FR 47859 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ...This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2014 (for discharges occurring on or after October 1, 2013 and on or before September 30, 2014) as required by the statute. This final rule also revised the list of diagnosis codes that may be counted toward an IRF's ``60 percent rule'' compliance calculation to determine ``presumptive compliance,'' update the IRF facility-level adjustment factors using an enhanced estimation methodology, revise sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument, revise requirements for acute care hospitals that have IRF units, clarify the IRF regulation text regarding limitation of review, update references to previously changed sections in the regulations text, and revise and update quality measures and reporting requirements under the IRF quality reporting program.

  12. Stroke Rehabilitation.

    PubMed

    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

  13. Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

    PubMed

    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 < 0.001, p = 0.001, p = 0.007 and p < 0.001, respectively), as well as at the 3-month follow-up (p < 0.001, p < 0.001, p = 0.009 and p < 0.001, respectively). Rehabilitation using 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

  14. Clinical utility of the AlphaFIM® instrument in stroke rehabilitation.

    PubMed

    Lo, Alexander; Tahair, Nicola; Sharp, Shelley; Bayley, Mark T

    2012-02-01

    The AlphaFIM instrument is an assessment tool designed to facilitate discharge planning of stroke patients from acute care, by extrapolating overall functional status from performance in six key Functional Independence Measure (FIM) instrument items. To determine whether acute care AlphaFIM rating is correlated to stroke rehabilitation outcomes. In this prospective observational study, data were analyzed from 891 patients referred for inpatient stroke rehabilitation through an Internet-based referral system. Simple linear and stepwise regression models determined correlations between rehabilitation-ready AlphaFIM rating and rehabilitation outcomes (admission and discharge FIM ratings, FIM gain, FIM efficiency, and length of stay). Covariates including demographic data, stroke characteristics, medical history, cognitive deficits, and activity tolerance were included in the stepwise regressions. The AlphaFIM instrument was significant in predicting admission and discharge FIM ratings at rehabilitation (adjusted R² 0.40 and 0.28, respectively; P < 0.0001) and was weakly correlated with FIM gain and length of stay (adjusted R² 0.04 and 0.09, respectively; P < 0.0001), but not FIM efficiency. AlphaFIM rating was inversely related to FIM gain. Age, bowel incontinence, left hemiparesis, and previous infarcts were negative predictors of discharge FIM rating on stepwise regression. Intact executive function and physical activity tolerance of 30 to 60 mins were predictors of FIM gain. The AlphaFIM instrument is a valuable tool for triaging stroke patients from acute care to rehabilitation and predicts functional status at discharge from rehabilitation. Patients with low AlphaFIM ratings have the potential to make significant functional gains and should not be denied admission to inpatient rehabilitation programs.

  15. Rehabilitation of children and infants with osteogenesis imperfecta. A program for ambulation.

    PubMed

    Gerber, L H; Binder, H; Weintrob, J; Grange, D K; Shapiro, J; Fromherz, W; Berry, R; Conway, A; Nason, S; Marini, J

    1990-02-01

    Management of children and infants with osteogenesis imperfecta (OI) poses difficult decisions for pediatricians, orthopedists, and physiatrists. These children are frequently frail with disabling bone and joint deformities and fractures. In an eight-year cumulative management of 12 children with OI, a comprehensive program included strengthening exercises to the pelvic girdle and lower extremity muscles, in addition to pool exercises and molded seating to support upright posture. Long leg braces were fitted when the children were able to sit unsupported. All 12 were fitted with braces; nine were functional ambulators, and three were home ambulators. Six children required femoral plating or rodding, two of whom subsequently had the metal removed. Lower extremity fractures averaged one and one-half per year prior to bracing for nine children who had fractures. There was 0.83 fracture per year for the ten children who had fractures after bracing. The degree of femoral bowing increased in four, decreased in four, and remained unchanged in four, while the degree of tibial bowing increased in two, decreased in nine, and remained unchanged in one during the observation period. A comprehensive rehabilitation program and long leg bracing with surgical operations on the femur result in a high level of functional activity for children with OI with an acceptable level of risk for fracture.

  16. [Work-Related Medical Rehabilitation in Cancer Rehabilitation - Short-Term Results from a Cluster-Randomized Multicenter-Trial].

    PubMed

    Wienert, Julian; Bethge, Matthias

    2018-05-25

    Rehabilitation programs that support return to work become increasingly relevant for cancer survivors. In Germany, such programs were established as work-related medical rehabilitation (WMR). The study investigated whether WMR leads to better results compared to medical rehabilitation (MR). We report effects on secondary outcomes when the rehabilitation program was completed. Clusters of participants were randomly assigned to WMR or MR. Patients of working age and an elevated risk of not returning to work were included. The grade of implementation was assessed by dose delivered and dose received. Study outcomes were assessed using scales measuring functioning and symptoms, coping with illness as well as self-reported work ability. Treatment effects were estimated using mixed linear models. From 232 planned randomized intervention groups, 165 (71%) were realized. In total, 476 patients were included. Mean age of participants was 50.7 years (SD=7.3). Most frequent primary diagnoses were malignant neoplasms of the breast. Participants in the WMR program reported significantly better outcomes regarding quality of life (SMD=0.17-0.25), fatigue (SMD=0.18-0.27), coping with illness (SMD=0.17-0.22), and self-reported work-ability (SMD=0.16) compared to participants in MR program (all p<0.05). The results indicate a positive effect in favor of WMR for cancer patients with an elevated risk of not returning to work at the end of their treatment. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 78 FR 2664 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-14

    ... with disabilities from underserved populations; (4) identify research gaps; (5) identify mechanisms for... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving... Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Minority...

  18. Rehabilitation program based on sensorimotor recovery improves the static and dynamic balance and modifies the basal ganglia neurochemistry

    PubMed Central

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

    2017-01-01

    Abstract Rehabilitation interventions represent an alternative strategy to pharmacological treatment in order to slow or reverse some functional aspects of disability in Parkinson's disease (PD). To date, the neurophysiological mechanisms underlying rehabilitation-mediated improvement in PD patients are still poorly understood. Interestingly, growing evidence has highlighted a key role of the glutamate in neurogenesis and brain plasticity. The brain levels of glutamate, and of its precursor glutamine, can be detected in vivo and noninvasively as “Glx” by means of proton magnetic resonance spectroscopy (1H-MRS). In the present pilot study, 7 PD patients with frequent falls and axial dystonia underwent 8-week rehabilitative protocol focused on sensorimotor improvement. Clinical evaluation and Glx quantification were performed before and after rehabilitation. The Glx assessment was focused on the basal ganglia in agreement with their key role in the motor functions. We found that the rehabilitation program improves the static and dynamic balance in PD patients, promoting a better global motor performance. Moreover, we observed that the levels of Glx within the left basal ganglia were higher after rehabilitation as compared with baseline. Thus, we posit that our sensorimotor rehabilitative protocol could stimulate the glutamate metabolism in basal ganglia and, in turn, neuroplasticity processes. We also hypothesize that these mechanisms could prepare the ground to restore the functional interaction among brain areas deputed to motor controls, which are affected in PD. PMID:29390267

  19. [Physical rehabilitation in multiple sclerosis: general principles and high-tech approaches].

    PubMed

    Peresedova, A V; Chernikova, L A; Zavalishin, I A

    2013-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation programs are of major importance for the preservation of physical, physiological, social and professional functioning and improvement of quality of life. Currently, it is generally assumed that physical activity is an important component of non-pharmacological rehabilitation in multiple sclerosis. Properly organized exercise is a safe and efficient way to induce improvements in a number of physiological functions. A multidisciplinary rehabilitative approach should be recommended. The main recommendations for the use of exercise for patients with multiple sclerosis have been listed. An important aspect of the modern physical rehabilitation in multiple sclerosis is the usage of high-tech methods. The published results of robot-assisted training to improve the hand function and walking impairment have been represented. An important trend in the rehabilitation of patients with multiple sclerosis is the reduction of postural disorders through training balance coordination. The role of transcranial magnetic stimulation in spasticity reducing is being investigated. The use of telemedicine capabilities is quite promising. Due to the fact that the decline in physical activity can lead to the deterioration of many aspects of physiological functions and, ultimately, to mobility decrease, further research of the role of physical rehabilitation as an important therapeutic approach in preventing the progression of disability in multiple sclerosis is required.

  20. Shock Incarceration: Rehabilitation or Retribution?

    ERIC Educational Resources Information Center

    MacKenzie, Doris Layton; And Others

    1989-01-01

    Reviews Louisiana's shock incarceration program used as alternative to standard prison incarceration. Program involves short period of imprisonment in a "boot camp" type atmosphere followed by three phases of intensive parole supervision. Examines the program in regard to its rehabilitative potential and compares program elements to…

  1. Inpatient rehabilitation outcomes for patients receiving left ventricular assist device.

    PubMed

    Alsara, Osama; Reeves, Ronald K; Pyfferoen, Mary D; Trenary, Tamra L; Engen, Deborah J; Vitse, Merri L; Kessler, Stacy M; Kushwaha, Sudhir S; Clavell, Alfredo L; Thomas, Randal J; Lopez-Jimenez, Francisco; Park, Soon J; Perez-Terzic, Carmen M

    2014-10-01

    The aim of this study was to evaluate outcomes of patients participating in inpatient rehabilitation program after left ventricular assist device (LVAD) implantation. Medical records of 94 patients who received LVADs between January 1, 2008, and June 30, 2010, at the Mayo Clinic in Rochester, MN, were retrospectively reviewed for demographic data, and inpatient rehabilitation functional outcomes were measured by the Functional Independence Measure scale. After successful implantation of LVAD, the patients were either discharged directly home from acute care (44%) or admitted to inpatient rehabilitation (56%). The patients admitted to inpatient rehabilitation were older than those discharged home. They were also more medically complex and more likely to have the LVAD placed as destination therapy. At discharge, significant improvement occurred in 17 of the 18 activities evaluated by the Functional Independence Measure scale. The mean total Functional Independence Measure scale score at admission was 77.1 compared with a score of 95.2 at discharge (P < 0.0001). Approximately half of the patients who received LVAD therapy were admitted in the inpatient rehabilitation. After the implantation of LVAD and inpatient rehabilitation, significant functional improvements were observed. Further studies addressing the role of inpatient rehabilitation for LVAD patients are warranted.

  2. Developing a Wearable Ankle Rehabilitation Robotic Device for in-Bed Acute Stroke Rehabilitation.

    PubMed

    Ren, Yupeng; Wu, Yi-Ning; Yang, Chung-Yong; Xu, Tao; Harvey, Richard L; Zhang, Li-Qun

    2017-06-01

    Ankle movement training is important in motor recovery post stroke and early intervention is critical to stroke rehabilitation. However, acute stroke survivors receive motor rehabilitation in only a small fraction of time, partly due to the lack of effective devices and protocols suitable for early in-bed rehabilitation. Considering the first few months post stroke is critical in stroke recovery, there is a strong need to start motor rehabilitation early, mobilize the ankle, and conduct movement therapy. This study seeks to address the need and deliver intensive passive and active movement training in acute stroke using a wearable ankle robotic device. Isometric torque generation mode under real-time feedback is used to guide patients in motor relearning. In the passive stretching mode, the wearable robotic device stretches the ankle throughout its range of motion to the extreme dorsiflexion forcefully and safely. In the active movement training mode, a patient is guided and motivated to actively participate in movement training through game playing. Clinical testing of the wearable robotic device on 10 acute stroke survivors over 12 sessions of feedback-facilitated isometric torque generation, and passive and active movement training indicated that the early in-bed rehabilitation could have facilitated neuroplasticity and helped improve motor control ability.

  3. Adding a vocational focus to mental health rehabilitation.

    PubMed

    Blankertz, L; Robinson, S

    1996-11-01

    The study examined the effect of adding two employment specialists to the staff of a community mental health center; their sole responsibility was to develop the skills and positive work attitudes that clients with severe mental illness need to enter the state vocational rehabilitation system or to seek employment. A total of 122 clients were randomly assigned to a program with an employment specialist or to a control group with no specialized vocational services. Clients in the program were taught work skills and attitudes in group and individual sessions and through a trial work experience. A schedule of rewards reinforced positive changes. Outcomes measured were skill gains, changes in work attitudes, attainment of employment, and entry into the state vocational rehabilitation system. At nine months, 34 of the 61 clients in the program achieved positive changes in vocational status that included competitive employment, participation in training and evaluation programs operated by the state vocational system, and formal referral to the system. Only one client in the control group was linked to the state system. Skill gains and positive changes in work attitudes were found for all program clients. Logistical regression suggested that program participation, rather than client characteristics, was an important predictor of a positive outcome. Over a relatively short time period, targeted vocational programs can help clients with severe mental illness develop the skills and attitudes necessary to attain employment or entry into the vocational rehabilitation system. Vocational rehabilitation can be an integral part of the rehabilitation process for all mental health clients.

  4. 78 FR 34897 - Final Priorities; National Institute on Disability and Rehabilitation Research-Disability and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ....133E-8.] Final Priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers AGENCY: Office... under the Disability and Rehabilitation Research Projects and Centers Program administered by the...

  5. Physical Therapy Principles in Rehabilitation

    PubMed Central

    Sparto, Patrick J.

    2016-01-01

    The use of vestibular rehabilitation for persons with balance and vestibular disorders is used to improve function and decrease dizziness symptoms. Principles of a vestibular rehabilitation program are described including common exercises and outcome measures used to report change. A review of negative and positive predictive factors related to recovery is also provided. PMID:22027077

  6. [First Results of Analysis of Russian Part of the European Register on Cardiac Rehabilitation EuroCaReD (European Cardiac Rehabilitation Database)].

    PubMed

    Pogosova, N V; Sokolova, O Iu; Iufereva, Iu M; Osipova, I V; Riamzina, I N

    2015-01-01

    The joint European Registry of patients with cardiovascular diseases participating in cardiac rehabilitation programs (European Cardiac Rehabilitation Database, EuroCaReD) is conducted in collaboration between the ESC and EACPR). It's main goals were to improve the routine use of cardiac rehabilitation, to develop joint standards for cardiac rehabilitation in all European countries and evidence based rehabilitation programs and to monitor any changes. In the EuroCaReD registry participated a total of 44 centers from 13 countries, including 3 centers from Russia, which enrolled 151 patients during 2010-2012. This paper is comparing the baseline demographics, clinical data and risk factors in Russian patients versus the rest of Europe. It was shown that cardiac rehabilitation patients in Russia, as in the whole cohort, are predominantly male. Elderly patients from Russia were 3 times less likely to be referred for rehabilitation than in Europe. Unlike the whole cohort Russian patients were almost never sent to rehabilitation because of heart failure or stable angina. Likewise the whole Europe Russian patients had an average of 3 cardiovascular risk factors before rehabilitation, but with some national differences in their prevalence and severity.

  7. Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY.

    PubMed

    Pack, Quinn R; Squires, Ray W; Lopez-Jimenez, Francisco; Lichtman, Steven W; Rodriguez-Escudero, Juan P; Lindenauer, Peter K; Thomas, Randal J

    2015-01-01

    Although strategies exist for improving cardiac rehabilitation (CR) participation rates, it is unclear how frequently these strategies are used and what efforts are being made by CR programs to improve participation rates. We surveyed all CR program directors in the American Association of Cardiovascular and Pulmonary Rehabilitation's database. Data collection included program characteristics, the use of specific referral and recruitment strategies, and self-reported program participation rates. Between 2007 and 2012, 49% of programs measured referral of inpatients from the hospital, 21% measured outpatient referral from office/clinic, 71% measured program enrollment, and 74% measured program completion rates. Program-reported participation rates (interquartile range) were 68% (32-90) for hospital referral, 35% (15-60) for office/clinic referral, 70% (46-80) for enrollment, and 75% (62-82) for program completion. The majority of programs utilized a hospital-based systematic referral, liaison-facilitated referral, or inpatient CR program referral (64%, 68%, and 60% of the time, respectively). Early appointments (<2 weeks) were utilized by 35%, and consistent phone call appointment reminders were utilized by 50% of programs. Quality improvement (QI) projects were performed by about half of CR programs. Measurement of participation rates was highly correlated with performing QI projects (P < .0001.) : Although programs are aware of participation rate gaps, the monitoring of participation rates is suboptimal, QI initiatives are infrequent, and proven strategies for increasing patient participation are inconsistently utilized. These issues likely contribute to the national CR participation gap and may prove to be useful targets for national QI initiatives.

  8. A retrospective observational study of functional outcomes, length of stay, and discharge disposition after an inpatient stroke rehabilitation program in Saudi Arabia.

    PubMed

    Bindawas, Saad M; Mawajdeh, Hussam; Vennu, Vishal; Alhaidary, Hisham

    2016-08-01

    Functional outcomes, length of stay (LOS), and discharge disposition have become frequent outcome measures among stroke patients after rehabilitation programs. To examine the trends of changes in functional outcomes, LOS, and discharge disposition in stroke patients discharged from an inpatient rehabilitation facility.All patients (n = 432) were admitted to a tertiary inpatient rehabilitation hospital in Riyadh, Saudi Arabia with stroke diagnoses from November 2008 to December 2014. The functional independence measure (FIM) instrument used to assess the patient's functional status. The LOS was measured as the number of days the patients spent in the hospital from the day of admission to the day of discharge. The FIM efficiency was used to measure the patient's rehabilitation progress. All of the variables of the prospectively collected data were retrospectively analyzed.There were significant changes by years in the total FIM ranging from 23 to 29 (P < 0.001) and subscores: FIM motor ranging from 20 to 26 (P < 0.001); FIM cognitive ranging from 1.8 to 3 (P < 0.001). The mean LOS remained constant, from 52 days in 2011 to 40 days in 2013. The FIM efficiency was stable between years and ranged from 0.52 to 0.72. The rates of discharge (to home) were significantly unstable and ranged from 100% in 2010 and 2011 to 92% in 2013.Our results suggest that functional outcomes in patients with stroke have improved after an inpatient stroke rehabilitation program between 2008 and 2014 even with a constant LOS. Discharge disposition has remained unstable over this period. To improve the efficiency of the stroke rehabilitation program in Saudi Arabia, there is a need to decrease the LOS and emphasize a comprehensive interdisciplinary approach.

  9. [Third phase of cardiac rehabilitation: a nurse-based "home-control" model].

    PubMed

    Albertini, Sara; Ciocca, Antonella; Opasich, Cristina; Pinna, Gian Domenico; Cobelli, Franco

    2011-12-01

    Phase 3 is a critical point for cardiac rehabilitation: many problems don't allow achieving a correct secondary prevention, in particular regarding the relationship between patient and cardiologist. Aiming at ensuring continuity of care of phase 3 cardiac rehabilitation patients, we have developed a telemetric educational program to stimulate in them the will and capacity to become active comanagers of their disease. Nurses specialized in cardiac rehabilitation, with the collaboration of the general practitioners, contact the patients by scheduled phone calls to collect questionnaires about their health status and the result of biochemistry. All the results are analyzed by the nurses and discussed with each patient (educational reinforcement). The effects of this program of comanagement of cardiac disease and secondary prevention are analyzed comparing each patient data at the discharge with data after one year and those coming from our archive (retrospective analysis). The patients enrolled in this study pay much more attention to the amount of food they eat; they tend not to gain weight, and they restart smoking in a reduced proportion compared to patients not enrolled in the study. However, despite having received better information on their cardiac disease, their compliance to physical training, consumption of healthy food, and pharmacological therapy is not improved. This study focuses on the role of a continuous educational program of a cardiac rehabilitation unit after the patient's discharge. This home control program conducted by nurses specialized in cardiac rehabilitation, with the assistance of cardiologists, psychologists and physiotherapists, and in collaboration with the general practitioner, was quite cheap, and helped maximizing the knowledge of the disease and reinforcing correct life style in the patients. The results are not as good as expected, probably because one year does not represent a sufficient time, or because the educational

  10. Exercise self-efficacy and symptoms of depression after cardiac rehabilitation: predicting changes over time using a piecewise growth curve analysis.

    PubMed

    Howarter, Alisha D; Bennett, Kymberley K; Barber, Carolyn E; Gessner, Stacia N; Clark, Jillian M R

    2014-01-01

    Cardiac rehabilitation is often recommended after experiencing a cardiac event and has been shown to significantly improve health outcomes among patients. Several psychosocial variables have been linked with cardiac rehabilitation program success, including exercise self-efficacy. However, little is known about temporal patterns in patients' exercise self-efficacy after program completion. This study examined changes in exercise self-efficacy among 133 cardiac rehabilitation patients and whether symptoms of depression impacted the rate of change in exercise self-efficacy. Participants completed questionnaires at the beginning and end of cardiac rehabilitation and at 6-month intervals for 2 years. Growth curve analyses showed that exercise self-efficacy levels were highest at the beginning of cardiac rehabilitation, significantly declined 6 months after cardiac rehabilitation, and leveled off over the next 18 months. Results also showed that baseline depressive symptoms interacted with time: Compared with participants with fewer symptoms, participants high in depressive symptoms began cardiac rehabilitation with lower levels of exercise self-efficacy and evidenced significant declines 6 months after cardiac rehabilitation. At no time were they equal to their counterparts in exercise self-efficacy, and their means were lower 2 years after cardiac rehabilitation than before cardiac rehabilitation. Our findings imply that patients show unrealistic optimism surrounding the ease of initiating and maintaining an exercise program and that integrating efficacy-building activities into cardiac rehabilitation, especially for patients who show signs of distress, is advisable.

  11. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    PubMed

    Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  12. The benefits of a comprehensive rehabilitation program in patients diagnosed with spastic quadriplegia

    PubMed Central

    Rogoveanu, OC; Tuțescu, NC; Kamal, D; Alexandru, DO; Kamal, C; Streba, CT; Trăistaru, MR

    2016-01-01

    Spastic quadriplegia has as an etiopathogenic substrate, a non-progressive brain lesion; however, the clinical manifestations of the disease evolve over time. Children diagnosed with spastic quadriplegia show a variety of symptoms in different areas: sensorimotor, emotional, cognitive, and social. The purpose of this study was to assess the functional status in patients diagnosed with spastic quadriplegia, who followed a complex medical rehabilitation program, during a year, and highlight the importance of using physical and kinetic techniques in improving their status. A total of 10 children diagnosed with spastic quadriplegia were included in the study and the Gross Motor Function Classification System (GMFCS) and manual ability classification system (MACS) were used to evaluate the functionality status of each patient. Every patient was evaluated initially (T1), after six months of program (T2), and after they completed the study. All the children were originally monitored daily, for 5 days per week for a period of one month, then two times a week for a year. A statistically significant difference regarding the modification of the GMFCS and MACS stage was found, which occurred between the first and the third evaluation. The inverse correlation of the statistical significance between the ages of patients and the decrease in GMFCS or MACS stage was highlighted; the younger the patient, the more the scale decreased. A direct link between the gross motor function and the manual ability was noticed. Applying a complex rehabilitation program has proven efficient by improving both the gross motor functionality and the manual ability. PMID:27974931

  13. The benefits of a comprehensive rehabilitation program in patients diagnosed with spastic quadriplegia.

    PubMed

    Rogoveanu, O C; Tuțescu, N C; Kamal, D; Alexandru, D O; Kamal, C; Streba, C T; Trăistaru, M R

    2016-01-01

    Spastic quadriplegia has as an etiopathogenic substrate, a non-progressive brain lesion; however, the clinical manifestations of the disease evolve over time. Children diagnosed with spastic quadriplegia show a variety of symptoms in different areas: sensorimotor, emotional, cognitive, and social. The purpose of this study was to assess the functional status in patients diagnosed with spastic quadriplegia, who followed a complex medical rehabilitation program, during a year, and highlight the importance of using physical and kinetic techniques in improving their status. A total of 10 children diagnosed with spastic quadriplegia were included in the study and the Gross Motor Function Classification System (GMFCS) and manual ability classification system (MACS) were used to evaluate the functionality status of each patient. Every patient was evaluated initially (T1), after six months of program (T2), and after they completed the study. All the children were originally monitored daily, for 5 days per week for a period of one month, then two times a week for a year. A statistically significant difference regarding the modification of the GMFCS and MACS stage was found, which occurred between the first and the third evaluation. The inverse correlation of the statistical significance between the ages of patients and the decrease in GMFCS or MACS stage was highlighted; the younger the patient, the more the scale decreased. A direct link between the gross motor function and the manual ability was noticed. Applying a complex rehabilitation program has proven efficient by improving both the gross motor functionality and the manual ability.

  14. Alcoholic liver disease patients' perspective of a coping and physical activity-oriented rehabilitation intervention after hepatic encephalopathy.

    PubMed

    Mikkelsen, Maria Rudkjaer; Hendriksen, Carsten; Schiødt, Frank Vinholt; Rydahl-Hansen, Susan

    2016-09-01

    To identify and describe the impact of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients after hepatic encephalopathy in terms of their interaction with professionals and relatives. Patients who have experienced alcohol-induced hepatic encephalopathy have reduced quality of life, multiple complications, and social problems, and rehabilitation opportunities for these patients are limited. A grounded theory study and an evaluation study of a controlled intervention study. Semi-structured interviews were conducted with 10 alcoholic liver disease patients who were diagnosed with hepatic encephalopathy and participated in a coping and physical activity-oriented rehabilitation intervention. Richard S. Lazarus's theory of stress and coping inspired the interview guide. The significance of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients' ability to cope with problems after surviving alcohol-induced hepatic encephalopathy in terms of their interaction with professionals and relatives was characterised by the core category 'regain control over the diseased body'. This is subdivided into three separate categories: 'the experience of being physically strong', 'togetherness' and 'self-control', and they impact each other and are mutually interdependent. Alcoholic liver disease patients described the strength of the rehabilitation as regaining control over the diseased body. Professionals and relatives of patients with alcoholic liver disease may need to focus on strengthening and preserving patients' control of their diseased body by facilitating the experience of togetherness, self-control and physical strength when interacting with and supporting patients with alcoholic liver disease. A coping and physical activity-oriented rehabilitation intervention may help alcoholic liver disease patients to regain control over their diseased body and give patients the experience

  15. [Effectiveness of therapeutic education and respiratory rehabilitation programs for the patient with asthma].

    PubMed

    Cano-De La Cuerda, Roberto; Useros-Olmo, Ana Isabel; Muñoz-Hellín, Elena

    2010-11-01

    Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. The education of the asthmatic patient and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in the scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient. Copyright © 2010 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Short- and long-term effects of the modified swedish version of the Active Communication Education (ACE) program for adults with hearing loss.

    PubMed

    Oberg, Marie; Bohn, Therese; Larsson, Ulrika

    2014-10-01

    In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the original ACE program were modified. The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39-82 yr old. Design was a between-group and within-group intervention study. The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions. The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group. The outcomes were measured before initiation of the program, 3 wk after program completion, and 6 mo after program completion and included communication strategy use, activity and participation, health-related quality of life, and anxiety and depression. In addition, outcomes were measured after program completion using the International Outcome Inventory-Alternative Interventions, a modified version of the Client Oriented Scale of Improvement, and qualitative feedback was obtained about the response to the program and actions taken as a result of participation. The treatment effects were examined using repeated-measures analyses of variance. Statistically significant effects were found for communication strategy use, activity and participation, and psychosocial well-being. Statistically significant effects were found for gender and degree of hearing loss, indicating that women and those with mild hearing

  17. Athletic pubalgia and associated rehabilitation.

    PubMed

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

    2014-11-01

    Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology. Both non-operative and post-operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post-operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption. Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non-operative or post-operative allows for a focused rehabilitative program. As more

  18. Pulmonary Rehabilitation and Palliative Care for the Lung Cancer Patient

    PubMed Central

    Sun, Virginia; Koczywas, Marianna; Kim, Jae; Raz, Dan; Hurria, Arti; Hayter, Jennifer

    2015-01-01

    Pulmonary rehabilitation, as a quality of life intervention, has a role to play in palliative care for lung cancer patients. Combining the art and skills of clinical care, physiological, and behavioral tools, pulmonary rehabilitation can serve to rebuild the functional capacity of patients limited by breathlessness and deconditioning. Exercise programs are the primary tool used to restore and rebuild the patient's endurance by challenging the entire pathway of oxygen transport and improving gas exchange. Other tools of pulmonary rehabilitation include breathing retraining, self-management skills, airway clearance techniques, bronchodilitation, smoking cessation and oxygen therapy. Pulmonary rehabilitation is now becoming a part of supportive care for patients undergoing chemotherapy and radiation therapy. The ability to be more active without suffering the consequences of dyspnea on exertion boosts the patient's self-efficacy and allows for an improved quality of life, so that lung cancer patients can participate in their family lives during this therapeutic challenge. PMID:26709350

  19. Problematising risk in stroke rehabilitation.

    PubMed

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

    2016-11-01

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

  20. Rehabilitation Strategies for the Athletic Individual with Early Knee Osteoarthritis.

    PubMed

    Jayabalan, Prakash; Ihm, Joseph

    2016-01-01

    Knee osteoarthritis (OA) is a major cause of disability in the United States. The condition has most commonly been associated with elderly sedentary individuals; however, it also can affect those who participate in regular athletic activities. The diagnosis and management of these individuals can be challenging because of both their higher level of physical activity and their overall athletic goals. Treatment requires an appropriate exercise regimen, rehabilitation program, and education of both the athlete and the coach. The focus of our article is to provide an up-to-date overview of the evaluation and management of the athletic individual who presents with symptomatic early knee OA, in particular, the nonsurgical rehabilitation treatment options available to the practitioner and the evidence to support these recommendations.

  1. Six-week physical rehabilitation protocol for anterior shoulder dislocation in athletes

    PubMed Central

    Gaballah, Ahmed; Zeyada, Mohamed; Elgeidi, Adham; Bressel, Eadric

    2017-01-01

    Anterior shoulder dislocations are common in young athletes. The mechanism for the first or primary shoulder dislocation may involve a collision or a fall typically with the arm in an abducted and externally rotated position. The aim of this study was to design a physical rehabilitation program using the elastic band and resistive exercise to improve joint strength and range of motion in individuals diagnosed with a first-time shoulder dislocation. Twelve physically active males with a first-time acute shoulder dislocation were asked to volunteer. Participants began a physical rehabilitation program 2 weeks after the shoulder dislocation, which was confirmed by a referring physician. The rehabilitation program was 6 weeks in duration and required the participants to engage in progressive resistive loads/duration using elastic bands and weights 5 days per week. Pretest and posttest measures included shoulder strength and range of motion. All outcome measures were compared between the injured and uninjured shoulder, which served as the control condition in this study. There were statistically significant differences between the injured and uninjured shoulder for measures of strength and range of motion during pretests (P<0.01) but not post-tests (P<0.53). Finally, there were no differences between shoulders in regards to the volume measure suggesting that any changes in muscle atrophy or swelling were not detected. The physical rehabilitation program proposed in this study was effective at improving strength and range of motion in the injured shoulder as evidenced by the similarity in posttest values between the injured and uninjured shoulder. PMID:28702449

  2. Benefits and costs of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease - a multi-centre randomised controlled equivalence trial.

    PubMed

    Holland, Anne E; Mahal, Ajay; Hill, Catherine J; Lee, Annemarie L; Burge, Angela T; Moore, Rosemary; Nicolson, Caroline; O'Halloran, Paul; Cox, Narelle S; Lahham, Aroub; Ndongo, Rebecca; Bell, Emily; McDonald, Christine F

    2013-09-08

    Pulmonary rehabilitation is widely advocated for people with chronic obstructive pulmonary disease (COPD) to improve exercise capacity, symptoms and quality of life, however only a minority of individuals with COPD are able to participate. Travel and transport are frequently cited as barriers to uptake of centre-based programs. Other models of pulmonary rehabilitation, including home-based programs, have been proposed in order to improve access to this important treatment. Previous studies of home-based pulmonary rehabilitation in COPD have demonstrated improvement in exercise capacity and quality of life, but not all elements of the program were conducted in the home environment. It is uncertain whether a pulmonary rehabilitation program delivered in its entirety at home is cost effective and equally capable of producing benefits in exercise capacity, symptoms and quality of life as a hospital-based program. The aim of this study is to compare the costs and benefits of home-based and hospital-based pulmonary rehabilitation for people with COPD. This randomised, controlled, equivalence trial conducted at two centres will recruit 166 individuals with spirometrically confirmed COPD. Participants will be randomly allocated to hospital-based or home-based pulmonary rehabilitation. Hospital programs will follow the traditional outpatient model consisting of twice weekly supervised exercise training and education for eight weeks. Home-based programs will involve one home visit followed by seven weekly telephone calls, using a motivational interviewing approach to enhance exercise participation and facilitate self management. The primary outcome is change in 6-minute walk distance immediately following intervention. Measurements of exercise capacity, physical activity, symptoms and quality of life will be taken at baseline, immediately following the intervention and at 12 months, by a blinded assessor. Completion rates will be compared between programs. Direct healthcare

  3. Early intensive rehabilitation after oral cancer treatment.

    PubMed

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

    2018-06-01

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

  4. Outcome analysis of individualized vestibular rehabilitation protocols

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Angel, C. R.; Pesznecker, S. C.; Gianna, C.

    2000-01-01

    OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These

  5. Medically related activities of application team program

    NASA Technical Reports Server (NTRS)

    1971-01-01

    Application team methodology identifies and specifies problems in technology transfer programs to biomedical areas through direct contact with users of aerospace technology. The availability of reengineering sources increases impact of the program on the medical community and results in broad scale application of some bioinstrumentation systems. Examples are given that include devices adapted to the rehabilitation of neuromuscular disorders, power sources for artificial organs, and automated monitoring and detection equipment in clinical medicine.

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

    PubMed

    Ebrahimi, Amir Abbas; Jamshidi, Ali Ashraf; Movallali, Guita; Rahgozar, Mehdi; Haghgoo, Hojjat Allah

    2017-11-01

    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.

  7. Is a rehabilitation treatment taxonomy the right answer to the rehabilitation black box?

    PubMed

    Cieza, Alarcos; Bickenbach, Jerome

    2014-01-01

    In this commentary on the development of an interventions taxonomy for medical rehabilitation, a rehabilitation treatment taxonomy (RTT), we acknowledge the authors' valuable contribution to rehabilitation science, and at the same time interrogate the assumption that a taxonomy has essential added value to address the challenge of rehabilitation's black box. The tripartite analytical structure of action of treatment, active ingredient, and mechanism of action, and not an RTT, is the key to addressing the rehabilitation black box. There is a need for clearly defined operationalized requirements of how the 3 components have to be expressed. We also recommend that this concerted effort be linked to all relevant stakeholders and all international endeavors that are pursuing a common goal of enhancing rehabilitation research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    2014-07-09

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

  9. Relationship between Self-Administered Cues and Rehabilitation Outcomes in Individuals with Aphasia: Understanding Individual Responsiveness to a Technology-Based Rehabilitation Program.

    PubMed

    Des Roches, Carrie A; Mitko, Annette; Kiran, Swathi

    2017-01-01

    An advantage of rehabilitation administered on computers or tablets is that the tasks can be self-administered and the cueing required to complete the tasks can be monitored. Though there are many types of cueing, few studies have examined how participants' response to rehabilitation is influenced by self-administered cueing, which is cueing that is always available but the individual decides when and which cue to administer. In this study, participants received a tablet-based rehabilitation where the tasks were selfpaced and remotely monitored by a clinician. The results of the effectiveness of this study were published previously (Des Roches et al., 2015). The current study looks at the effect of cues on accuracy and rehabilitation outcomes. Fifty-one individuals with aphasia completed a 10-week program using Constant Therapy on an iPad targeted at improving language and cognitive deficits. Three questions were examined. The first examined the effect of cues on accuracy collapsed across time. Results showed a trend where the greater the cue use, the lower the accuracy, although some participants showed the opposite effect. This analysis divided participants into profiles based on cue use and accuracy. The second question examined how each profile differed in percent cue use and on standardized measures at baseline. Results showed that the four profiles were significantly different in frequency of cues and scores on WAB-R, CLQT, BNT, and ASHA-FACS, indicating that participants with lower scores on the standardized tests used a higher percentage of cues, which were not beneficial, while participants with higher scores on the standardized tests used a lower frequency of cues, which were beneficial. The third question examined how the relationship between cues and accuracy was affected by the course of treatment. Results showed that both more and less severe participants showed a decrease in cue use and an increase in accuracy over time, though more severe

  10. Technologic Advances in Aural Rehabilitation: Applications and Innovative Methods of Service Delivery

    PubMed Central

    Sweetow, Robert W.; Sabes, Jennifer Henderson

    2007-01-01

    The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described. PMID:17494876

  11. Technologic advances in aural rehabilitation: applications and innovative methods of service delivery.

    PubMed

    Sweetow, Robert W; Sabes, Jennifer Henderson

    2007-06-01

    The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

  12. Perceived needs for different components in a rehabilitation program among cancer survivors with chronic fatigue compared to survivors without chronic fatigue.

    PubMed

    Gjerset, Gunhild M; Loge, Jon H; Kiserud, Cecilie E; Fosså, Sophie D; Gudbergsson, Sævar B; Oldervoll, Line M; Wisløff, Torbjørn; Thorsen, Lene

    2017-02-01

    Knowledge about the user' needs is important to develop targeted rehabilitation for cancer patients with chronic fatigue (CF). The aims of the study were to examine prevalence of CF in cancer survivors attending an one-week inpatient educational program (IEP) and to identify characteristics of those with CF. Further to examine the perceived needs for different components in a rehabilitation program, need of complex rehabilitation (at least two components) and aspects of health-related quality of life (HRQoL) among survivors with CF versus those without CF. Cancer survivors ≥18 years, diagnosed with different types of cancer within the last 10 years and attending a one-week IEP were invited to this cross-sectional study. CF was assessed by the Fatigue Questionnaire, perceived needs by asking a question about needs for different components in a rehabilitation program and HRQoL was assessed by The Medical Outcomes Study Short Form 36. Of 564 participants, 45% reported CF. Breast cancer, mixed cancer types (including small groups with different cancer types) and comorbidities increased the risk for having CF. Compared to participants without CF, the participants with CF reported more frequently need for physical training (86% vs. 65%, p < 0.001), physiotherapy (71% vs. 55%, p < 0.001) and nutrition counseling (68% vs. 53%, p = 0.001). Among participants with CF, 75% reported need for three or more components whereas 54% reported need for the same number of components among those without CF (p < 0.001). Almost half of the cancer survivors attending the IEP had CF. Physical training, physiotherapy and nutrition counseling were the most frequently reported needs and significantly more often observed in participants with CF than without CF. A higher percentage of those with CF reported need for a complex rehabilitation compared to those without CF. More research is necessary to obtain more knowledge to further make targeted programs to better match cancer

  13. Exploratory study on the effects of a robotic hand rehabilitation device on changes in grip strength and brain activity after stroke.

    PubMed

    Pinter, Daniela; Pegritz, Sandra; Pargfrieder, Christa; Reiter, Gudrun; Wurm, Walter; Gattringer, Thomas; Linderl-Madrutter, Regina; Neuper, Claudia; Fazekas, Franz; Grieshofer, Peter; Enzinger, Christian

    2013-01-01

    The brain mechanisms underlying successful recovery of hand fuenction after stroke are still not fully understood, although functional MRI (fMRI) studies underline the importance of neuronal plasticity. We explored potential changes in brain activity in 7 patients with subacute to chronic stroke (69 ± 8 years) with moderate- to high-grade distal paresis of the upper limb (Motricity Index: 59.4) after standardized robotic finger-hand rehabilitation training, in addition to conventional rehabilitation therapy for 3 weeks. Behavioral and fMRI assessments were carried out before and after training to characterize changes in brain activity and behavior. The Motricity Index (pre: 59.4, post: 67.2, P < .05) and grip force (pre: 7.26, post: 11.87, P < .05) of the paretic hand increased significantly after rehabilitation. On fMRI, active movement of the affected (left) hand resulted in contralesional (ie, ipsilateral) activation of the primary sensorimotor cortex prior to rehabilitation. After rehabilitation, activation appeared "normalized," including the ipsilesional primary sensorimotor cortex and supplementary motor area (SMA). No changes and no abnormalities of activation maps were seen during movement of the unaffected hand. Subsequent region-of-interest analyses showed no significant ipsilesional activation increases after rehabilitation. Despite behavioral improvements, we failed to identify consistent patterns of functional reorganization in our sample. This warrants caution in the use of fMRI as a tool to explore neural plasticity in heterogeneous samples lacking sufficient statistical power.

  14. 34 CFR 674.39 - Loan rehabilitation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Loan rehabilitation. 674.39 Section 674.39 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Terms of Loans § 674.39 Loan rehabilitation. (a) Each...

  15. 34 CFR 674.39 - Loan rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Loan rehabilitation. 674.39 Section 674.39 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Terms of Loans § 674.39 Loan rehabilitation. (a) Each...

  16. Economic Outcome of Employment for Older Participants in Rehabilitation Services Funded by the Rehabilitation Services Administration

    ERIC Educational Resources Information Center

    Wadsworth, John S.; Estrada-Hernandez, Noel; Kampfe, Charlene M.; Smith, S. Mae

    2008-01-01

    The purpose of this study was to determine if persons who were age 65 or older and who participated in vocational rehabilitation programs funded by the Rehabilitation Services Administration (RSA) experienced an increase in earnings from paid employment at the conclusion of services. Preservice and postservice earnings for 9,787 consumers of RSA…

  17. Longitudinal Study of the Vocational Rehabilitation Services Program. Final Report 2: VR Services and Outcomes.

    ERIC Educational Resources Information Center

    Hayward, Becky J.; Schmidt-Davis, Holly

    This report is the second in a series of four final reports that present the findings of the Longitudinal Study of the Vocational Rehabilitation (VR) Services Program. Initiated in fall 1992, the study has tracked VR participation and post-VR experiences of applicants to and consumers of VR services (n=8,500) for up to 3 years following exit from…

  18. From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals' experiences when facilitating a recovery-oriented rehabilitation program.

    PubMed

    Dalum, Helle Stentoft; Pedersen, Inge Kryger; Cunningham, Harry; Eplov, Lene Falgaard

    2015-12-01

    The recovery model has influenced mental health services and fostered new standards for best practice. However, knowledge about how mental health care professionals (HCPs) experience recovery-oriented programs is sparse. This paper explores HCPs' experiences when facilitating a recovery-oriented rehabilitation program. The research question is how do HCPs experience a change in their attitude and practice when applying recovery-oriented programs? This paper draws on semi-structured in-depth qualitative interviews conducted with 16 HCPs experienced in facilitating a recovery-oriented rehabilitation program in either the USA or Denmark. Three themes emerged from the HCPs' reflections on changes in attitudes and practices: "Hopeful Attitude" captures a change in the HCPs' attitude toward a more positive view on the future for clients' living with mental illness; "A New Focus in the Dialogue With Clients" thematizes how the HCPs focus more on the individual's own goal for recovery rather than disease-induced goals in the dialog with clients; "A Person-Centered Role" comprises a shift in the professional role whereby the HCPs value the client's own ideas in addition to the professional's standards. This study supports the theory of the recovery model by its empirical findings and indications that when facilitating a recovery-oriented program, HCPs experience recovery-oriented changes in their attitude toward life with mental illness, and it alters their professional practice toward a stronger focus on client's own goals during treatment. More studies are needed to further clarify how changes in HCPs' attitudes translate into changes in mental health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Changes in muscle activity and stature recovery after active rehabilitation for chronic low back pain.

    PubMed

    Lewis, Sandra; Holmes, Paul; Woby, Steve; Hindle, Jackie; Fowler, Neil

    2014-06-01

    Patients with low back pain often demonstrate elevated paraspinal muscle activity compared to asymptomatic controls. This hyperactivity has been associated with a delayed rate of stature recovery following spinal loading tasks. The aim of this study was to investigate the changes in muscle activity and stature recovery in patients with chronic low back pain following an active rehabilitation programme. The body height recovery over a 40-min unloading period was assessed via stadiometry and surface electromyograms were recorded from the paraspinal muscles during standing. The measurements were repeated after patients had attended the rehabilitation programme and again at a six-month follow-up. Analysis was based on 17 patients who completed the post-treatment analysis and 12 of these who also participated in the follow-up. By the end of the six months, patients recovered significantly more height during the unloading session than at their initial visit (ES = 1.18; P < 0.01). Greater stature recovery immediately following the programme was associated with decreased pain (r = -0.55; P = 0.01). The increased height gain after six months suggests that delayed rates of recovery are not primarily caused by disc degeneration. Muscle activity did not decrease after treatment, perhaps reflecting a period of adaptation or altered patterns of motor control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. [Rehabilitation in rheumatology].

    PubMed

    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.