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Sample records for 3-month rehabilitation program

  1. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A 3-Month Study with Proprioceptive Neuromuscular Facilitation.

    PubMed

    Zhou, Zhihao; Sun, Yao; Wang, Ninghua; Gao, Fan; Wei, Kunlin; Wang, Qining

    2016-01-01

    In this paper, we aim to investigate the effect of proprioceptive neuromuscular facilitation (PNF)-based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS). A modified robot-assisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3-month robotic PNF training. Their impaired sides were used as the experimental group, while their unimpaired sides as the control group. A robotic intervention for the experimental group started from a 2-min passive stretching to warming-up or relaxing the soleus and gastrocnemius muscles and also ended with the same one. Then a PNF training session including 30 trials was activated between them. The rehabilitation trainings were carried out three times a week as an addition to their regular rehabilitation exercise. Passive range of motion, resistance torque, and stiffness were measured in both ankles before and after the interventions. The changes in Achilles tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the 3 months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased (p < 0.01), resistance torque under different dorsiflexion angle levels (0°, 10°, and 20°) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasi-static stiffness under different dorsiflexion angle levels (0°, 10°, and 20°) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilles's tendon length shortened (p < 0.01), while its thickness showed no significant change (p > 0.05). The robotic rehabilitation also improved the

  2. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A 3-Month Study with Proprioceptive Neuromuscular Facilitation

    PubMed Central

    Zhou, Zhihao; Sun, Yao; Wang, Ninghua; Gao, Fan; Wei, Kunlin; Wang, Qining

    2016-01-01

    In this paper, we aim to investigate the effect of proprioceptive neuromuscular facilitation (PNF)-based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle–foot Rehabilitation System (RARS). A modified robot-assisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3-month robotic PNF training. Their impaired sides were used as the experimental group, while their unimpaired sides as the control group. A robotic intervention for the experimental group started from a 2-min passive stretching to warming-up or relaxing the soleus and gastrocnemius muscles and also ended with the same one. Then a PNF training session including 30 trials was activated between them. The rehabilitation trainings were carried out three times a week as an addition to their regular rehabilitation exercise. Passive range of motion, resistance torque, and stiffness were measured in both ankles before and after the interventions. The changes in Achilles tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the 3 months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased (p < 0.01), resistance torque under different dorsiflexion angle levels (0°, 10°, and 20°) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasi-static stiffness under different dorsiflexion angle levels (0°, 10°, and 20°) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilles’s tendon length shortened (p < 0.01), while its thickness showed no significant change (p > 0.05). The robotic rehabilitation also improved the

  3. Outpatient Pain Rehabilitation Programs

    PubMed Central

    Chen, Joseph J

    2006-01-01

    Outpatient pain rehabilitation programs that include an interdisciplinary approach have been shown to be effective treatments for patients with chronic pain. The objectives of this article are to describe the common interdisciplinary pain rehabilitation programs available, the appropriate indications for use, the components of typical pain rehabilitation programs, the short-term and long-term success rates, the costs of attending these programs, and the significant societal costs of those patients who do not complete these programs and do not return to work. PMID:16789457

  4. Employment program for patients with severe mental illness in Malaysia: a 3-month outcome.

    PubMed

    Wan Kasim, Syarifah Hafizah; Midin, Marhani; Abu Bakar, Abdul Kadir; Sidi, Hatta; Nik Jaafar, Nik Ruzyanei; Das, Srijit

    2014-01-01

    This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI). A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment. The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]). Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Life habits and prosthetic profile of persons with lower-limb amputation during rehabilitation and at 3-month follow-up.

    PubMed

    Zidarov, Diana; Swaine, Bonnie; Gauthier-Gagnon, Christiane

    2009-11-01

    To assess performance of life habits among persons with lower-limb amputation at admission, at discharge, and 3 months after rehabilitation discharge and describe their prosthetic profile at discharge and follow-up. Case series. Inpatient rehabilitation. Unilateral persons with lower-limb amputation (N=19; 14 men; mean age, 53.4+/-14.6y). Interdisciplinary rehabilitation. Life habits performance and prosthetic profile. In the daily activities subdomain, the lowest performances were observed for mobility and housing at all evaluation times. Within the social role subdomain, employment, recreation, and community life scores were the lowest for the 3 evaluations. Mean scores for all activities of daily living subdomain categories significantly increased (P<.05) during rehabilitation except for personal care and communication. Only community life (social roles subdomain) significantly increased during rehabilitation; life habits remained unchanged after discharge. Fifty-eight percent of patients at discharge versus 68.4% at follow-up used their prosthesis for more than 9 hours a day, and this increased significantly postdischarge (P=.017). Locomotor capability with prosthesis was similarly high at discharge and follow-up. Among persons with lower-limb amputation, social role life habits appear to be more disturbed than those associated with activities of daily living. At discharge, prosthetic wear and locomotor capabilities with prosthesis were high and tended to improve on return to the community.

  6. Influence of a 3-month training program on muscular damage and neutrophil function in male university freshman judoists.

    PubMed

    Koga, Toshihiko; Umeda, Takashi; Kojima, Arata; Tanabe, Masaru; Yamamoto, Yousuke; Takahashi, Ippei; Iwasaki, Hiroki; Iwane, Kaori; Matsuzaka, Masashi; Nakaji, Shigeyuki

    2013-01-01

    We studied the effects of a high intensity and high frequency 3-month training program on muscle damage and neutrophil function in male judoists. The study included 15 male judoists who started intensive judo training program after a 6-month break. Creatine kinase (CK), neutrophil counts and reactive oxygen species (ROS) production capability as well as phagocytic activity (PA) of neutrophils were measured at 2 stages; entering university (pre-training) and after 3-month training (post-training). At both points, we investigated parameters three times: just before, immediately after and 24 h after a 2-h practice session. Practice-mediated change in CK was lower at post-training than at pre-training. Neutrophil count significantly increased after 2-h practice but recovered 24 h later whereas it showed no subsequent and further increased at 24 h post-practice. Although neutrophil ROS production capability and PA both decreased (breakdown) after practice session, ROS production capability increased and PA decreased (well-adapted) at the post-training. Long-term training strengthened muscular function and improved neutrophil reaction against practice-mediated stress. Copyright © 2012 John Wiley & Sons, Ltd.

  7. 78 FR 35808 - Proposed priority-Rehabilitation Training: Rehabilitation Long-Term Training Program-Vocational...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... CFR Chapter III Proposed priority--Rehabilitation Training: Rehabilitation Long- Term Training Program... and Rehabilitative Services proposes a priority under the Rehabilitation Training: Rehabilitation Long-Term Training program. The Assistant Secretary may use this priority for competitions in fiscal...

  8. A 3-Month Jump-Landing Training Program: A Feasibility Study Using the RE-AIM Framework

    PubMed Central

    Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain

    2013-01-01

    Context: Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. Objective: To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Design: Randomized controlled trial. Setting: National and regional basketball teams. Patients or Other Participants: Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. Intervention(s): All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. Main Outcome Measure(s): The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. Results: The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Conclusions: Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries. PMID:23675788

  9. Management of Youth Rehabilitation Programs. Program Audit.

    ERIC Educational Resources Information Center

    Geizer, Bernard P., Ed.

    This report presents the results of an evaluation of New York State's Division for Youth (DFY) rehabilitation programs, which range from secure facilities to residential homes. The goals of the evaluation were to assess the level of expenditures for facility operation and use, to determine the scope of programs and the extent to which they meet…

  10. Rehabilitation in the Work Injury Program.

    ERIC Educational Resources Information Center

    Berkowitz, Monroe; Berkowitz, Edward D.

    1991-01-01

    Examines the reasons for the workers' compensation and vocational rehabilitation programs drifting apart; the reasons for their getting together again in the 1970s; and the reasons for the current state of affairs, in which compensation programs are retreating from mandatory referral for rehabilitation. Urges vocational rehabilitation profession…

  11. Final priority; Rehabilitation Training: Rehabilitation Long-Term Training program--rehabilitation specialty areas. Final priority.

    PubMed

    2014-07-23

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training: Rehabilitation Long-Term Training program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years in order to fund any of the rehabilitation specialty areas listed in this notice. The specific rehabilitation specialty areas to be funded in a given year will be listed in a notice inviting applications. This priority is designed to ensure that the Department funds high-quality rehabilitation programs in the following nine rehabilitation specialty areas of national need: Rehabilitation Administration (84.129C); Rehabilitation Technology (84.129E); Vocational Evaluation and Work Adjustment (84.129F); Rehabilitation of Individuals Who Are Mentally Ill (84.129H); Rehabilitation Psychology (84.129J); Rehabilitation of Individuals Who are Blind or Have Vision Impairments (84.129P); Rehabilitation of Individuals Who are Deaf or Hard of Hearing (84.129Q); Job Development and Job Placement Services (84.129R); and Comprehensive System of Personnel Development (84.129W). These programs must meet rigorous standards in order to provide rehabilitation professionals the training and qualifications necessary to meet the current challenges facing State vocational rehabilitation (VR) agencies and related agencies and assist individuals with disabilities in achieving high-quality employment outcomes.

  12. 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.

  13. Cardiac Rehabilitation Program at Rehabilitation Hospital of the Pacific

    PubMed Central

    Spanuchart, Ittikorn; Mausolf, Chris; Gabriel, Susie; Tsubota, Shawn; Baker, Justina; Fukuyama, Osamu

    2014-01-01

    Introduction: For the past 20 years, multiple studies have demonstrated that cardiac rehabilitation and secondary prevention programs reduce cardiovascular risk and event rates significantly (up to 20%–25%) in patients with acute coronary syndrome (ACS), stable ischemic heart disease (IHD), and patients who have undergone percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Consequently, the American Heart Association (AHA) and American College of Cardiology (ACC) designated cardiac rehabilitation as a Class I indication for these patients. Status: On the island of O‘ahu, comprehensive cardiac rehabilitation programs have not been available at any of the major hospitals for at least the past several years. Because of the desperate need for these services, Rehabilitation Hospital of the Pacific (REHAB) officially instituted a comprehensive cardiac rehabilitation program that is the only cardiac rehab program on the island of Oahu that contributes to the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) data registry and has been going through the process of national certification effective as of December 1, 2012. It is well-known that the major problem of cardiac rehabilitation programs in this country is suboptimal participation, ie, only 25%–30% of eligible patients are actually referred to these programs. Our data suggests that underutilization of cardiac rehab programs is extremely severe here in Honolulu where probably less than 5% of eligible patients are actually referred to this program. We will discuss the importance of improving utilization at the patient level, physician level, third-party payer level, in the general medical community as well as in the general public to positively impact overall mortality and morbidity in the state of Hawai‘i.

  14. Federal Offenders Rehabilitation Collaboration Research Program.

    ERIC Educational Resources Information Center

    1964

    This paper gives the specifics of a federal offenders rehabilitation program implementation and evaluation which will test and demonstrate the effects of providing intensive vocational rehabilitation services to federal offenders. The authors note that criminal offenders have difficulty in vocational adjustment, and this is exacerbated by their…

  15. 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…

  16. Adherence to Sports-Injury Rehabilitation Programs.

    ERIC Educational Resources Information Center

    Fisher, A. Craig; And Others

    1988-01-01

    Analysis of 41 injured college athletes' responses to a questionnaire revealed that those athletes who adhered to their rehabilitation program were more self-motivated, tolerated pain better, perceived that they worked harder at their rehabilitation, and were less bothered by scheduling of sessions and athletic training environmental conditions.…

  17. Adherence to Sports-Injury Rehabilitation Programs.

    ERIC Educational Resources Information Center

    Fisher, A. Craig; And Others

    1988-01-01

    Analysis of 41 injured college athletes' responses to a questionnaire revealed that those athletes who adhered to their rehabilitation program were more self-motivated, tolerated pain better, perceived that they worked harder at their rehabilitation, and were less bothered by scheduling of sessions and athletic training environmental conditions.…

  18. 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…

  19. Characteristics of effective and efficient rehabilitation programs.

    PubMed

    Johnston, Mark V; Wood, Kenneth D; Fiedler, Roger

    2003-03-01

    To investigate the characteristics of rehabilitation hospitals and units correlated with gains in motor and cognitive function, after adjusting for case severity of the patients admitted and for length of stay (LOS). The Uniform Data System for Medical Rehabilitation (UDSMR) database was first analyzed to develop a method of adjusting for patient case severity on admission. Rehabilitation programs were surveyed to assess characteristics commonly thought to be associated with efficiency and effectiveness. Data on these characteristics were linked to UDSMR data on patient characteristics and functional gain. Seventy-seven rehabilitation hospitals across the United States. A total of 37,692 inpatients from the participating rehabilitation hospitals. Comprehensive rehabilitation programs not altered by researcher. Program effectiveness was estimated by gains in motor and cognitive subscale scores of the FIM trade mark instrument between admission and discharge, adjusted for indicators of caseload severity at admission. Efficiency was estimated by adjusting gains for LOS as well. Primary factors affecting both motor and cognitive gains included admission function (treated curvilinearly), age, certain diagnostic distinctions, onset-admission interval, admission class, and LOS. Correlations between staffing intensity and numerous other program characteristics with functional gain were meager, each accounting for less than 2% of variance. LOS was predicted by a number of factors, notably by the percentage of managed care cases (r=-.20), but not by staffing intensity. Relationships between rehabilitation practices and functional gains by patients do not appear to be simple or overt. Continued research is needed to identify reliable connections between rehabilitative processes and patient outcomes in practice. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

  20. The effect of a 3-month prevention program on the jump-landing technique in basketball: a randomized controlled trial.

    PubMed

    Aerts, Inne; Cumps, Elke; Verhagen, Evert; Wuyts, Bram; Van De Gucht, Sam; Meeusen, Romain

    2015-02-01

    In jump-landing sports, the injury mechanism that most frequently results in an injury is the jump-landing movement. Influencing the movement patterns and biomechanical predisposing factors are supposed to decrease injury occurrence. To evaluate the influence of a 3-mo coach-supervised jump-landing prevention program on jump-landing technique using the jump-landing scoring (JLS) system. Randomized controlled trial. On-field. 116 athletes age 15-41 y, with 63 athletes in the control group and 53 athletes in the intervention group. The intervention program in this randomized control trial was administered at the start of the basketball season 2010-11. The jump-landing training program, supervised by the athletic trainers, was performed for a period of 3 mo. The jump-landing technique was determined by registering the jump-landing technique of all athletes with the JLS system, pre- and postintervention. After the prevention program, the athletes of the male and female intervention groups landed with a significantly less erect position than those in the control groups (P < .05). This was presented by a significant improvement in maximal hip flexion, maximal knee flexion, hip active range of motion, and knee active range of motion. Another important finding was that postintervention, knee valgus during landing diminished significantly (P < .05) in the female intervention group compared with their control group. Furthermore, the male intervention group significantly improved (P < .05) the scores of the JLS system from pre- to postintervention. Malalignments such as valgus position and insufficient knee flexion and hip flexion, previously identified as possible risk factors for lower-extremity injuries, improved significantly after the completion of the prevention program. The JLS system can help in identifying these malalignments. Therapy, prevention, level 1b.

  1. Legal Aspects of Cardiac Rehabilitation Exercise Programs.

    ERIC Educational Resources Information Center

    Herbert, William; Herbert, David L.

    1988-01-01

    A medical model is used to examine liability issues related to cardiac rehabilitation programs. Obtaining effective informed consent from patients, standardizing policies and procedures, and exercise prescription and monitoring are among the proposed elements of a risk management model for developing safe and legally defensible programs. (IAH)

  2. Legal Aspects of Cardiac Rehabilitation Exercise Programs.

    ERIC Educational Resources Information Center

    Herbert, William; Herbert, David L.

    1988-01-01

    A medical model is used to examine liability issues related to cardiac rehabilitation programs. Obtaining effective informed consent from patients, standardizing policies and procedures, and exercise prescription and monitoring are among the proposed elements of a risk management model for developing safe and legally defensible programs. (IAH)

  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. 38 CFR 21.284 - Reentrance into a rehabilitation program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... rehabilitation program. 21.284 Section 21.284 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 Induction into A Rehabilitation Program § 21.284 Reentrance into a...

  5. 38 CFR 21.284 - Reentrance into a rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... rehabilitation program. 21.284 Section 21.284 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 Induction into A Rehabilitation Program § 21.284 Reentrance into a...

  6. 42 CFR 485.717 - Condition of participation: Rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Rehabilitation program... PROVIDERS Conditions of Participation for Clinics, Rehabilitation Agencies, and Public Health Agencies as... participation: Rehabilitation program. This condition and standards apply only to a rehabilitation agency's...

  7. The effect of a 3-month moderate-intensity physical activity program on body composition in overweight and obese African American college females

    PubMed Central

    Casazza, K.; Durant, N. H.

    2014-01-01

    Summary This study evaluated body composition outcomes following a 3-month exercise program for overweight/obese Black women. BMI decreased over the 3-month study despite an observed increase in body fat. Enhancements in bone marrow density and muscle density were also observed. Results show promising yet hypothesis-generating findings to explore in future research. Introduction Few studies have evaluated the relationship between aerobic physical activity (PA) and body composition among young adult overweight/obese African American (AA) women. Purpose The current study evaluated the effect of a 3-month moderate-intensity aerobic physical activity intervention for overweight and obese young adult women on bone, lean, and fat mass. Methods Participants (n=15) were a randomly selected subset of AA female college students (M age=21.7 years; M BMI= 33.3) enrolled in a larger PA promotion pilot study (n=31). Study protocol required participants to engage in four 30–60-min moderate-intensity aerobic PA sessions each week. Whole body composition was measured by dual-energy X-ray absorptiometry (DXA), and peripheral quantitative computed tomography (pQCT) was used to assess additional quantitative and qualitative assessment of the radius. Results BMI decreased over the duration of the study (P=.034), reflected by a marginal decrease in body weight (P=.057). However, unexpectedly, increases in adipose tissue measures were observed, including total body fat (P=.041), percent body fat (P=.044), trunk fat (P=.031), and percent trunk fat (P=.041). No changes in DXA-measured bone outcomes were observed (i.e., bone mineral density, P=.069; bone mineral content, P=.211). Results from the pQCT assessment showed that bone marrow density increased (P=.011), but cortical density remained stable (P=.211). A marginally significant increase in muscle density (P=.053) and no changes in muscle area (P=.776) were observed. Conclusions A 3-month moderate-intensity PA program was associated

  8. 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)…

  9. 24 CFR 8.30 - Rental rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Rental rehabilitation program. 8.30... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Program Accessibility § 8.30 Rental rehabilitation program. Each grantee or state recipient in the rental rehabilitation program shall, subject to the priority in 24 CFR...

  10. 24 CFR 8.30 - Rental rehabilitation program.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Rental rehabilitation program. 8.30... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Program Accessibility § 8.30 Rental rehabilitation program. Each grantee or state recipient in the rental rehabilitation program shall, subject to the priority in 24 CFR...

  11. An evaluation of a postoperative rehabilitation program after spinal surgery and its impact on outcome.

    PubMed

    McGregor, Alison H; Henley, Ania; Morris, Tim P; Doré, Caroline J

    2012-04-01

    This study invited patients to evaluate the content and style of a rehabilitation program used as an intervention in a multicenter, factorial, randomized controlled trial of the postoperative management of spinal surgery patients. To determine the acceptability and content of the rehabilitation program. The use of rehabilitation after spinal surgery is sporadic, and the evidence for its benefit is mixed. A randomized controlled trial was conducted to determine whether functional outcome of spinal surgery could be improved by a postoperative rehabilitation program and/or an educational booklet provided at hospital discharge, each compared with usual care. Patients randomized to postoperative rehabilitation began the course 6 weeks after surgery. At the end of the course of 12 classes, patients completed an evaluation of content, style, and length using forced choice and open questions. Patients not attending the final class completed the evaluation at their 3-month review. Compliance with rehabilitation was poor, with 41% of subjects failing to attend any classes and 16% attending less than half. Compliance with the evaluation was 100% for the 105 patients attending 1 or more classes. The length, content, and approach to the classes were rated positively, and patients gave the class a median rating of 9 of 10, range 5 to 10, with 91% rating the classes as 7 or above. Compliance with a postoperative rehabilitation program was disappointing, but the program was assessed positively and of benefit by those who attended. Issues were raised in relation to timing and location of classes.

  12. 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…

  13. 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...

  14. 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,…

  15. Clinical Internship Training Program in Psychiatric Vocational Rehabilitation.

    ERIC Educational Resources Information Center

    Geckle, Michelle O.; Katz, Lynda J.

    This manual has been designed for university-based training programs in rehabilitation counseling, psychiatric rehabilitation field sites, and other potential training sites and community programs, that may wish to implement a clinical training program in psychiatric/vocational rehabilitation. The manual is formatted to follow the trainee/student…

  16. 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.

  17. Your Baby's Growth: 3 Months

    MedlinePlus

    ... Games, and the Internet Your Baby's Growth: 3 Months KidsHealth > For Parents > Your Baby's Growth: 3 Months Print A A A What's in this article? ... continue to grow in weight and length this month. How Much Will My Baby Grow? The first ...

  18. An Overview of the Federal Offenders Rehabilitation Program.

    ERIC Educational Resources Information Center

    1966

    The Federal Offenders Rehabilitation Program is designed to test experimentally the centrality of employment in offender rehabilitation. Specifically, does appropriate employment, obtained through the services of vocational rehabilitation counseling, change an offender's pattern of behavior? Does this change occur in the direction of integration…

  19. [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.

  20. 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…

  1. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Rehabilitation dentistry; (9) Physical therapy; (10) Occupational therapy; (11) Speech pathology and audiology; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... the specialty of physical medicine and rehabilitation. (b) The Rehabilitation Long-Term...

  2. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Rehabilitation dentistry; (9) Physical therapy; (10) Occupational therapy; (11) Speech pathology and audiology; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... the specialty of physical medicine and rehabilitation. (b) The Rehabilitation Long-Term...

  3. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Rehabilitation dentistry; (9) Physical therapy; (10) Occupational therapy; (11) Speech pathology and audiology; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... the specialty of physical medicine and rehabilitation. (b) The Rehabilitation Long-Term...

  4. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) Rehabilitation dentistry; (9) Physical therapy; (10) Occupational therapy; (11) Speech pathology and audiology; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... the specialty of physical medicine and rehabilitation. (b) The Rehabilitation Long-Term...

  5. 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

    ... Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program--Advanced Rehabilitation Research Training (ARRT) Projects AGENCY: Office of Special Education and Rehabilitative Services, National Institute on Disability and Rehabilitation Research, Department of Education. ACTION: Notice...

  6. 9 CFR 206.3 - Monthly report.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STOCKYARDS PROGRAMS), DEPARTMENT OF AGRICULTURE SWINE CONTRACT LIBRARY § 206.3 Monthly report. (a) Do I need... swine processing plant that it operates or at which it has swine slaughtered that has the slaughtering... report, each packer must provide the following information: (1) Number of swine to be delivered under...

  7. 9 CFR 206.3 - Monthly report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STOCKYARDS PROGRAMS), DEPARTMENT OF AGRICULTURE SWINE CONTRACT LIBRARY § 206.3 Monthly report. (a) Do I need... swine processing plant that it operates or at which it has swine slaughtered that has the slaughtering... following information: (1) Number of swine to be delivered under existing contracts. Existing contracts are...

  8. 9 CFR 206.3 - Monthly report.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STOCKYARDS PROGRAMS), DEPARTMENT OF AGRICULTURE SWINE CONTRACT LIBRARY § 206.3 Monthly report. (a) Do I need... swine processing plant that it operates or at which it has swine slaughtered that has the slaughtering... report, each packer must provide the following information: (1) Number of swine to be delivered under...

  9. 9 CFR 206.3 - Monthly report.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STOCKYARDS PROGRAMS), DEPARTMENT OF AGRICULTURE SWINE CONTRACT LIBRARY § 206.3 Monthly report. (a) Do I need... swine processing plant that it operates or at which it has swine slaughtered that has the slaughtering... report, each packer must provide the following information: (1) Number of swine to be delivered under...

  10. 9 CFR 206.3 - Monthly report.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STOCKYARDS PROGRAMS), DEPARTMENT OF AGRICULTURE SWINE CONTRACT LIBRARY § 206.3 Monthly report. (a) Do I need... swine processing plant that it operates or at which it has swine slaughtered that has the slaughtering... report, each packer must provide the following information: (1) Number of swine to be delivered under...

  11. 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... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING General § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed...

  12. [National Registry of Cardiac Rehabilitation Programs in México].

    PubMed

    Ilarraza Lomelí, Hermes; Herrera Franco, Rodolfo; Lomelí Rivas, Alvaro; Zavala Ramírez, Juana; Martínez Ramírez, Leonel; Ramos Becerril, Francisco José; Romo Escamilla, Ricardo Elías; Pacheco Beltrán, Nancy; Alonso Sánchez, Jesús; Mendoza Díaz, Pedro Miguel; Alvarez Cerro, Margarita; Cassaigne Guasco, María Elena; Mayela Muñoz Gutiérrez, Luz María

    2009-01-01

    Cardiac Rehabilitation and secondary prevention programs are a group of therapeutic maneuvers that can reduce the adverse impact of cardiovascular disease, by using the cardiovascular risk factors reduction, through secondary prevention and exercise training therapy programs. This program started in Mexico in 1944, since then, several health institutions are working on a public or private basis, mainly in an isolated way. This article presents data about fourteen cardiac rehabilitation institutions that answered the first national registry of cardiac rehabilitation programs (RENAPREC) in 2007. On this study, we observed that these centers were mainly private; nevertheless, almost all of the referred population was attended in public health institutions. The core-components for an adequate cardiac rehabilitation attention were satisfied by almost all these centers. The patients used to pay, by their own, this kind of medical practice. In our country, only the 0.58% of the population, that needed to be included on a cardiac rehabilitation program, was covered. This phenomena is due, in one hand, to the reduced number of cardiac rehabilitation centers in Mexico, but on the other hand, it happens because the primary physician do not refer all the eligible patients to this kid of programs. RENAPREC can be one first attempt to consolidate all the activities around the inter-institutional cardiac rehabilitation and secondary prevention programs in our country.

  13. [Adherence to interdisciplinary Pulmonary Rehabilitation Program].

    PubMed

    Boim, Clarisa; Caberlotto, Oscar; Storni, Miguel; Cortiñaz, Marta; Monti, Fernanda; Khoury, Marina

    2014-01-01

    Participation in a Pulmonary Rehabilitation Program (PRP) improves dyspnea, functional capacity and quality of life in patients with chronic respiratory disease. A retrospective study was carried out to identify variables related to compliance in an out patient PRP at an Argentine center and to evaluate the results in compliant patients. The PRP included an "acquisition" stage consisting of 16 weeks of supervised training twice weekly and lectures on treatment benefits, inhalation devices used, smoking cessation, symptoms recognition and flair up management, among others. Patients were reassessed after this stage. Patients completing the acquisition stage were considered PRP compliant. Of 388 patients evaluated for admission 102 (26.3%) complied with PRP. Multiple logistic regression analysis (Forward Stepwise; p < 0.10 to be eligible for entry into the model) was used to identify factors related to "program compliance". The final model was as follows: having health insurance coverage (OR = 3.99; CI90% = 2.24-7.12), commute time under 60 minutes (OR = 2.07; CI90% = 1.37-3.11) and financial capacity (OR = 2.11; CI90% = 1.03-4.31). All patients complied with the PRP showed significant improvement in the six-minute walking test and quality of life. The results warn about low compliance and their relationship with socioeconomic variables.

  14. 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

  15. Client Assistance Program: A Rehabilitation Resource. Institute on Rehabilitation Issues (15th, Tampa, Florida, December 1988).

    ERIC Educational Resources Information Center

    Pankowski, Joe; Rice, B. Douglas

    This report provides guidelines for Client Assistance Programs (CAPs), established to assist applicants and clients of programs and facilities funded under the Rehabilitation Act of 1973. This report developed out of a study to provide information to increase cooperative approaches of benefit to both programs and clients and to create training…

  16. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING: REHABILITATION LONG-TERM TRAINING General § 386.1 What is the Rehabilitation Long-Term Training program? (a) The... 34 Education 2 2013-07-01 2013-07-01 false What is the Rehabilitation Long-Term Training program...

  17. Clinical and Rehabilitative Medicine Research: Program Overview

    DTIC Science & Technology

    2011-01-26

    rehabilitation  for  limb  salvage and spinal injury  patients • Exercise and fitness systems and strategies   • Improved orthotics, prosthetics,  robotics  to... REHABILITATION 2011 MHS Conference Investment Highlights • Prosthetics:  Lower Extremity: USAMRMC Managed Congressional funding o C-Leg Generation 2...and quality of life following lower extremity trauma • Funding amount to consortium: $40 million (September 2010 – September 2015) REHABILITATION 2011

  18. Efficacy of a 3 month training program on the jump-landing technique in jump-landing sports. Design of a cluster randomized controlled trial

    PubMed Central

    2010-01-01

    Background With the relatively high rate of injuries to the lower extremity due to jump-landing movement patterns and the accompanied high costs, there is need for determining potential preventive programs. A program on the intervention of jump-landing technique is possibly an important preventative measure since it appeared to reduce the incidence of lower extremity injuries. In real life situations, amateur sports lack the infrastructure and funds to have a sports physician or therapist permanently supervising such a program. Therefore the current prevention program is designed so that it could be implemented by coaches alone. Objective The objective of this randomized controlled trial is to evaluate the effect of a coach supervised intervention program targeting jump-landing technique on the incidence of lower extremity injuries. Methods Of the 110 Flemish teams of the elite division, 24 teams are included and equally randomized to two study groups. An equal selection of female and male teams with allocation to intervention and control group is obtained. The program is a modification of other prevention programs previously proven to be effective. All exercises in the current program are adjusted so that a more progressive development in the exercise is presented. Both the control and intervention group continue with their normal training routine, while the intervention group carries out the program on jump-landing technique. The full intervention program has a duration of three months and is performed 2 times a week during warm-up (5-10 min). Injuries are registered during the entire season. Discussion The results of this study can give valuable information on the effect of a coach supervised intervention program on jump-landing technique and injury occurrence. Results will become available in 2011. Trial registration Trial registration number: NTR2560 PMID:21144030

  19. The Rehabilitation Medicine Scientist Training Program: impact and lessons learned.

    PubMed

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

    2009-03-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining National Institutes of Health 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 was funded by a K12 grant from the National Center for Medical Rehabilitation Research, as one strategy for increasing the number of research-productive physiatrists. The Rehabilitation Medicine Scientist Training Program's structure was revised in 2001 to improve the level of preparation of incoming trainees and to provide a stronger central mentorship support network. We describe the original and revised structure of the Rehabilitation Medicine Scientist Training Program and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that Rehabilitation Medicine Scientist Training Program 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 yrs of training.

  20. 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

  1. 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...) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION CONTINUING EDUCATION PROGRAMS General § 389.1 What is the Rehabilitation Continuing Education Program? This...

  2. 38 CFR 21.282 - Effective date of induction into a rehabilitation program; retroactive induction.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... induction into a rehabilitation program; retroactive induction. 21.282 Section 21.282 Pensions, Bonuses, and... Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Induction into A Rehabilitation Program § 21.282 Effective date of induction into a rehabilitation program; retroactive induction. (a)...

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

    PubMed

    2014-07-25

    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 Disability and Rehabilitation Research Project (DRRP) on Improving Methods of Evaluating Return on Investment (ROI) for the State Vocational Rehabilitation Services Program (VR Program). 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 for the priority to contribute to improved employment outcomes for individuals with disabilities.

  4. 77 FR 40596 - Applications for New Awards: Disability and Rehabilitation Research Projects and Centers Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ... Applications for New Awards: Disability and Rehabilitation Research Projects and Centers Program; Disability and Rehabilitation Research Projects; Employment of Individuals With Disabilities AGENCY: Office of... Information National Institute on Disability and Rehabilitation Research (NIDRR)-- Disability and...

  5. 77 FR 40601 - Final Priority: Disability and Rehabilitation Research Projects and Centers Program; Disability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ... Final Priority: Disability and Rehabilitation Research Projects and Centers Program; Disability Rehabilitation Research Project; Employment of Individuals With Disabilities AGENCY: Office of Special Education...: 84.133A-1. Final Priority; National Institute on Disability and Rehabilitation Research (NIDRR...

  6. 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

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

    PubMed

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

    2015-10-01

    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.

  8. Effect of a safe patient handling program on rehabilitation outcomes.

    PubMed

    Campo, Marc; Shiyko, Mariya P; Margulis, Heather; Darragh, Amy R

    2013-01-01

    To evaluate the effect of a safe patient handling (SPH) program on rehabilitation mobility outcomes. Retrospective cohort study. A rehabilitation unit in a hospital system. Consecutive patients (N=1291) over a 1-year period without an SPH program in place (n=507) and consecutive patients over a 1-year period with an SPH program in place (n=784). The SPH program consisted of administrative policies and patient handling technologies. The policies limited manual patient handling. Equipment included ceiling- and floor-based dependent lifts, sit-to-stand assists, ambulation aides, friction-reducing devices, motorized hospital beds and shower chairs, and multihandled gait belts. The mobility subscale of the FIM. Patients rehabilitated in the group with SPH achieved similar outcomes to patients rehabilitated in the group without SPH. A significant difference between groups was noted for patients with initial mobility FIM scores of 15.1 and higher after controlling for initial mobility FIM score, age, length of stay, and diagnosis. Those patients performed better with SPH. SPH programs do not appear to inhibit recovery. Fears among therapists that the use of equipment may lead to dependence may be unfounded. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. 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.

  11. Community based rehabilitation program for people with musculoskeletal conditions.

    PubMed

    Polovina, Andrea; Bobinac-Georgievski, Ana; Jaksić, Mirka; Polovina-Prolosić, Tajana; Grazio, Simeon

    2007-06-01

    Community based rehabilitation program in people with musculoskeletal conditions was evaluated using Dartmouth COOP Functional Health Assessment Charts/WONCA (COOP/WONCA charts). The program consisted of educative and training protocol in a primary healthcare setting. It had two parts, both with six visits, in the first part three times a week and in the second part once a week. Clients with musculoskeletal conditions (N = 204) were included if they agreed to take active part in the rehabilitation process. The first part of the program was completed by 77 clients, and complete program by 52 subjects. Positive changes on the COOP/WONCA charts were achieved by more than 50% of the subjects that completed the program, in all categories but Social Activities. The program proved effective in terms of short-term evaluation with COOP/WONCA charts in those that complete the program. The high dropout rate and long-term efficiency have yet to be investigated.

  12. 38 CFR 21.282 - Effective date of induction into a rehabilitation program; retroactive induction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... induction into a rehabilitation program; retroactive induction. 21.282 Section 21.282 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 Induction into A Rehabilitation Program...

  13. Rehabilitation Counseling in the State or Federal Program: Is There a Future?

    ERIC Educational Resources Information Center

    O'Brien, Michael; Graham, Michael

    2009-01-01

    Rehabilitation counseling has played a significant role in the public rehabilitation program since its inception. Rehabilitation educators have also been critical in this partnership. This article reviews current trends in the relationships between public rehabilitation agencies, university programs, accreditation bodies, and others to discuss…

  14. Rehabilitation Counseling in the State or Federal Program: Is There a Future?

    ERIC Educational Resources Information Center

    O'Brien, Michael; Graham, Michael

    2009-01-01

    Rehabilitation counseling has played a significant role in the public rehabilitation program since its inception. Rehabilitation educators have also been critical in this partnership. This article reviews current trends in the relationships between public rehabilitation agencies, university programs, accreditation bodies, and others to discuss…

  15. [Growing complexity of cardiologic intensive rehabilitation: motor rehabilitation resources and programs of physical training].

    PubMed

    Michelis, E; Capurro, E; Remaggi, C; Belloni, L; Griffo, R

    2002-09-01

    In the last few years the population referred to cardiac rehabilitation centers has changed profoundly: the number of survivors of acute cardiac events has increased and heart surgery is being proposed to ever greater numbers of elderly patients with frequent and greater comorbidities, which make the management of physical training programs more complex. Consequently, just as rehabilitation cardiologists have had to expand their field of analyses and professional skills and nurses have had to integrate their care protocols, physiotherapists too have had to adapt the management of motor rehabilitation programs to the various needs and problems of each patient in the different phases of recovery. The aim of this paper is to present and discuss the procedures followed in our center concerning both the mode and contents of a standard course of motor rehabilitation for patients without complications and those for patients with complications. The paper analyzes the various assessments, the training program, the instruments of control and verification of the results, and discusses the instruments of intervention in patients affected by complications such as respiratory disturbances, musculoskeletal impairment, complications arising from injury, neurological deficit and severe deconditioning. Finally, the role of the physiotherapist in the active, propositive management of a recovery program is discussed.

  16. Postural motor programming in paraplegic patients during rehabilitation.

    PubMed

    Seelen, H A; Potten, Y J; Adam, J J; Drukker, J; Spaans, F; Huson, A

    1998-03-01

    One of the basic aims in the rehabilitation of thoracic spinal cord injured (SCI) patients concerns the regaining of sitting posture control. This implies the development of new postural strategies requiring the adjustment of motor programming processes. The aim of this study was to investigate the time course of postural reorganization during active, clinical rehabilitation of thoracic SCI patients with different SCI levels. Thus changes in motor programming in sitting balance control were investigated in two groups of complete low or high thoracic SCI patients. At several stages during the rehabilitation process an experiment was held in which sitting posture was perturbed systematically using submaximal reaching movements over four reaching distances. This bimanual reaching task was presented as a visual precue choice reaction time (RT) task in which reaching distance (i.e. grade of postural perturbation) was precued. Results indicated that in both high and low thoracic SCI patients RTs in movements involving postural perturbation became shorter during the course of the rehabilitation period. However, low thoracic SCI patients were generally slower in the programming of balance perturbing movements than high thoracic SCI patients, a phenomenon that did not change over time. Furthermore, initial differences in RTs as a function of grade of postural perturbation disappeared in both groups in the course of the rehabilitation phase. Precue benefit, equally large for both groups, did not change as a function of rehabilitation time. It is concluded that the observed phenomena signify the gradual development of new central postural control processes in both SCI groups during rehabilitation. Low thoracic SCI patients, having more residual sensorimotor functions, seem to adopt more complex strategies in maintaining and restoring sitting balance that take longer to specify and to programme. High thoracic SCI patients seem to rely on simpler strategies using more passive

  17. Veterans’ Benefits: The Vocational Rehabilitation and Employment Program

    DTIC Science & Technology

    2009-03-12

    VR&E), one of five major programs administered by the Veterans Benefits Administration ( VBA ) of the Department of Veterans Affairs (VA), addresses...delivery strategies differ from those of many other VBA programs as they require personal interaction with the veteran to deliver services and have the...largest network of service delivery points of any VBA program.3 History In 1918, Congress passed P.L. 65-178, the Vocational Rehabilitation Act, to

  18. Veterans’ Benefits: The Vocational Rehabilitation and Employment Program

    DTIC Science & Technology

    2010-02-26

    programs administered by the Veterans Benefits Administration ( VBA ) of the Department of Veterans Affairs (VA), addresses this concern.1 The program’s...those of many other VBA programs as they require personal interaction with the veteran to deliver services and have the largest network of service...delivery points of any VBA program.3 History In 1918, Congress passed P.L. 65-178, the Vocational Rehabilitation Act, to provide for the retraining

  19. Incorporating kettlebells into a lower extremity sports rehabilitation program.

    PubMed

    Brumitt, Jason; En Gilpin, Hui; Brunette, Meredith; Meira, Erik P

    2010-12-01

    The primary goal of a sports rehabilitation program is to return the injured athlete back to competition as quickly and as safely as possible. Sports physical therapists utilize a variety of exercise equipment to help an athlete restore function after an injury. An injured athlete's therapeutic exercise program frequently includes the prescription of functional strengthening and power exercises during the later stages of rehabilitation. One piece of exercise equipment, the kettlebell, has gained popularity for its ability to allow the user to perform functional power exercises. The unique exercises that can be performed with kettlebells may have utility in sports physical therapy practice. This clinical suggestion outlines the clinical rationale for the inclusion of kettlebell exercises when rehabilitating an athlete with a lower extremity injury.

  20. INCORPORATING KETTLEBELLS INTO A LOWER EXTREMITY SPORTS REHABILITATION PROGRAM

    PubMed Central

    En Gilpin, Hui; Brunette, Meredith; Meira, Erik P.

    2010-01-01

    The primary goal of a sports rehabilitation program is to return the injured athlete back to competition as quickly and as safely as possible. Sports physical therapists utilize a variety of exercise equipment to help an athlete restore function after an injury. An injured athlete's therapeutic exercise program frequently includes the prescription of functional strengthening and power exercises during the later stages of rehabilitation. One piece of exercise equipment, the kettlebell, has gained popularity for its ability to allow the user to perform functional power exercises. The unique exercises that can be performed with kettlebells may have utility in sports physical therapy practice. This clinical suggestion outlines the clinical rationale for the inclusion of kettlebell exercises when rehabilitating an athlete with a lower extremity injury. PMID:21655384

  1. Rehabilitation

    MedlinePlus

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

  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

    ... Disability and Rehabilitation Research Projects and Centers Program; Traumatic Brain Injury Model Systems... Program--Disability Rehabilitation Research Project (DRRP)-- Traumatic Brain Injury Model Systems Centers... priority for Traumatic Brain Injury Model Systems (TBIMS) Centers. The Assistant Secretary may use...

  3. 75 FR 32857 - State Vocational Rehabilitation Services Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION 34 CFR Part 361 State Vocational Rehabilitation Services Program CFR Correction In Title 34 of the Code of Federal Regulations, Parts 300 to 399, revised as of July 1, 2009, on page 267, in Sec. 361.42, in...

  4. 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…

  5. 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…

  6. Amputee care education in physical medicine and rehabilitation residency programs.

    PubMed

    Elias, Joseph Abraham; Morgenroth, David Crespi

    2013-02-01

    The aim of this study was to assess amputee care-related educational offerings and barriers to further educational opportunities in United States physical medicine and rehabilitation residency programs. A two-part survey was distributed to all United States physical medicine and rehabilitation residency program directors. Part 1 assessed the use of educational tools in amputee education. Part 2 assessed the potential barriers to amputee care-related education. Sixty-nine percent of the program directors responded. Seventy-five percent or more of the programs that responded have didactic lectures; grand rounds; reading lists; self-assessment exam review; gait analysis training; training with prosthetists; faculty with amputee expertise; and amputee care during inpatient, outpatient, and consult rotations. Less than 25% of the programs use intranet resources. No more than 14% of the programs said any one factor was a major barrier. However, some of the most prominent major barriers were limited faculty number, finances, and patient volume. The factors many of the programs considered somewhat of a barrier included lack of national standardized resources for curriculum, resident time, and faculty time. This study identified the most commonly used amputee educational opportunities and methods in physical medicine and rehabilitation residencies as well as the barriers to furthering resident amputee education. Developing Web-based resources on amputee care and increasing awareness of physiatrists as perioperative consultants could improve resident amputee education and have important implications toward optimizing care of individuals with amputation.

  7. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Rehabilitation Research and Related Projects: (1) Disability and Rehabilitation Research Projects. (2) Field... 34 Education 2 2010-07-01 2010-07-01 false What is the Disability and Rehabilitation Research... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM General § 350.1 What is the...

  8. Student Decision-Making in Selecting Rehabilitation Counseling Programs and Profession

    ERIC Educational Resources Information Center

    Arokiasamy, Charles; Rajani, Gita; Tracz, Susan; Orteiza, Roslyn

    2007-01-01

    The current and ever-growing shortage of qualified rehabilitation counselors in the country has made recruitment a high priority among rehabilitation counseling programs. This study identified factors that influenced students' decisions to choose or not choose the rehabilitation counseling profession or a particular rehabilitation counseling…

  9. Student Decision-Making in Selecting Rehabilitation Counseling Programs and Profession

    ERIC Educational Resources Information Center

    Arokiasamy, Charles; Rajani, Gita; Tracz, Susan; Orteiza, Roslyn

    2007-01-01

    The current and ever-growing shortage of qualified rehabilitation counselors in the country has made recruitment a high priority among rehabilitation counseling programs. This study identified factors that influenced students' decisions to choose or not choose the rehabilitation counseling profession or a particular rehabilitation counseling…

  10. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Body mass index. (iv) Systolic blood pressure. (v) Diastolic blood pressure. (vi) The need for cholesterol, blood pressure, and diabetes medications. (3) A list of approved intensive cardiac rehabilitation... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes...

  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

    ...) Body mass index. (iv) Systolic blood pressure. (v) Diastolic blood pressure. (vi) The need for cholesterol, blood pressure, and diabetes medications. (3) A list of approved intensive cardiac rehabilitation... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes...

  12. 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.

  13. Efficacy of a 3-month lifestyle intervention program using a Japanese-style healthy plate on body weight in overweight and obese diabetic Japanese subjects: a randomized controlled trial.

    PubMed

    Yamauchi, Keiko; Katayama, Tomomi; Yamauchi, Takahiro; Kotani, Kazuhiko; Tsuzaki, Kokoro; Takahashi, Kaoru; Sakane, Naoki

    2014-11-24

    The portion size of food is a determinant of energy intake, linking with obese traits. A healthy plate for portion control has recently been made in a Japanese style. The aim of the current study was to assess the efficacy of a lifestyle intervention program using the Japanese-style healthy plate on weight reduction in overweight and obese diabetic Japanese subjects. We randomized overweight and obese diabetic subjects (n = 19, 10 women) into an intervention group including educational classes on lifestyle modification incorporating the healthy plate (n = 10) or a waiting-list control group (n = 9). The intervention period was three months, and the educational classes using the healthy plate were conducted monthly in a group session for the intervention group. The body weight, blood glycemic and metabolic measures, and psychosocial variables were measured at the baseline and after the 3-month intervention in both groups. The impression of the intervention was interviewed using a structured questionnaire. There was one drop-out in the control group. No adverse events were reported in the groups. Subjects in the intervention group had a greater weight change from baseline to the end of the 3-month intervention period (-3.7 +/- 2.5 [SD] kg in the intervention group vs. -0.1 +/- 1.4 kg in the control group, P = 0.002). Most subjects recorded that the use of a healthy plate could be recommended to other people. The lifestyle intervention program using the Japanese-style healthy plate, which was developed for portion control, may effectively reduce body weight in overweight and obese diabetic subjects in Japan. Further studies are needed to establish the efficacy of this methodology on weight management.

  14. Effect of a Caregiver's Education Program on Stroke Rehabilitation

    PubMed Central

    2017-01-01

    Objective To evaluate effects of caregiver's education program on their satisfaction, as well as patient functional recovery, performed in addition to daily conventional rehabilitation treatment. Methods Three hundred eleven subjects diagnosed with first-onset stroke and transferred to the Department of Physical Medicine and Rehabilitation of Inha University Hospital were surveyed. In 2015, caregivers attended an education program for acute and subacute stroke patients. Patients who received an additional rehabilitation therapy were assigned to the experimental group (n=81), whereas the control group (n=100) consisted of transfer cases in 2014 with only conventional treatment. The experimental group was classified by severity using the Korean version of the National Institutes of Health Stroke Scale (K-NIHSS), which was administered to all 181 subjects, in addition to, the Korean version of the Mini Mental Status Examination (K-MMSE), a Modified Barthel Index (K-MBI), and the Berg Balance Scale (K-BBS). Caregiver satisfaction and burden before and after education programs were assessed using the Canadian Occupational Performance Measure (COPM), as well as family burden and caregiver burnout scales. Results No significant intergroup difference was observed between initial K-NIHSS, K-MMSE, K-BBS, K-MBI scores, and times from admission to transfer. Those with moderate or severe strokes under the experimental condition showed a more significant improvement than the control group as determined by the K-NIHSS and K-BBS, as well as tendential K-MMSE and K-MBI score increases. Satisfaction was significantly greater for family members and formal caregivers of patients with strokes of moderate severity in the experimental group. Conclusion The caregiver's education program for stroke subjects had a positive outcome on patients' functional improvement and caregiver satisfaction. The authors believe that the additional rehabilitation therapy with the education program aids

  15. Outcomes of dysphagia intervention in a pulmonary rehabilitation program.

    PubMed

    McKinstry, Anita; Tranter, Maria; Sweeney, Joanne

    2010-06-01

    People with chronic obstructive pulmonary disease (COPD) or chronic respiratory disease demonstrate an increased prevalence of oropharyngeal dysphagia as a consequence of impaired coordination between respiration and swallowing function. To date, the effect of patient education and intervention on the management of oropharyngeal dysphagia within pulmonary rehabilitation programs has not been reported or evaluated. Data were collected on participants who were enrolled in the Outpatient Pulmonary Rehabilitation Program and who received dysphagia intervention. Intervention consisted of some or all of the following: (1) a 1-hour dysphagia education program, (2) screening for oropharyngeal dysphagia, and (3) individual comprehensive oropharyngeal dysphagia assessment and management if a screening assessment was failed. A statistically significant improvement was found in participants' knowledge of dysphagia and COPD (P < 0.001). Participants' retention of this knowledge 4 days post education remained statistically significant (P < 0.001). Twenty-seven percent of participants who were screened had symptoms of oropharyngeal dysphagia. Fifty-five (53%) participants receiving further individual dysphagia assessment/management correctly completed pre/post swallowing-related quality-of-life surveys (SWAL-QOL). Statistically significant improvement was found in the following subscales: Burden of Dysphagia (P < 0.009), Physical Problems of Dysphagia (P < 0.012) and Managing Diet Options/Food Selection (P < 0.016). Dysphagia education, screening, and management in a pulmonary rehabilitation program improved participants' swallowing-related quality of life and overall self-management of chronic respiratory disease and dysphagia.

  16. Interval Throwing and Hitting Programs in Baseball: Biomechanics and Rehabilitation.

    PubMed

    Chang, Edward S; Bishop, Meghan E; Baker, Dylan; West, Robin V

    2016-01-01

    Baseball injuries from throwing and hitting generally occur as a consequence of the repetitive and high-energy motions inherent to the sport. Biomechanical studies have contributed to understanding the pathomechanics leading to injury and to the development of rehabilitation programs. Interval-based throwing and hitting programs are designed to return an athlete to competition through a gradual progression of sport-specific exercises. Proper warm-up and strict adherence to the program allows the athlete to return as quickly and safely as possible.

  17. 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.

  18. Pelvic floor rehabilitation program: report of 10 years of experience.

    PubMed

    Lopes, Maria Helena Baena de Moraes; Costa, Juliana Neves da; Lima, Júnia Leonne Dourado de Almeida; Oliveira, Lea Dolores Reganhan de; Caetano, Aletha Silva

    2017-01-01

    to relate the creation, experience of establishment and service performed in the Pelvic Floor Rehabilitation Program [(PRAP)], a project of the School of Nursing of University of Campinas (UNICAMP), developed at a health unity in Campinas, São Paulo, Brazil. this Program appeared due to the high demand of patients with urinary incontinence (UI) and need of formation or qualification of professionals to serve those customers and multiply the actions at other health unities. Nowadays, the PRAP is in its tenth year, and it has served 102 patients with UI and other dysfunctions of the pelvic floor and lower urinary tract, qualified 480 health professionals and stimulated researches. the preventive actions of pelvic floor rehabilitation are important areas of the nurse's performance and initiatives as the related ones contribute for the professional formation and practice based on evidences.

  19. 40 CFR 35.935-16 - Sewer use ordinance and evaluation/rehabilitation program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .../rehabilitation program. 35.935-16 Section 35.935-16 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...-Clean Water Act § 35.935-16 Sewer use ordinance and evaluation/rehabilitation program. (a) The grantee... sewer use ordinance, and the grantee is complying with the sewer system evaluation and rehabilitation...

  20. 40 CFR 35.935-16 - Sewer use ordinance and evaluation/rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .../rehabilitation program. 35.935-16 Section 35.935-16 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...-Clean Water Act § 35.935-16 Sewer use ordinance and evaluation/rehabilitation program. (a) The grantee... sewer use ordinance, and the grantee is complying with the sewer system evaluation and rehabilitation...

  1. 42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... rehabilitation program. 485.58 Section 485.58 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...: SPECIALIZED PROVIDERS Conditions of Participation: Comprehensive Outpatient Rehabilitation Facilities § 485.58 Condition of participation: Comprehensive rehabilitation program. The facility must provide a...

  2. 76 FR 24213 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

    ... 42 CFR Part 412 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units and... Services 42 CFR Part 412 RIN 0938-AQ28 Medicare Program; Inpatient Rehabilitation Facility...

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

    PubMed

    2013-05-20

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Research Training Center (RRTC) on Disability Statistics and Demographics 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.

  5. 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.

  6. [Impact of cardiac rehabilitation programs on coronary risk profile].

    PubMed

    Ilarraza Lomelí, Hermes

    2007-01-01

    Rehabilitation and secondary prevention in patients with cardiovascular disease impact positively on their mortality, morbility, economy and quality of life. In addition, they are a coadjuvant to the medical programs to treatment even in high risk patients. It is advisable to cardiologists that in their medical practice, advise to their low risk patients, on physical activity as a secondary prevention measure. In those high risk patients is better to refer them to expert hands.

  7. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... heart-lung transplant. (vii) For cardiac rehabilitation only, other cardiac conditions as specified...) Body mass index. (iv) Systolic blood pressure. (v) Diastolic blood pressure. (vi) The need for cholesterol, blood pressure, and diabetes medications. (3) A list of approved intensive cardiac...

  8. Costs of cardiac rehabilitation and enhanced lifestyle modification programs.

    PubMed

    Lee, A James; Shepard, Donald S

    2009-01-01

    Inadequate payment to providers for traditional cardiac rehabilitation (CR) and lifestyle modification programs may contribute to low utilization, but little systematic evidence exists. This article estimates and compares the per-patient costs and revenues for 3 types of secondary prevention programs: the Dr Dean Ornish Program for Reversing Heart Disease (Ornish), the Benson-Henry Mind/Body Medical Institute's Cardiac Wellness Program (M/BMI), and CR. The authors developed an Excel spreadsheet template for the costs of a secondary prevention program and calibrated it to 7 programs that provided the necessary data. The calibration was based on budgets, cost accounting, statistical reports, and structured interviews (in person or by telephone). The 4 lifestyle programs (2 Ornish and 2 M/BMI) cost almost 4 times as much per patient as the 3 traditional CR programs (means of $7,176 and $1,828, respectively; difference P < .05). The Ornish program costs averaged more than twice those of M/BMI ($9,895 and $4,458, respectively; difference P < .10). Medicare-allowed charges (including co-payments) were $5,650 for Ornish, $4,800 for M/BMI, and about $32.50 per session or $683 overall for CR. Programs achieved the lowest costs per patient by carefully matching program capacity to demand. In none of the programs did net revenues cover costs. The findings suggest that 4 patients could attend a traditional CR program for the cost of 1 patient in an enhanced program.

  9. 77 FR 480 - Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Institute on Disability and Rehabilitation Research (NIDRR), Department of Education. ACTION: Notice... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program--Field...

  10. Vocational Rehabilitation and Employment Program--basic entitlement; effective date of induction into a rehabilitation program; cooperation in initial evaluation. Final rule.

    PubMed

    2010-01-20

    This document amends Vocational Rehabilitation and Employment Program regulations of the Department of Veterans Affairs (VA). Specifically, it amends provisions concerning: Individuals' basic entitlement to vocational rehabilitation benefits and services; effective dates of induction into a rehabilitation program, including retroactive induction; and individuals' cooperation and lack of cooperation in the initial evaluation process. The amendments are intended to update pertinent regulations to reflect changes in law, to provide VA's interpretation of applicable law, and to improve clarity.

  11. 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.

  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. 34 CFR 385.1 - What is the Rehabilitation 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 Training program? 385.1 Section 385.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING General...

  14. 75 FR 47798 - Office of Special Education and Rehabilitative Services-Special Demonstration Programs-Model...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... Office of Special Education and Rehabilitative Services--Special Demonstration Programs--Model...) Served by State Vocational Rehabilitation (VR) Agencies AGENCY: Office of Special Education and... Assistance (CFDA) Number: 84.235L. SUMMARY: The Assistant Secretary for Special Education and Rehabilitative...

  15. 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? 390.1 Section 390.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION SHORT...

  16. 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) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION...

  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? 390.1 Section 390.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION...

  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? 390.1 Section 390.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION...

  19. 34 CFR 385.1 - What is the Rehabilitation 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 Training program? 385.1 Section 385.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING...

  20. 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? 390.1 Section 390.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION...

  1. 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? 390.1 Section 390.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION...

  2. 34 CFR 385.1 - What is the Rehabilitation 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 Training program? 385.1 Section 385.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING...

  3. 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 Section 385.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION REHABILITATION TRAINING...

  4. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Rehabilitation Engineering Research Centers. (Authority: Sec. 204; 29 U.S.C. 762) ... 34 Education 2 2013-07-01 2013-07-01 false What is the Disability and Rehabilitation Research... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM General § 350.1 What is the...

  5. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Rehabilitation Engineering Research Centers. (Authority: Sec. 204; 29 U.S.C. 762) ... 34 Education 2 2012-07-01 2012-07-01 false What is the Disability and Rehabilitation Research... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM General § 350.1 What is the...

  6. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Rehabilitation Engineering Research Centers. (Authority: Sec. 204; 29 U.S.C. 762) ... 34 Education 2 2014-07-01 2013-07-01 true What is the Disability and Rehabilitation Research... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM General § 350.1 What is the...

  7. Cancer nutrition rehabilitation program: the role of social work.

    PubMed

    Townsend, D; Accurso-Massana, C; Lechman, C; Duder, S; Chasen, M

    2010-11-01

    The Cancer Nutrition Rehabilitation (cnr) program at the McGill University Health Centre is an interdisciplinary 8-week treatment program offering patients information, education, treatment, and support in areas such as diet, exercise, and rehabilitation, plus resources to address their psychosocial needs. The program social worker helps the patient and the patient's family to cope with the illness, to problem-solve, and to obtain needed resources. Here, we present a description of these patients-demographics, medical diagnoses, and psychosocial needs as assessed by the Person-in-Environment standardized instrument-derived from the social-work files of the 75 patients referred to social work in the period February 2007-December 2008. The reason most frequently reported for referral to social work was assistance with psychosocial problems. For 41.3% of the sample, these problems were assessed as high severity, and almost half the patients in the sample (47.8%) were assessed as having inadequate coping ability. Patient age was the most important demographic variable. Although seniors (63-94 years of age) were the least likely to have high-severity psychosocial problems, they were the most likely to have inadequate coping ability. That finding suggests that the cnr social worker, in addition to dealing with the instrumental, practical needs of cancer patients, is in a unique position to respond to their emotional difficulties in coping with their illness, and that health care professionals need to pay particular attention to the coping ability of elderly patients.

  8. 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

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

    PubMed

    Hardison, Mark E; Roll, Shawn C

    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.

  10. An innovation in psychiatric rehabilitation programming. Supported education.

    PubMed

    Palmer-Erbs, V K; Unger, K V

    1997-01-01

    1. In the rehabilitation and recovery process, every person deserves a carefully tailored plan to meet individual needs. 2. The best nursing practice begins with a link between the nursing process and creative critical thinking skills, focusing on connecting with the consumer to build a strong rehabilitation-oriented relationship. 3. The rehabilitation process is enhanced when the nurse uses principles of psychiatric rehabilitation and has knowledge about local and state rehabilitation options available-including supported education.

  11. Employment and Other Outcomes After a Vocational Program in a Rehabilitation Center. Milwaukee Media for Rehabilitation Research Reports. Number 11.

    ERIC Educational Resources Information Center

    Overs, Robert P.

    This is a structured interview study of a 20% random sample consisting of 148 clients interviewed a year after leaving a rehabilitation center vocational program. Employment outcome is related to age, marital status, impairments, education, race, social class, program completion, attendance and punctuality. Clients' occupational distribution in…

  12. Vocational Rehabilitation and Employment program--self-employment. Final rule.

    PubMed

    2010-01-20

    This document amends the vocational rehabilitation and employment regulations of the Department of Veterans Affairs (VA) concerning self-employment for individuals with qualifying disabilities. We are making changes to conform VA's regulations for self-employment programs for veterans, and for servicemembers awaiting discharge, to statutory provisions, including provisions limiting eligibility for certain supplies, equipment, stock, and license fees to individuals with the most severe service-connected disabilities. We are also making related changes in VA's regulations affecting eligibility for such assistance for certain veterans' children with birth defects in self-employment programs. In addition, we are amending our regulations regarding the approval authority for self-employment plans to make certain requirements less restrictive and less burdensome, to remove a vague and overly broad requirement, to make changes to reflect longstanding VA policy, and to make nonsubstantive clarifying changes.

  13. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes assessment... the program and at the end of the program. (ii) Objective clinical measures of exercise performance... osteopathy as defined in section 1861(r)(1) of the Act. Physician-prescribed exercise means aerobic...

  14. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes assessment... the program and at the end of the program. (ii) Objective clinical measures of exercise performance... osteopathy as defined in section 1861(r)(1) of the Act. Physician-prescribed exercise means aerobic...

  15. The experiences of patients undertaking a 'virtual' cardiac rehabilitation program.

    PubMed

    Banner, Davina; Lear, Scott; Kandola, Daman; Singer, Joel; Horvat, Dan; Bates, Joanna; Ignaszewski, Andrew

    2015-01-01

    Cardiac rehabilitation programs (CRP) are medically supervised, multidisciplinary programs that provide secondary prevention aimed at addressing risk factors and improving lifestyle behaviours for patients following an acute cardiac event. CRPs have been demonstrated to be a cost-effective and evidence-based mechanism to improve patient outcomes, but despite the known benefits of these programs, uptake remains poor. Poor attendance has been linked to many factors, but geographical accessibility is a key concern, since many CRPs are limited to hospitals in urban areas. The widespread availability of the Internet has made it possible to provide virtual health services to populations that may have previously been hard to access. This paper examines the qualitative findings from a 16-month mixed methods randomized controlled trial examining the impact of a virtual CRP (vCRP). The vCRP was revealed to be an accessible, appropriate, convenient and effective way to deliver cardiac rehabilitation services, with patients experiencing both clinical improvements and a high level of satisfaction. To understand the experience of patients undertaking the vCRP, semi-structured interviews were undertaken with a purposive sample of 22 participants. An analysis of the qualitative interviews revealed that the vCRP improved participants' access to healthcare professionals, supported them to make healthy choices, and enhanced feelings of accountability due to greater surveillance. Barriers to participation, such as computer literacy, and general perceptions of a vCRP were also examined. Further investigation into the use and long-term effectiveness of virtual programs across a broader range of healthcare settings is warranted, particularly in those with multiple chronic diseases and those located in rural and remote communities.

  16. 40 CFR 35.935-16 - Sewer use ordinance and evaluation/rehabilitation program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-Clean Water Act § 35.935-16 Sewer use ordinance and evaluation/rehabilitation program. (a) The grantee... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Sewer use ordinance and evaluation/rehabilitation program. 35.935-16 Section 35.935-16 Protection of Environment ENVIRONMENTAL PROTECTION...

  17. 40 CFR 35.935-16 - Sewer use ordinance and evaluation/rehabilitation program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-Clean Water Act § 35.935-16 Sewer use ordinance and evaluation/rehabilitation program. (a) The grantee... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Sewer use ordinance and evaluation/rehabilitation program. 35.935-16 Section 35.935-16 Protection of Environment ENVIRONMENTAL PROTECTION...

  18. 40 CFR 35.935-16 - Sewer use ordinance and evaluation/rehabilitation program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...-Clean Water Act § 35.935-16 Sewer use ordinance and evaluation/rehabilitation program. (a) The grantee... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Sewer use ordinance and evaluation/rehabilitation program. 35.935-16 Section 35.935-16 Protection of Environment ENVIRONMENTAL PROTECTION...

  19. 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. ...

  20. 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. ...

  1. 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. ...

  2. 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. ...

  3. 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. ...

  4. A PROJECT DEMONSTRATING THE EFFECTIVENESS OF VOCATIONAL REHABILITATION SERVICES IN A TOTAL PSYCHIATRIC CARE PROGRAM.

    ERIC Educational Resources Information Center

    Georgia State Board of Health, Atlanta.

    A COOPERATIVE PROGRAM OFFERED A COMPLETE RANGE OF INTEGRATED MEDICAL, PSYCHOLOGICAL, SOCIAL, AND VOCATIONAL SERVICES TO REINTEGRATE MENTAL PATIENTS INTO THE LIFE OF THE COMMUNITY. THE PROGRAM PROPOSED TO DEMONSTRATE THE EFFECTIVENESS OF CERTAIN REHABILITATION PROCEDURES TO EXTEND AND IMPROVE REHABILITATION SERVICES, AND TO ESTABLISH EFFECTIVE…

  5. 75 FR 75693 - Rehabilitation Mortgage Insurance Underwriting Program Section 203(k); Notice of Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... URBAN DEVELOPMENT Rehabilitation Mortgage Insurance Underwriting Program Section 203(k); Notice of... information: Title of Proposal: Rehabilitation Mortgage Insurance Underwriting Program Section 203(k). OMB.... Specifically, under Section 203(k) of the Act, the Secretary is authorized to insure mortgages that fund...

  6. Multicultural Education and Training in Rehabilitation Counseling Education Programs

    ERIC Educational Resources Information Center

    Donnell, Chandra M.; Robertson, Stacia L.; Shannon, Cozetta D.

    2009-01-01

    Racial-ethnic backgrounds of rehabilitation counseling clientele have become increasingly diverse. Additionally, the current emphasis on globalization and international rehabilitation in diverse communities requires educators to examine teaching methods and strategies to best train rehabilitation counselors working within these complex diverse…

  7. Multicultural Education and Training in Rehabilitation Counseling Education Programs

    ERIC Educational Resources Information Center

    Donnell, Chandra M.; Robertson, Stacia L.; Shannon, Cozetta D.

    2009-01-01

    Racial-ethnic backgrounds of rehabilitation counseling clientele have become increasingly diverse. Additionally, the current emphasis on globalization and international rehabilitation in diverse communities requires educators to examine teaching methods and strategies to best train rehabilitation counselors working within these complex diverse…

  8. 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.

  9. Effects of Physical-Exercise-Based Rehabilitation Programs on the Quality of Life of Patients With Parkinson's Disease: A Systematic Review of Randomized Controlled Trials.

    PubMed

    Cascaes da Silva, Franciele; Iop Rda, Rodrigo; Domingos Dos Santos, Patrícia; Aguiar Bezerra de Melo, Lídia Mara; Barbosa Gutierres Filho, Paulo José; da Silva, Rudney

    2016-07-01

    This study aimed to determine the effects of physical-exercise-based rehabilitation programs on quality of life of patients with Parkinson's disease through a systematic review of randomized clinical trials. For this purpose the following electronic databases were selected: Medline by PubMed, Cochrane, Web of Science, and PEDro. The search strategy included the proposed descriptors in the Medical Subject Headings (MeSH), associated with a sensitive list of terms to search for randomized controlled trials (RCTs), without year and language restrictions. Fourteen studies were potentially relevant, and these studies were included. Physical-exercise-based rehabilitation programs realized 2-4 times a week, 60 min each session, for 6-12 weeks, and follow-up of 3 months promotes significant positive effects on quality of life in Parkinson's disease patients at mild to moderate stages and disease duration around 6 years.

  10. 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

  11. 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.

  12. [Polygraphy in hospitalized children under 3 months].

    PubMed

    Zenteno, Daniel; Rodríguez-Núñez, Iván; Molina, Ignacio; Peña, Rubén; Rivas, Carla; Tapia, Jaime; Brockmann, Pablo

    2017-04-01

    Apnea and apparently lethal events have great etiological diversity thus complementary tests may help diagnosis. The aim of this study was to describe the results of polygraph studies of children under 3 months hospitalized with suspected apnea. Retrospective case series. Children under 3 months with suspected apnea were considered and in whom a polygraphy (PG) was performed during hospitalization. General data, the apnea/hypopnea index (AHI), index of central. apnea, obstructive apnea index, average and minimum saturation were recorded. Desaturation index (ID) below 80% higher 1 per hour, one or more events of desaturation below 80% for more than 20 seconds or an AHI greater than or equal 1 were considered as criteria of sleep disorder breathing (SLB). Descriptive analysis was performed and the associations between AHI and saturation parameters were determined. 51 patients, 32 males, entered the study. 15,6% had altered PG. In 5 of them coexisted more than one diagnostic criterion. Iin 15,6% of the patients was observed an IAH greater 1, in 7.8% a desaturation index below 80% and in 11,8% a desaturation index under 80% for 20 seconds greater than 1. The AHI was associated with the parameters of saturation. Most of the patients had normal PG and among patients with a suggestive SLB a pattern of respiratory immaturity prevailed, which is characteristic of this age.

  13. Neuroticism and Fatigue 3 Months After Ischemic Stroke: A Cross-Sectional Study.

    PubMed

    Lau, Chieh Grace; Tang, Wai Kwong; Liu, Xiang Xin; Liang, Hua Jun; Liang, Yan; Mok, Vincent; Wong, Adrian; Ungvari, Gabor S; Kutlubaev, Mansur A; Wong, Ka Sing

    2017-04-01

    To examine the relation between neuroticism and fatigue in Chinese patients with stroke. Cross-sectional study. Acute stroke unit. Survivors of ischemic stroke (N=191) recruited from the acute stroke unit between May 1, 2010, and September 1, 2011. Not applicable. The personality trait of neuroticism was measured with the neuroticism subscale of the Chinese version of the NEO Five-Factor Inventory. The level of fatigue was measured with the Fatigue Assessment Scale. The National Institutes of Health Stroke Scale, Geriatric Depression Scale, Barthel Index, and Mini-Mental State Examination were administered to obtain demographic and clinical information. Fatigue severity 3 months after stroke positively correlated with Geriatric Depression Scale and NEO Five-Factor Inventory neuroticism scores and negatively correlated with the Barthel Index score. Neuroticism, independent of depressive symptoms, is a predictor of fatigue severity 3 months after stroke. Interventions such as psychological screening programs are warranted for early detection of patients at high risk of poststroke depression. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Comparison of Cast-in-Place Concrete Stay-in-Place Forming Systems for Lock Wall Rehabilitation

    DTIC Science & Technology

    1993-10-01

    Maintenance, and Technical Report REMR-CS-41 Rehabilitation Research Program October 1993 Comparison of Cast-in-Place Concrete Versus Precast Concrete ...Rehabilitation Research Program Comparison of Cast-in-Place Concrete Versus Precast Concrete Stay-in-Place Forming Systems for Lock Wall Rehabilitation...Headquarters, U.S. Army Corps of Engineers The follow ino t,, o letters used as part of the number designating technical reports of research published

  15. A Five-Week Training Program for Vocational Rehabilitation Workshop Supervisors. Report of the Proceedings.

    ERIC Educational Resources Information Center

    Indiana Vocational Technical Coll., Indianapolis.

    Under a grant provided by the Indiana State Board of Vocational and Technical Education, the Indiana Vocational Technical College developed and conducted a five-week training program for vocational rehabilitation workshop supervisors. Nineteen persons participated, representing state-wide organizations involved with rehabilitation activities.…

  16. 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.…

  17. 75 FR 3165 - Vocational Rehabilitation and Employment Program-Periods of Eligibility

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... AFFAIRS 38 CFR Part 21 RIN 2900-AM84 Vocational Rehabilitation and Employment Program--Periods of... Department of Veterans Affairs (VA) concerning periods of eligibility applicable to VA's provision of... Rehabilitation Under 38 U.S.C. Chapter 31. The amendments in the proposed rule concerned periods of eligibility...

  18. 34 CFR 389.1 - What is the Rehabilitation Continuing Education Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false What is the Rehabilitation Continuing Education Program? 389.1 Section 389.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  19. 34 CFR 389.1 - What is the Rehabilitation Continuing Education Program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false What is the Rehabilitation Continuing Education Program? 389.1 Section 389.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What is the Rehabilitation Continuing Education Program? 389.1 Section 389.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  1. Career Selection and Use of Accommodations by Students with Disabilities in Rehabilitation Education Programs.

    ERIC Educational Resources Information Center

    Glover-Graf, Noreen M.; Janikowski, Timothy P.

    2001-01-01

    The Rehabilitation Counselor Disability (RCD) Survey was administered to 186 rehabilitation students throughout the United States. Data were gathered related to disability, program awareness of disability, influence of disability upon career choice, levels of functional limitation, and use of accommodations. Most indicated moderate functional…

  2. The Reasoning and Rehabilitation Program: Assessing Short- and Long-Term Outcomes among Male Swedish Prisoners

    ERIC Educational Resources Information Center

    Berman, Anne H.

    2004-01-01

    Background: Rehabilitation programs for criminal offenders target primary outcomes such as effects on criminogenic needs and secondary outcomes of reducing recidivism. Most evaluation studies focus only on one type of outcome. This study evaluated outcomes on both primary and secondary targets of the Reasoning and Rehabilitation (R&R) program…

  3. Shaping State Rehabilitation Programs through Consumer Partnerships: Issues and Strategies. Report from the Study Group.

    ERIC Educational Resources Information Center

    Fry, Ronald R., Ed.

    Targeted to state vocational rehabilitation administrators and leaders, this document discusses the recommendations of a study group that investigated approaches, ways, methods, and strategies for increasing the involvement of individuals with disabilities in the operation and management of state agency rehabilitation programs. Part 1, "Consumer…

  4. 34 CFR 350.1 - What is the Disability and Rehabilitation Research Projects and Centers Program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true 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...

  5. 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

    2017-02-25

    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

  6. The Economic Impact of an Expanded Program of Vocational Rehabilitation.

    ERIC Educational Resources Information Center

    Wright, George N.; Reagles, Kenneth W.

    Through an analytic technique this monograph studies the economic impact of the ratio of benefits to costs of the vocational rehabilitation process. The primary purpose of the research was to compare the relative value of the rehabilitation for the culturally disadvantaged to that of the medically disabled by benefit-cost analysis. The results of…

  7. A Survey of Safety Training in Rehabilitation Counselor Education Programs

    ERIC Educational Resources Information Center

    Davis, Alan H.; Schultz, Jared C.; Anderson, Christine A.; Bartley, Lindsie

    2009-01-01

    Although rehabilitation counselors face increasing risk to safety including threats, acts of violence, and other workplace hazards, academic training has generally struggled to keep up with the developing need for training in this area. Data from a questionnaire adapted for rehabilitation education from prior studies in counselor education and…

  8. A Survey of Safety Training in Rehabilitation Counselor Education Programs

    ERIC Educational Resources Information Center

    Davis, Alan H.; Schultz, Jared C.; Anderson, Christine A.; Bartley, Lindsie

    2009-01-01

    Although rehabilitation counselors face increasing risk to safety including threats, acts of violence, and other workplace hazards, academic training has generally struggled to keep up with the developing need for training in this area. Data from a questionnaire adapted for rehabilitation education from prior studies in counselor education and…

  9. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... vocational rehabilitation unit personnel in program areas essential to the effective management of the unit's 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...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... vocational rehabilitation unit personnel in program areas essential to the effective management of the unit's 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...

  11. Developing a culturally based cardiac rehabilitation program: the HELA study.

    PubMed

    Look, Mele A; Kaholokula, Joseph Keawe; Carvhalo, Amy; Seto, Todd; de Silva, Mapuana

    2012-01-01

    Heart disease disproportionately affects Native Hawaiians and other Pacific people. In response, researchers proposed and communities endorsed, developing a cardiac rehabilitation (CR) program based on the hula, a Native Hawaiian dance form. The utilization of cultural practices in health interventions can improve outcomes and increase enrollment and retention, but requires sensitivity and understanding. This paper provides the conceptual framework and methods used for integration of multiple communities' perspectives to inform the design of a hula-based CR intervention. Specific strategies and processes were established to ensure the equity of scientific-clinical and patient- cultural knowledge and perspectives. Multiple methods were used and a flow diagram defined steps for the intervention development. Patient and cultural consultations provided information about the multidimensional benefits of hula and its use in a CR intervention. Clinical and scientific consultations provided specific guidelines for exercise prescription and patient monitoring. Integrating findings from all consultations identified important direction and requirements. Community-based participatory research (CBPR) principles guided a complex collaboration of multiple communities; although time consuming, inclusive consultations provided valuable information and relationships.

  12. 76 FR 15964 - Funding Priorities: Disability and Rehabilitation Research Projects and Centers Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... National ADA Network Research Collaborative (Collaborative). The Collaborative must be designed to... clearly-identified research designs to generate reliable and valid findings. (b) Improved ADA stakeholder... Funding Priorities: Disability and Rehabilitation Research Projects and Centers Program AGENCY: Office of...

  13. 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

    ... From the Federal Register Online via the Government Publishing Office 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 National...

  14. Erectile dysfunction in patients in a cardiac rehabilitation program.

    PubMed

    Maroto-Montero, José M; Portuondo-Maseda, M Teresa; Lozano-Suárez, Maximino; Allona, Antonio; de Pablo-Zarzosa, Carmen; Morales-Durán, María D; Muriel-Garcia, Alfonso; Royuela-Vicente, Ana

    2008-09-01

    Erectile dysfunction is common in patients with coronary heart disease. The aim of this study was to investigate the incidence of, etiological factors associated with, and treatment results obtained in this condition in patients participating in a cardiac rehabilitation program. The study included 420 male patients with heart disease who were taking part in a multicomponent therapeutic program that involved physical exercise, psychological techniques and risk factor reduction. Overall, erectile dysfunction was present in 216 patients (52.6%) and there were clear associations with age (P< .001), diabetes mellitus (P< .001), arterial hypertension (P=.029), cigarette smoking (P=.044) and treatment with angiotensin-converting enzyme inhibitors (P=.003) and diuretics (P< .001). However, there were no links to treatment with beta-blockers, calcium antagonists, statins or antiplatelet agents. There were direct associations with trait anxiety (P=.009) and state anxiety (P=.006) and with depression (P=.003). The final multivariate analysis model included diabetes mellitus, smoking, diuretic use, state anxiety and age as significant variables. Only 59 patients agreed to treatment with a phosphodiesterase-5 inhibitor, with positive results in 45 (76.27%). Treatment was contraindicated in 41 patients because they were taking nitrates for myocardial ischemia. The remaining patients expressed no interest, had relationship problems or were worried about complications. The incidence of erectile dysfunction was substantial. The condition was directly associated with risk factors for atherosclerosis, treatment, and psychological disorders (i.e., anxiety and depression). Relationship problems and the fear of complications may explain why many patients refused to take phosphodiesterase-5 inhibitors.

  15. State of the art: how to set up a pulmonary rehabilitation program.

    PubMed

    Jenkins, Sue; Hill, Kylie; Cecins, Nola M

    2010-11-01

    Pulmonary rehabilitation plays an essential role in the management of symptomatic patients with COPD. The benefits of rehabilitation include a decrease in dyspnoea and fatigue, and improvements in exercise tolerance and health-related quality of life. Importantly, rehabilitation reduces hospitalization for acute exacerbations and is cost-effective. Although most of the evidence for pulmonary rehabilitation has been obtained in patients with COPD, symptomatic individuals with other respiratory diseases have been shown to benefit. In this review we outline a stepwise approach to establish, deliver and evaluate a pulmonary rehabilitation program (PRP) that would be feasible in most settings. Throughout the review we have specified the minimum requirements for a PRP to facilitate the establishment of programs using limited resources. Recommendations for staffing and other resources required for a PRP are presented in the first section. Exercise training is a focus of the section on program delivery as this is the component of rehabilitation that has the strongest level of evidence for benefit. Program considerations for patients with respiratory conditions other than COPD are described. Different approaches for delivering the education component of a PRP are outlined and recommendations are made regarding topics for group and individual sessions. The problems commonly encountered in pulmonary rehabilitation, together with recommendations to avoid these problems and strategies to assist in their resolution, are discussed. The review concludes with recommendations for evaluating a PRP. © 2010 The Authors; Respirology © 2010 Asian Pacific Society of Respirology.

  16. [Early severe malnutrition and psychomotor development. Effects of a rehabilitation program].

    PubMed

    Colombo, M; López, I; De Andraca, I

    1993-06-01

    This study evaluates the psychomotor development of 228 undernourished infants submitted to an integral rehabilitation program in Nutritional Recovery Centers. At admission these children present a moderate retardation of their developmental quotient: mean 0.59 +/- 0.17, improving significantly to mean 0.79 +/- 0.4 (p < 0.001) after an average period of 178.2 +/- 63.9 days of intervention. As regards areas of development, rehabilitation only demonstrates a significant change in coordination and language, not so in the social and motor areas. Those children presenting the most severe developmental delays are also those who obtain the greater benefits from this integral rehabilitation program.

  17. The Outcomes and Impact of a Post-Earthquake Rehabilitation Program in China: A Qualitative Study.

    PubMed

    Chung, Eva Yin-Han

    2017-01-01

    This study evaluated the outcomes and impact of a post-earthquake rehabilitation program in Sichuan, China. A case-study approach was adopted to conduct an in-depth examination of the program. The results show that the program effectively enhanced the functional outcomes of earthquake survivors. However, the empowerment of earthquake survivors with disabilities requires further consideration, and the local community's ownership of the program must also be addressed. A combination of institution- and community-based approaches was advocated in developing the post-earthquake rehabilitation program to enhance its impact on the local community. © The Author(s) 2016.

  18. Complex exercise rehabilitation program for women of the II period of age with metabolic syndrome.

    PubMed

    Lee, Eun-Ok; Olga, Kozyreva

    2013-04-01

    The purpose of this study was to develop a complex exercise program integrating Eastern and Western complex exercise rehabilitation programs in order to examine the effects of it on the human body with the subjects for women of the II period of mature age with metabolic syndrome. The subjects of this study are 60 II period of mature aged women with metabolic syndrome living in G City, and the experimental group conducted Taekwon-aerobic exercise, European rehabilitation gymnastics, gym ball exercise, and elastic band exercise while the control group performed European rehabilitation gymnastics, gym ball exercise, and elastic band exercise which is the rehabilitation program being presently conducted in Russia, for 90 min per day for three weeks. Two-way ANOVA with repeated measures was utilized to verify pre and post-intergroup difference, and the significant level was set as P< 0.05. Whereas body weight, % fat, WHR, SBP, DBP and blood glucose were significant decreased, muscle weight and pulse wave velocity were significant increased after complex exercise rehabilitation programs Both Eastern and Western complex exercise rehabilitation programs showed positive effects on the body of the II period of mature aged women with metabolic syndrome, and if various exercise programs are conducted, it will be more effective in improving II period of mature aged women's metabolic syndrome afterwards.

  19. Complex exercise rehabilitation program for women of the II period of age with metabolic syndrome

    PubMed Central

    Lee, Eun-Ok; Olga, Kozyreva

    2013-01-01

    The purpose of this study was to develop a complex exercise program integrating Eastern and Western complex exercise rehabilitation programs in order to examine the effects of it on the human body with the subjects for women of the II period of mature age with metabolic syndrome. The subjects of this study are 60 II period of mature aged women with metabolic syndrome living in G City, and the experimental group conducted Taekwon-aerobic exercise, European rehabilitation gymnastics, gym ball exercise, and elastic band exercise while the control group performed European rehabilitation gymnastics, gym ball exercise, and elastic band exercise which is the rehabilitation program being presently conducted in Russia, for 90 min per day for three weeks. Two-way ANOVA with repeated measures was utilized to verify pre and post-intergroup difference, and the significant level was set as P< 0.05. Whereas body weight, % fat, WHR, SBP, DBP and blood glucose were significant decreased, muscle weight and pulse wave velocity were significant increased after complex exercise rehabilitation programs Both Eastern and Western complex exercise rehabilitation programs showed positive effects on the body of the II period of mature aged women with metabolic syndrome, and if various exercise programs are conducted, it will be more effective in improving II period of mature aged women’s metabolic syndrome afterwards. PMID:24278877

  20. The Economic Impact of an Expanded Program of Vocational Rehabilitation. Wisconsin Studies in Vocational Rehabilitation.

    ERIC Educational Resources Information Center

    Wright, George N.; Reagles, Kenneth W.

    Benefit-cost analysis was used in this study to compare the relative value of rehabilitation for the culturally disadvantaged to that of the medically disabled. The Wood County Project, which was designed to demonstrate the potential benefits of extending services to all handicapped persons, was evaluated in terms of the impact on clients, the…

  1. Assessment of awareness amongst school teachers regarding prevention and emergency management of dentoalveolar traumatic injuries in school children in Pune City, before and 3 months after dental educational program.

    PubMed

    Karande, Namrata; Shah, Preetam; Bhatia, Mitali; Lakade, Laxmi; Bijle, Mohammed Nadeem Ahmed; Arora, Nitin; Bhalla, Monika

    2012-11-01

    Children have boundless energy, so, they are continuously engaged in some or the other physical activity. It is seen that when child reaches school age, accidents in the school environment in the form of falls, injuries due to contact sports, fights, abuse, etc. are very common and the main cause of traumatic dental injuries. Trauma may vary from minor enamel chipping or avulsion to extensive maxillofacial damage, more serious neck and brain injury, which may cause pain, disfigurement and mental agony, having immediate and long lasting effects. In such cases, a school teacher is in the right position to handle such an emergency and refer the child to the concerned dental surgeon or a pedodontist for further needful care. The main reason for delayed treatment of dental trauma is that people present at the site of injury are unaware of protocol of rapid and appropriate management leading to improper first aid treatment. The purpose of this study was to investigate the awareness of a group of school teachers from different schools about the prevention and emergency management of dental trauma in school children, by means of a questionnaire. Then educating them and reassessing their knowledge after a period of 3 months. Unfortunately, the public is unaware of the risks and does not have enough information about first aid emergency treatment or to avoid traumatic injuries.

  2. International Students in Rehabilitation Counseling Education Programs: Results from a National Survey

    ERIC Educational Resources Information Center

    Zhu, Yanan; Degeneffe, Charles Edmund

    2011-01-01

    A national sample of 21 international students in Rehabilitation Counseling Education (RCE) programs was surveyed on their connection to their programs, the stressors they experienced during graduate studies, and their recommendations for RCE programs to better support international students. Participants engaged in limited social activities due…

  3. International Students in Rehabilitation Counseling Education Programs: Results from a National Survey

    ERIC Educational Resources Information Center

    Zhu, Yanan; Degeneffe, Charles Edmund

    2011-01-01

    A national sample of 21 international students in Rehabilitation Counseling Education (RCE) programs was surveyed on their connection to their programs, the stressors they experienced during graduate studies, and their recommendations for RCE programs to better support international students. Participants engaged in limited social activities due…

  4. Plan for Development of an Educational Program in Rehabilitative Optometry. Final Report.

    ERIC Educational Resources Information Center

    Association of Schools and Colleges of Optometry, Washington, DC.

    The development of a model educational program in rehabilitative optometry is examined in terms of a statement of the scope of practice of the profession, analysis of existing educational programs in the field, and competency objectives to which the model educational program is directed. A survey of nine of the 13 institution members of the…

  5. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Rehabilitation Unit In-Service Training program? This program is designed to support projects for training State vocational rehabilitation unit personnel in program areas essential to the effective management of the unit's... Act. The program may include training designed— (a) To address recruitment and retention of...

  6. The Rehabilitation Executive's Evaluation System (TREES). Appendix A of: Vocational Rehabilitation Program Standards Evaluation System. Final Report. Volume II: Using the System: An Analytic Paradigm for Management.

    ERIC Educational Resources Information Center

    Stoddard, Susan; And Others

    The Program Standards Evaluation System was developed in response to evaluation requirements in the 1973 Rehabilitation Act. The system includes procedures for using standards data to monitor and evaluate vocational rehabilitation (VR) service outcomes and outputs as well as standards on key procedural issues. This report, which is Appendix A of…

  7. Insomnia in clients with chronic, work-related musculoskeletal pain in a work recovery rehabilitation program.

    PubMed

    Harman, Katherine; Keating, Eileen; Mayes, Susan; Walsh, Jane; MacCallum, Sally

    2014-01-01

    There is a high prevalence of sleep disturbance with people experiencing chronic pain. Although multi-disciplinary rehabilitation programs address many contributing factors for chronic pain, the impact of insomnia on clients is not often measured. Two studies were used to: first explore the experience of insomnia in a group of clients with chronic pain and then, in a group enrolled in a six-week work recovery rehabilitation program, compare measures of sleep disturbance at entry and upon its completion. Sixteen clients participated in focus groups and 29 completed questionnaires; 46% were women and the average age was 43 years. They had a wide range of work-related musculoskeletal injuries and all had chronic pain. First two, semi-structured focus group interviews explored sleep disturbance. Then a different set of participants completed three sleep questionnaires before and after completing a rehabilitation program. Focus group participants described sleep disturbance consistent with clinical insomnia and how it had a considerable impact on their lives. Completed questionnaires confirmed the presence of sleep disturbance at admission into a six-week rehabilitation program and at discharge, most measures were unchanged. Although chronic pain rehabilitation generally includes interdisciplinary approaches, specific attention to insomnia is not part of this chronic pain rehabilitation program and therefore it is not surprising that there was no appreciable change by the end of the program. However, because sleep disturbance is prevalent in the chronic pain population and in this sample, and has such a strong impact on the individual's daytime functioning, effective interventions directed at sleep restriction and stimulus control should complement chronic pain rehabilitation programs.

  8. 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

  9. Secondary Transition Personnel Preparation in Rehabilitation Counselor Education Programs

    ERIC Educational Resources Information Center

    Plotner, Anthony J.; Fleming, Allison R.

    2014-01-01

    Rehabilitation counselors are increasingly called on to provide services to transition-aged youth. However, preparation and training efforts are not sufficient to ensure that counselors have the required knowledge and skills to adequately serve these students and young adults. The purpose of this study was to investigate how secondary…

  10. 38 CFR 21.284 - Reentrance into a rehabilitation program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... veteran has sustained a substantial loss of independence; or (ii) Other changes in the veteran's circumstances have caused a substantial loss of independence; and (2) The provisions of § 21.162 pertaining to... occurred subsequent to the declaration of rehabilitation to the point of employability, is no longer...

  11. 38 CFR 21.284 - Reentrance into a rehabilitation program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... veteran has sustained a substantial loss of independence; or (ii) Other changes in the veteran's circumstances have caused a substantial loss of independence; and (2) The provisions of § 21.162 pertaining to... occurred subsequent to the declaration of rehabilitation to the point of employability, is no longer...

  12. 38 CFR 21.284 - Reentrance into a rehabilitation program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... veteran has sustained a substantial loss of independence; or (ii) Other changes in the veteran's circumstances have caused a substantial loss of independence; and (2) The provisions of § 21.162 pertaining to... occurred subsequent to the declaration of rehabilitation to the point of employability, is no longer...

  13. Impact of rehabilitation programs on dependency and functional performance of patients with major lower limb amputations

    PubMed Central

    AlSofyani, Mohammad A.; AlHarthi, Abdulaziz S.; Farahat, Fayssal M.; Abuznadah, Wesam T.

    2016-01-01

    Objectives: To determine pattern and impact of physical rehabilitation on dependency and functional performance of patients. Methods: This retrospective chart review was carried out between July and August 2012 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Data were collected using demographic, clinical, and dependency assessment checklists. Results: Patients who underwent major lower limb amputations between January 2007 and April 2012 (n=121) were included in the study. There were 84 (69.4%) male and 37 (30.6%) female patients with a mean ± standard deviation of 63.3±17.4 years old. Diabetes mellitus was the most frequent cause in 63.6% of patients. Only one-third of the amputees (32.2%) have records of completion of their rehabilitation programs, although 20.7% of them completed the <50% of the scheduled rehabilitation sessions, 17.2% attended between 50% and 80%, and the remaining 62.1% attended more than 80% of the scheduled sessions. Muscle power scores in each side of the upper and lower limbs were significantly better following rehabilitation (p<0.0001). Basic functions of mobility and transfer have also significantly improved (p<0.05). Conclusions: Overall dependency and functional performance were significantly better following implementation of the physical rehabilitation programs. A multidisciplinary team approach is mandatory to improve compliance of patients toward the rehabilitation programs. PMID:27652362

  14. 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.

  15. Specialized Rehabilitation Programs for Children and Adolescents with Severe Disabling Chronic Pain: Indications, Treatment and Outcomes

    PubMed Central

    Stahlschmidt, Lorin; Zernikow, Boris; Wager, Julia

    2016-01-01

    Children and adolescents with highly disabling chronic pain of high intensity and frequency are admitted to specialized pain rehabilitation programs. Some barriers to obtaining this specialized care include a lack of availability of treatment centers, a perceived social stigma and individual barriers such as socioeconomic status. Specialized rehabilitation programs for severe disabling chronic pain worldwide have similarities regarding admission criteria, structure and therapeutic orientation. They differ, however, regarding their exclusion criteria and program descriptions. The short- and long-term effectiveness of some rehabilitation programs is well documented. All countries should promote the establishment of future pediatric pain centers to improve the health care of children and adolescents suffering from severe chronic pain. Standardized reporting guidelines should be developed to describe treatments and outcomes to enable comparability across treatment centers. PMID:27879631

  16. Implementing and sustaining an early rehabilitation program in a medical intensive care unit: A qualitative analysis.

    PubMed

    Eakin, Michelle N; Ugbah, Linda; Arnautovic, Tamara; Parker, Ann M; Needham, Dale M

    2015-08-01

    Early rehabilitation programs in a medical intensive care unit can improve patient outcomes, but clinicians face barriers in implementing and sustaining such programs. We sought to describe a multidisciplinary team perspective regarding how to implement and sustain a successful early rehabilitation program. Semistructured interviews were conducted with 20 staff and faculty who were involved in the early rehabilitation program at the Johns Hopkins Hospital Medical Intensive Care Unit. Transcripts were evaluated using the Consolidated Framework of Implementation Research Theory. Four major constructs emerged as important, as follows: (1) necessary components, (2) implementation strategies, (3) perceived barriers, and (4) positive outcomes. All participants reported that staff buy-in was necessary, whereas having a multidisciplinary team with good communication among team members was reported as helpful by 90% of participants. The most common barrier reported was increased staff workload (80%). All participants (100%) noted improved patient outcomes as an important benefit, and 95% reported improved job satisfaction. This qualitative study of a successful early rehabilitation program highlights the importance of assessing and engaging a multidisciplinary team before implementation and the positive outcomes of early rehabilitation on staff by improving job satisfaction and changing the culture of a hospital unit. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. 75 FR 55785 - Office of Special Education Programs, Office of Special Education and Rehabilitative Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Office of Special Education Programs, Office of Special Education and Rehabilitative Services, Department... Office of Special Education Programs (OSEP) funds NCEO to address national, State, and local assessment...

  18. 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...

  19. A National Survey of Adjunct Faculty in Rehabilitation Counseling Education Programs

    ERIC Educational Resources Information Center

    Degeneffe, Charles Edmund; Offutt, C. Raymond

    2008-01-01

    A national sample of 54 adjunct faculty members in rehabilitation counseling programs were surveyed to ascertain reasons why they chose to teach and how they contributed to their respective programs. Constant comparative analysis revealed a variety of reasons for why adjunct faculty enjoy teaching, including a desire to influence future…

  20. Inquiry into Charges of Mismanagement in Delaware's Vocational Rehabilitation, Employment, and Social Services Programs.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    The report by the comptroller general of the United States is directed toward an inquiry into charges of misuse of Federal funds in Delaware's vocational rehabilitation program. Significant program developments are reviewed to provide background data in understanding the specific charges. The charges involved: administrative salaries, cancelling…

  1. Paralysis: Rehabilitation

    MedlinePlus

    ... your health and quality of life. Find a rehabilitation center near you and become familiar with different therapies. > ... NeuroRecovery Network® The NRN is a network of rehabilitation centers located across the country. > Christopher's exercise program Learn ...

  2. Fatigue after liver transplantation: effects of a rehabilitation program including exercise training and physical activity counseling.

    PubMed

    van den Berg-Emons, Rita J G; van Ginneken, Berbke T J; Nooijen, Carla F J; Metselaar, Herold J; Tilanus, Huug W; Kazemier, Geert; Stam, Henk J

    2014-06-01

    It is hypothesized that increasing physical fitness and daily physical activity can lead to a reduction in fatigue. However, standard medical care following liver transplantation seldom includes rehabilitation that focuses on physical fitness and physical activity. The aim of this study was to explore whether a rehabilitation program can reduce fatigue in recipients of liver transplants. Furthermore, effects on physical fitness, physical activity, and cardiovascular risk were studied, and adherence, satisfaction, and adverse events were assessed. This was an uncontrolled intervention study. The study took place in an outpatient rehabilitation clinic. Eighteen recipients of a liver transplant who were fatigued participated in a 12-week rehabilitation program including physical exercise training and counseling on physical activity. The primary outcome measure was fatigue. Other outcome measures were: aerobic capacity, muscle strength, body fat, daily physical activity, lipid profile, and glycemic control. All measurements were performed before and after the rehabilitation program. Adherence, satisfaction, and adverse events were registered. After the program, participants were significantly less fatigued, and the percentage of individuals with severe fatigue was 22% to 53% lower than before the program. In addition, aerobic capacity and knee flexion strength were significantly higher, and body fat was significantly lower after the program. Participants were able to perform physical exercise at the target training intensity, no adverse events were registered, and attendance (93%) and mean patient satisfaction (8.5 out of 10, range=7-10) were high. No control group was used in the study. A rehabilitation program consisting of exercise training and physical activity counseling is well tolerated and seems promising in reducing fatigue and improving fitness among recipients of liver transplants. © 2014 American Physical Therapy Association.

  3. 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.

  4. Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment effective?

    PubMed

    Alison, Jennifer A; McKeough, Zoe J

    2014-11-01

    Pulmonary rehabilitation is an essential component of chronic obstructive pulmonary disease (COPD) management with strong evidence supporting the efficacy of pulmonary rehabilitation to improve exercise capacity and quality of life, as well as reduce hospital admissions. However, it is estimated that only 2-5% of people with COPD who could benefit from pulmonary rehabilitation have access to programs. Most research on the benefits of pulmonary rehabilitation has used equipment such as cycle ergometers and treadmills for endurance training and weight machines for resistance training. To enable greater availability of pulmonary rehabilitation, the efficacy of exercise training using minimal equipment needs to be evaluated. Randomised controlled trials that used minimal, low cost equipment for endurance (eight trials) and strength training (three trials) compared to no training in people with COPD were evaluated. Statistically and clinically significant differences in functional exercise capacity and quality of life, as well as improvements in strength were demonstrated when exercise training with minimal equipment was compared to no training [six-minute walk test: mean difference 40 (95% CI: 13 to 67) metres; St George's Respiratory Questionnaire: mean difference -7 (95% CI: -12 to -3) points]. While the number of studies is relatively small and of variable quality, there is growing evidence that exercise training using minimal, low cost equipment may be an alternative to equipment-intensive pulmonary rehabilitation programs.

  5. Feeding Your 1- to 3-Month-Old

    MedlinePlus

    ... 2-Year-Old Feeding Your 1- to 3-Month-Old KidsHealth > For Parents > Feeding Your 1- to 3-Month-Old Print A A A en español Alimentar ... meses de edad During your baby's first 3 months, breast milk or formula will provide all the ...

  6. Feeding Your 1- to 3-Month-Old

    MedlinePlus

    ... 2-Year-Old Feeding Your 1- to 3-Month-Old KidsHealth > For Parents > Feeding Your 1- to 3-Month-Old A A A en español Alimentar a ... meses de edad During your baby's first 3 months, breast milk or formula will provide all the ...

  7. Program Evaluation: A Beginning Statement. A Report from the Study Group on Guidelines for Evaluating Vocational Rehabilitation Programs and Services. Information Memorandum RSA-IM-72-61.

    ERIC Educational Resources Information Center

    Research and Training Center, Institute, WV.

    This training guide for evaluating vocational rehabilitation programs and services is designed for use by state vocational rehabilitation agencies in developing a system for evaluating either their overall program or specific aspects of it. The manual first addresses itself to the rationale for program evaluation, and then examines the evaluation…

  8. Evaluating compliance to a cardiac rehabilitation program in a private general hospital

    PubMed Central

    Mair, Vanessa; Breda, Ana Paula; Nunes, Marcos Eduardo Boquembuzo; de Matos, Luciana Diniz Nagem Janot

    2013-01-01

    ABSTRACT Objective: Identify the primary factors that influenced the participant in our cardiovascular rehabilitation program towards missing their therapy sessions, and to correlate those factors with age, cardiovascular risk, and motivation of our population. Methods: We conducted a retrospective study with 42 patients (69.15±13.93 years) participating in the cardiac rehabilitation program at a general hospital in São Paulo, through the analysis of two scales applied during the initial evaluation: Cardiac Rehabilitation Barriers Scale and scale of the original provision. We used Spearman correlation to relate them to absenteeism, cardiovascular risk age and duration of cardiac rehabilitation. Results: The total score of barriers was 31±6 and the mean score of 1.47±0.31. The main barriers subscales were related to “travel/labor dispute” and “personal problems/family.” The percentage of absenteeism was 8.4% in the number of sessions that could be made in the month. The faults and cancellations were positively correlated with cardiovascular risk (p=0.01; r=0.4) and negatively with scale provision of baseline (p=0.03; r=-0.35) and age (p=0.02; r=-0.35). Conclusion: “Travel/labor dispute”, “personal/ family problems”, and low initial provision are the main factors absenteism in a cardiac rehabilitation program in a general hospital in São Paulo. PMID:24136752

  9. Rehabilitation Programs for Cystic Fibrosis – View from a CF Center

    PubMed Central

    Griese, M; Busch, P; Caroli, D; Mertens, B; Eismann, C; Harari, M; Staudter, H; Kappler, M

    2010-01-01

    Background: Rehabilitation programs are comprehensive interventions which effectively improve the health status and reduce costs in chronic respiratory illnesses. Because patients with cystic fibrosis have been discouraged to participate for concerns of microbial cross infection, the efficacy of systematic rehabilitation is unknown for this group. Methods: We retrospectively studied 142 cystic fibrosis patients aged 2-46 years who participated in rehabilitation programs taking place in Germany/Switzerland and in Israel, focusing on changes in lung function and weight. Results: During 172 stays in 97 patients in Israel and 68 stays in 45 patients rehabilitating in Germany/Switzerland, overall lung function and weight improved. Outcome did not differ between Israel and German/Swiss sites. Interestingly, lung function improved during the initial phase of the stay, whereas weight gain was sustained throughout. The study uncovered gaps in reporting sufficient individual outcome information back to the admitting centre. Conclusions: Rehabilitation programs specified for cystic fibrosis patients need to be assessed prospectively to optimize treatment of this life limiting condition. PMID:20200661

  10. Effect of a cardiac rehabilitation program on exercise oscillatory ventilation in Japanese patients with heart failure.

    PubMed

    Yamauchi, Fumitake; Adachi, Hitoshi; Tomono, Jun-Ichi; Toyoda, Shigeru; Iwamatsu, Koichi; Sakuma, Masashi; Nakajima, Toshiaki; Oshima, Shigeru; Inoue, Teruo

    2016-10-01

    Although exercise oscillatory ventilation has emerged as a potent independent risk factor for adverse prognosis in heart failure, it is not well known whether cardiac rehabilitation can improve oscillatory ventilation. In this study, we investigated the magnitude of oscillations in ventilation before and after cardiac rehabilitation in chronic heart failure patients with exercise oscillatory ventilation. Cardiac rehabilitation (5-month program) was performed in 26 patients with chronic heart failure who showed an oscillatory ventilation pattern during cardiopulmonary exercise testing (CPX). After the 5-month rehabilitation program was completed, the patients again underwent CPX. To determine the magnitude of oscillations in ventilation, the amplitude and cycle length of the oscillations were calculated and compared with several other parameters, including biomarkers that have established prognostic value in heart failure. At baseline before cardiac rehabilitation, both oscillation amplitude (R = 0.625, P < 0.01) and cycle length (R = 0.469, P < 0.05) were positively correlated with the slope of minute ventilation vs. carbon dioxide production. Plasma BNP levels were positively correlated with amplitude (R = 0.615, P < 0.01) but not cycle length (R = 0.371). Cardiac rehabilitation decreased oscillation amplitude (P < 0.01) but failed to change cycle length. The change in amplitude was positively correlated with the change in BNP levels (R = 0.760, P < 0.01). Multiple regression analysis showed that only the change in amplitude was an independent predictor of the change in BNP levels (R = 0.717, P < 0.01). A 5-month cardiac rehabilitation program improves exercise oscillatory ventilation in chronic heart failure patients by reducing the oscillation amplitude. This effect is associated with a reduction of plasma BNP levels, potentially contributing to an improvement of heart failure.

  11. [Patient Education Programs in Child and Adolescent Rehabilitation].

    PubMed

    de Vries, U; Hampel, P; Petermann, F

    2017-04-01

    Comprehensive evidence has been provided for the significant increase in most chronic physical illnesses among children and adolescents. Therefore, early diagnosis and multimodal intervention in childhood and adolescence is required to prevent a chronic course of disease. Thus, patient education is essential for the medical child and adolescent rehabilitation. In particular, in developing asthma, atopic dermatitis and obesity training in the past, a basic consensus on the theory and methodology of patient education has emerged. Specifically, in addition to illness-specific modules, generic modules and treatment objectives should be incorporated.

  12. 34 CFR 350.2 - What is the purpose of the Disability and Rehabilitation Research Project and Centers Program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... purpose of the Disability and Rehabilitation Research Project and Centers Program? The purpose of the... 34 Education 2 2014-07-01 2013-07-01 true What is the purpose of the Disability and Rehabilitation Research Project and Centers Program? 350.2 Section 350.2 Education Regulations of the Offices of the...

  13. 34 CFR 350.2 - What is the purpose of the Disability and Rehabilitation Research Project and Centers Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... What is the purpose of the Disability and Rehabilitation Research Project and Centers Program? The purpose of the Disability and Rehabilitation Research Project and Centers Program is to plan and conduct... 34 Education 2 2013-07-01 2013-07-01 false What is the purpose of the Disability and...

  14. 34 CFR 350.2 - What is the purpose of the Disability and Rehabilitation Research Project and Centers Program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... purpose of the Disability and Rehabilitation Research Project and Centers Program? The purpose of the... 34 Education 2 2011-07-01 2010-07-01 true What is the purpose of the Disability and Rehabilitation Research Project and Centers Program? 350.2 Section 350.2 Education Regulations of the Offices of the...

  15. 34 CFR 350.2 - What is the purpose of the Disability and Rehabilitation Research Project and Centers Program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... What is the purpose of the Disability and Rehabilitation Research Project and Centers Program? The purpose of the Disability and Rehabilitation Research Project and Centers Program is to plan and conduct... 34 Education 2 2012-07-01 2012-07-01 false What is the purpose of the Disability and...

  16. 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

  17. Herbal, vitamin, and mineral supplement use in patients enrolled in a cardiac rehabilitation program.

    PubMed

    Nieva, Reynaria; Safavynia, Seyed A; Lee Bishop, Kathy; Laurence, Sperling

    2012-01-01

    The use of complementary and alternative medicine is common and continues to rise each year, both in the general population and among those with cardiovascular disease. While some supplements may incur risk, particularly when used concomitantly with cardiovascular medications, others have proven benefits. However, supplements such as antioxidants and many herbs can have significant interactions with cardiovascular medications. This study aimed to identify the percentage of patients enrolled in a cardiac rehabilitation program taking herbal, vitamin, and mineral supplements. Electronic and paper charts of 235 patients enrolled in a phase 3 cardiac rehabilitation program were reviewed. Their demographics, medical history, and medications were stratified in an Excel chart, using a large matrix from which data were imported into Matlab for analysis. Custom Matlab programs were created and compiled to determine variables of interest, including percentages of patients with a specific medical condition taking certain supplements. Sixty-seven percent of patients enrolled in the cardiac rehabilitation program were taking vitamins, with or without minerals (67%, 158 of 235). Multivitamin is the most common form of supplement (51%, 119 of 235), followed by fish oil/omega-3 polyunsaturated fatty acids (27%, 64 of 235). The majority of patients in a phase 3 cardiac rehabilitation program are taking some form of herbal, vitamin, or mineral supplement. Given frequent, complicated patient medication regimens, it is important to educate patients on the potential benefits as well as lack of evidence and possible dangers of supplements.

  18. Herbal, Vitamin, and Mineral Supplement Use in Patients Enrolled in a Cardiac Rehabilitation Program

    PubMed Central

    Nieva, Reynaria; Safavynia, Seyed A.; Bishop, Kathy Lee; Sperling, Laurence

    2015-01-01

    PURPOSE The use of complementary and alternative medicine is common and continues to rise each year, both in the general population and among those with cardiovascular disease. While some supplements may incur risk, particularly when used concomitantly with cardiovascular medications, others have proven benefits. However, supplements such as antioxidants and many herbs can have significant interactions with cardiovascular medications. This study aimed to identify the percentage of patients enrolled in a cardiac rehabilitation program taking herbal, vitamin, and mineral supplements. METHODS Electronic and paper charts of 235 patients enrolled in a phase 3 cardiac rehabilitation program were reviewed. Their demographics, medical history, and medications were stratified in an Excel chart, using a large matrix from which data were imported into Matlab for analysis. Custom Matlab programs were created and compiled to determine variables of interest, including percentages of patients with a specific medical condition taking certain supplements. RESULTS Sixty-seven percent of patients enrolled in the cardiac rehabilitation program were taking vitamins, with or without minerals (67%, 158 of 235). Multivitamin is the most common form of supplement (51%, 119 of 235), followed by fish oil/omega-3 polyunsaturated fatty acids (27%, 64 of 235). CONCLUSION The majority of patients in a phase 3 cardiac rehabilitation program are taking some form of herbal, vitamin, or mineral supplement. Given frequent, complicated patient medication regimens, it is important to educate patients on the potential benefits as well as lack of evidence and possible dangers of supplements. PMID:22878561

  19. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    PubMed

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  20. Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients.

    PubMed

    Yoo, Chanuk; Yong, Mi-Hyun; Chung, Jaeyeop; Yang, Yeongae

    2015-08-01

    [Purpose] The objective of this study was to examine the effect of cognitive rehabilitation using a computer on cognitive function and activities of daily living in stroke patients presenting impairment of cognitive function. [Subjects] Forty-six stroke patients were divided into two groups (a training group and control group) through random assignment. [Methods] The training group received rehabilitation therapy and an additional computerized cognitive rehabilitation program using The RehaCom software 30 minutes/day, 5 times/week for 5 weeks. The control group received only rehabilitation therapy including physical and occupational therapy. A comparative analysis on all subjects was conducted before and after the experiment using a cognitive test and activities of daily living test. [Results] After 5 weeks of therapy, the training group presented statistically significant improvement in cognitive function assessment items of digit span, visual span, visual learning, auditory continuous performance, visual continuous performance, and others compared with the control group but did not present statistically significant improvement in activities of daily living. [Conclusion] It was revealed through this study that computerized cognitive rehabilitation with the RehaCom program results in improvement in cognitive function and can be used as a treatment tool beneficial to stroke patients presenting cognitive impairment.

  1. Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients

    PubMed Central

    Yoo, Chanuk; Yong, Mi-hyun; Chung, Jaeyeop; Yang, Yeongae

    2015-01-01

    [Purpose] The objective of this study was to examine the effect of cognitive rehabilitation using a computer on cognitive function and activities of daily living in stroke patients presenting impairment of cognitive function. [Subjects] Forty-six stroke patients were divided into two groups (a training group and control group) through random assignment. [Methods] The training group received rehabilitation therapy and an additional computerized cognitive rehabilitation program using The RehaCom software 30 minutes/day, 5 times/week for 5 weeks. The control group received only rehabilitation therapy including physical and occupational therapy. A comparative analysis on all subjects was conducted before and after the experiment using a cognitive test and activities of daily living test. [Results] After 5 weeks of therapy, the training group presented statistically significant improvement in cognitive function assessment items of digit span, visual span, visual learning, auditory continuous performance, visual continuous performance, and others compared with the control group but did not present statistically significant improvement in activities of daily living. [Conclusion] It was revealed through this study that computerized cognitive rehabilitation with the RehaCom program results in improvement in cognitive function and can be used as a treatment tool beneficial to stroke patients presenting cognitive impairment. PMID:26355244

  2. Eccentric Exercise Program Design: A Periodization Model for Rehabilitation Applications

    PubMed Central

    Harris-Love, Michael O.; Seamon, Bryant A.; Gonzales, Tomas I.; Hernandez, Haniel J.; Pennington, Donte; Hoover, Brian M.

    2017-01-01

    The applied use of eccentric muscle actions for physical rehabilitation may utilize the framework of periodization. This approach may facilitate the safe introduction of eccentric exercise and appropriate management of the workload progression. The purpose of this data-driven Hypothesis and Theory paper is to present a periodization model for isokinetic eccentric strengthening of older adults in an outpatient rehabilitation setting. Exemplar and group data are used to describe the initial eccentric exercise prescription, structured familiarization procedures, workload progression algorithm, and feasibility of the exercise regimen. Twenty-four men (61.8 ± 6.3 years of age) completed a 12-week isokinetic eccentric strengthening regimen involving the knee extensors. Feasibility and safety of the regimen was evaluated using serial visual analog scale (VAS, 0–10) values for self-reported pain, and examining changes in the magnitude of mean eccentric power as a function of movement velocity. Motor learning associated with the familiarization sessions was characterized through torque-time curve analysis. Total work was analyzed to identify relative training plateaus or diminished exercise capacity during the progressive phase of the macrocycle. Variability in the mean repetition interval decreased from 68 to 12% during the familiarization phase of the macrocycle. The mean VAS values were 2.9 ± 2.7 at the start of the regimen and 2.6 ± 2.9 following 12 weeks of eccentric strength training. During the progressive phase of the macrocycle, exercise workload increased from 70% of the estimated eccentric peak torque to 141% and total work increased by 185% during this training phase. The slope of the total work performed across the progressive phase of the macrocycle ranged from −5.5 to 29.6, with the lowest slope values occurring during microcycles 8 and 11. Also, mean power generation increased by 25% when eccentric isokinetic velocity increased from 60 to 90° s−1

  3. Eccentric Exercise Program Design: A Periodization Model for Rehabilitation Applications.

    PubMed

    Harris-Love, Michael O; Seamon, Bryant A; Gonzales, Tomas I; Hernandez, Haniel J; Pennington, Donte; Hoover, Brian M

    2017-01-01

    The applied use of eccentric muscle actions for physical rehabilitation may utilize the framework of periodization. This approach may facilitate the safe introduction of eccentric exercise and appropriate management of the workload progression. The purpose of this data-driven Hypothesis and Theory paper is to present a periodization model for isokinetic eccentric strengthening of older adults in an outpatient rehabilitation setting. Exemplar and group data are used to describe the initial eccentric exercise prescription, structured familiarization procedures, workload progression algorithm, and feasibility of the exercise regimen. Twenty-four men (61.8 ± 6.3 years of age) completed a 12-week isokinetic eccentric strengthening regimen involving the knee extensors. Feasibility and safety of the regimen was evaluated using serial visual analog scale (VAS, 0-10) values for self-reported pain, and examining changes in the magnitude of mean eccentric power as a function of movement velocity. Motor learning associated with the familiarization sessions was characterized through torque-time curve analysis. Total work was analyzed to identify relative training plateaus or diminished exercise capacity during the progressive phase of the macrocycle. Variability in the mean repetition interval decreased from 68 to 12% during the familiarization phase of the macrocycle. The mean VAS values were 2.9 ± 2.7 at the start of the regimen and 2.6 ± 2.9 following 12 weeks of eccentric strength training. During the progressive phase of the macrocycle, exercise workload increased from 70% of the estimated eccentric peak torque to 141% and total work increased by 185% during this training phase. The slope of the total work performed across the progressive phase of the macrocycle ranged from -5.5 to 29.6, with the lowest slope values occurring during microcycles 8 and 11. Also, mean power generation increased by 25% when eccentric isokinetic velocity increased from 60 to 90° s(-1) while

  4. 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…

  5. Stressors Experienced by Relatives of Patients in an Innovative Rehabilitation Program.

    ERIC Educational Resources Information Center

    Quine, Susan; And Others

    1993-01-01

    Conducted 450 interviews with 78 family caregivers of 37 patients with severe brain injuries in rehabilitation treatment program in acute care hospital. Found that involvement in providing treatment was stressful, because of both demands on the family and unproven efficacy of treatment. Findings suggest that family's ability to provide treatment…

  6. Leveling the Playing Field: The Development of a Distance Education Program in Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Leech, Linda L.; Holcomb, John M.

    2004-01-01

    This article describes the curriculum design and development of an online Master's degree program in Rehabilitation Counseling at the University of South Carolina. The use of Bloom's Taxonomy as a method for selecting distance education techniques and teaching methods to ensure equivalency of the educational experience to traditional classroom…

  7. 76 FR 45697 - Vocational Rehabilitation and Employment Program-Changes to Subsistence Allowance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... these projections. Cost Benefit The Post-9/11 subsistence allowance rates are greater than the current... rehabilitation program are also found in tables in 38 CFR 21.260(b), with current rates published yearly on the... allowance must be paid in a manner different than the way current subsistence allowance is paid....

  8. 76 FR 49669 - Vocational Rehabilitation and Employment Program-Changes to Subsistence Allowance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 21 RIN 2900-AO10 Vocational Rehabilitation and Employment Program--Changes to Subsistence Allowance Correction In rule document 2011-19473 appearing on pages 45697-45705 in the issue of...

  9. Developing an Employability Assessment and Planning Program in Rehabilitation & Educational Settings. Participant's Workbook.

    ERIC Educational Resources Information Center

    Farley, Roy C.; Bolton, Brian

    This participant's workbook is one component of an instructional package designed to aid in developing a model employability assessment and planning program for use in rehabilitation and education of persons with disabilities. "An Employability Development Model," outlines the career development and employability development process, major…

  10. 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…

  11. 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…

  12. Characteristics of Telephone Applicants to a Residential Rehabilitation Program for Homeless Veterans.

    ERIC Educational Resources Information Center

    Seidner, Andrea L.; And Others

    1990-01-01

    Gathered descriptive data on 163 telephone applicants to residential rehabilitation program for homeless veterans and compared data with general veteran and homeless populations. Found subjects to be young, educated group of homeless men with histories of relatively high, stable functioning and high rates of medical, substance abuse, psychiatric,…

  13. 78 FR 40458 - American Indian Vocational Rehabilitation Services Program; Notice of Tribal Consultation and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... American Indian Vocational Rehabilitation Services Program; Notice of Tribal Consultation and Request for... ``reservation'' that is used to determine eligibility for a grant under the American Indian Vocational... eligible applicants for an AIVRS grant are the governing bodies of Indian tribes located on Federal...

  14. A Content Analysis of Multicultural Counseling Syllabi from Rehabilitation Counseling Programs

    ERIC Educational Resources Information Center

    Stebnicki, Mark; Cubero, Chris

    2008-01-01

    A content analysis of multicultural counseling syllabi from the Council on Rehabilitation Education (CORE) accredited programs was conducted. Using CORE accreditation standards that apply to Social and Cultural Diversity knowledge and outcome areas (Section C.2) and Middleton et al. (2000) proposed multicultural competencies and standards for…

  15. A Content Analysis of Multicultural Counseling Syllabi from Rehabilitation Counseling Programs

    ERIC Educational Resources Information Center

    Stebnicki, Mark; Cubero, Chris

    2008-01-01

    A content analysis of multicultural counseling syllabi from the Council on Rehabilitation Education (CORE) accredited programs was conducted. Using CORE accreditation standards that apply to Social and Cultural Diversity knowledge and outcome areas (Section C.2) and Middleton et al. (2000) proposed multicultural competencies and standards for…

  16. 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…

  17. 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)

  18. 24 CFR 511.50 - State election to administer a rental rehabilitation program.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false State election to administer a rental rehabilitation program. 511.50 Section 511.50 Housing and Urban Development Regulations...

  19. 24 CFR 511.50 - State election to administer a rental rehabilitation program.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false State election to administer a rental rehabilitation program. 511.50 Section 511.50 Housing and Urban Development Regulations...

  20. 24 CFR 511.50 - State election to administer a rental rehabilitation program.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM CLEARANCE AND URBAN RENEWAL RENTAL... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false State election to administer a rental rehabilitation program. 511.50 Section 511.50 Housing and Urban Development Regulations...

  1. 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…

  2. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Applications for New Awards; Disability and Rehabilitation Research Projects and Centers Program; National Data and Statistical Center for the Burn Model Systems AGENCY: Office of Special Education and...

  3. 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)

  4. 75 FR 3163 - Vocational Rehabilitation and Employment Program-Basic Entitlement; Effective Date of Induction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... rehabilitation program, VA may authorize payment of tuition, fees, and other verifiable expenses that an... and procedure, Armed forces, Civil rights, Claims, Colleges and universities, Conflict of interests... Sec. 21.264 for tuition, fees, and other verifiable expenses that an individual paid or...

  5. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability

    PubMed Central

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-01-01

    [Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Muscle strength and dynamic coordination were evaluated using the Y Balance Test, and isokinetic muscle strength of ankle dorsiflexion, plantarflexion, inversion, and eversion were measured before and after the 12-week program. [Results] Following 12 weeks of rehabilitation exercise, there were statistically significant improvements in the ratios of dorsiflexor strength to plantarflexor strength, eversion strength, and inversion strength on the left side. The other variables showed no significant changes. [Conclusion] The rehabilitation exercise program for chronic ankle instability helped to reduce pain, and to restore normal joint range of motion, muscle strength and endurance, and functional ability. Active protocols to improve complex functions need to be developed to complement these results. PMID:27313347

  6. 76 FR 47835 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and... research and computations used to support an un-weighted regression methodology. ] Response: We provided... 42 CFR Part 412 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for...

  7. A survey of state programs to finance rehabilitation and community services for individuals with brain injury.

    PubMed

    Vaughn, S L; King, A

    2001-02-01

    This article will review and compare existing state-funded programs and their approaches to financing, administering, and delivering an array of services, including rehabilitation and home and community-based services and supports to individuals with traumatic brain injury (TBI) and their families. A state-by-state chart provides funding and operational characteristics of the programs. The state menu of services provided and how they are delivered are also described. The article addresses how these programs fit within their overall state service delivery system, trends and changes that programs may be undergoing, and the influences that shape these programs.

  8. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial.

    PubMed

    Silder, Amy; Sherry, Marc A; Sanfilippo, Jennifer; Tuite, Michael J; Hetzel, Scott J; Heiderscheit, Bryan C

    2013-05-01

    Randomized, double-blind, parallel-group clinical trial. 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). 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. 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. 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. 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. Therapy, level 1b-.

  9. 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

  10. Identifying predictors of resilience at inpatient and 3-month post-spinal cord injury

    PubMed Central

    Warren, Ann Marie; Reynolds, Megan; Agtarap, Stephanie; Hamilton, Rita; Trost, Zina; Monden, Kimberly

    2016-01-01

    Objectives To identify (1) changes in psychosocial factors, (2) relationships between psychosocial factors, and (3) significant predictors of resilience in adults with spinal cord injury (SCI) during inpatient rehabilitation and at 3-month post-discharge. Design Cross sectional with convenience sample based on inclusion/exclusion criteria. Setting Inpatient rehabilitation hospital and community-based follow-up. Participants Individuals with a SCI. Interventions Not applicable. Outcome measures Demographic, resilience, self-efficacy for managing a chronic health issue, depression, social roles/activity limitations, and pain. Results The final sample consisted of 44 respondents (16 women and 28 men). Results of repeated measure analyses of variance indicated no significant changes in variables between inpatient and 3-month follow-up. Bivariate correlations revealed associations between resilience and self-efficacy at inpatient (r = 0.54, P < 0.001), and resilience and depression (r = −0.69, P < 0.001) and self-efficacy (r = 0.67, P < 0.001) at 3-month follow-up. Hierarchical regression analyses a significant model predicting resilience at inpatient stay (R = 0.61; adjusted R2 = 0.24, P = 0.023), and at 3-month follow-up (R = 0.83; adjusted R2 = 0.49, P = 0.022). Self-efficacy was the strongest predictor at inpatient stay (β = 0.46, P  =  0.006) and depression was strongest at 3-month follow-up (β = −0.80, P = 0.007). Conclusion Results suggest that although resilience appears to be stable from inpatient to 3-month follow-up, different factors are stronger predictors of resilience across time. Based on current results, an assessment of self-efficacy during inpatient rehabilitation and an identification of depression at 3-month follow-up may be important factors to help identify those at risk of health issues overtime. PMID:25297474

  11. Preparing for the real world. Program helps rehabilitation patients perform everyday tasks.

    PubMed

    Parthemore, W

    1994-11-01

    St. Francis Health Care Centre in Green Springs, OH, decided in 1991 to enlist local merchants in a program in rehabilitative medicine. The program, named for Green Springs's main street, is "Broadway: A Route Home." Broadway is a program for persons who, because of severe illness or injury, require extended rehabilitation. Along with care for continuing physical or cognitive problems, such patients often need help in performing tasks--buying groceries, cashing a check, renting a video--that most people take for granted. Under the Broadway program patients can practice these tasks safely in shops, restaurants, and theaters in Green Springs and other nearby communities. Later, escorted by therapists, some patients journey to larger cities and, finally, to their own communities, to exercise everyday skills.

  12. [The occupational therapist's role in an interdisciplinary team within the Rehabilitation and External Aids Program].

    PubMed

    Pelatelli, Agustina; Romero, Celeste; Uño Carreño, Mercedes

    2012-01-01

    The role of an occupational therapist in the Mental Health team, particularly in the Rehabilitation and Assisted Discharge Program (PREA), is to provide a focus on the person and on a meaningful occupation for him. The interdisciplinary team of each device, involving an occupational therapist, performs planning goals and implementing the means to achieve through strategies of psychosocial rehabilitation. Meanwhile, intervention strategies are developed and individual support for each person is given to carry out a project of life in the community, building a social, occupational and significant work in order to enhance users' recovery.

  13. 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.

  14. 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

  15. The Effect of a Self Exercise Program in Cardiac Rehabilitation for Patients with Coronary Artery Disease

    PubMed Central

    Kim, Chul; Youn, Jo Eun

    2011-01-01

    Objective To investigate the effect of self exercise in cardiac rehabilitation on cardiopulmonary exercise capacity for selected patients with coronary artery disease. Method The subjects of this study were patients who received percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery and who participated in a cardiac rehabilitation program. The supervised exercise group participated in 6-8 weeks of aerobic exercise training with telemetry ECG monitoring in hospital. The self exercise group, whose exercise risk was low, was instructed to participiate in self exercise training in a community exercise environment according to the exercise tolerance test (ETT) using a modified Bruce protocol. Both groups underwent ETTs before and 6 months after initiation of the cardiac rehabilitation program. We compared the supervised group with the self exercise groups on exercise capacity. Results After 6 months, the supervised exercise group showed significant changes in maximum oxygen consumption, maximal heart rate, resting heart rate, and submaximal rate pressure product. The self exercise group also showed significant improvement of maximum oxygen consumption and submaximal rate pressure product. However, the changing rate of maximum oxygen consumption was significantly higher in the supervised exercise group than the self exercise group. Conclusion Both the supervised and self exercise groups showed similar improvement of cardiopulmonary exercise capacity after 6 months' participation in the cardiac rehabilitation program. However, the changing rate of maximum oxygen consumption, maximal heart rate, and resting heart rate were significantly higher in the supervised exercise group than the self exercise group. PMID:22506148

  16. [Feasibility of a geriatric multidisciplinary outpatient rehabilitation program-lessons learned].

    PubMed

    Mak, Rachel G; de Groot, Aafke J; Vreeburg, Ellen M; Smalbrugge, Martin; Depla, Marja F I A

    2016-04-01

    To describe the feasibility of a geriatric multidisciplinary outpatient rehabilitation program, developed in Vivium Naarderheem. A prospective pilot study using a pretest-posttest design with measurements of the level of (social) participation, health related quality of life, and caregiver strain at the start (T0) and the end (T1) of the program. Feasibility was studied by structured interviews with participants, professionals and management. We included 18 patients, fifteen of which were admitted after stroke. The program was highly appreciated by patients. Management and professionals thought that factors of influence on the program were transportation of patients, adequate planning and deployment of staff, and adequate financing. The program was regarded feasible. Although some patients reported a higher level of participation, the only statistically significant finding was a deterioration in self-perceived health. In this study most of the patients participated after stroke. The geriatric multidisciplinary outpatient rehabilitation program, following inpatient geriatric rehabilitation, was highly appreciated by patients, and considered feasible by management and professionals.

  17. Home-based vs supervised rehabilitation programs following knee surgery: a systematic review.

    PubMed

    Papalia, Rocco; Vasta, Sebastiano; Tecame, Andrea; D'Adamio, Stefano; Maffulli, Nicola; Denaro, Vincenzo

    2013-01-01

    Following knee surgery, rehabilitation can dramatically affect the postoperative course and the final outcomes of the procedure. We systematically reviewed the current literature comparing clinical outcomes of home-based and outpatient supervised rehabilitation protocols following knee surgery. We searched Medline, CINAHL, Embase, Google Scholar, The Cochrane Library and SPORTDiscus. The reference lists of the previously selected articles were then examined by hand. Only studies comparing clinical outcomes of patients who had undergone knee surgery followed by different rehabilitation programs were selected. Then the methodological quality of each article was evaluated using the Coleman methodology score (CMS), a 10-criterion scoring list assessing the methodological quality of the selected studies. Eighteen studies were evaluated in the present review. Three were retrospective studies. The remaining 15 studies were prospective randomized clinical trials. The supervised and home-based protocols did not show an overall significant difference in the outcomes achieved within the studies reviewed. The mean CMS was 77.2. The heterogeneity of the rehabilitation protocols used in the studies reviewed makes it difficult to draw definite conclusion on the subject. Supervision and location does not seem to directly determine the final outcomes. Numerous variables, including comorbidities and motivation, could influence the results and deserve to be accounted for in future investigations. Better designed studies are needed to show a clear superiority of one rehabilitation approach over another and its applicability to the various surgical procedures involving the knee.

  18. Learning, Play, and Your 1- to 3-Month-Old

    MedlinePlus

    ... Old Learning, Play, and Your 1- to 3-Month-Old KidsHealth > For Parents > Learning, Play, and Your 1- to 3-Month-Old Print A A A What's in this ... start responding even more to you during these months — and will even give you a smile! Babies ...

  19. Medical Care and Your 1- to 3-Month-Old

    MedlinePlus

    ... Old Medical Care and Your 1- to 3-Month-Old KidsHealth > For Parents > Medical Care and Your 1- to 3-Month-Old Print A A A What's in this ... When to Call the Doctor During these early months, you might have many questions about your baby's ...

  20. Medical Care and Your 1- to 3-Month-Old

    MedlinePlus

    ... Old Medical Care and Your 1- to 3-Month-Old KidsHealth > For Parents > Medical Care and Your 1- to 3-Month-Old A A A What's in this article? ... When to Call the Doctor During these early months, you might have many questions about your baby's ...

  1. Learning, Play, and Your 1- to 3-Month-Old

    MedlinePlus

    ... Old Learning, Play, and Your 1- to 3-Month-Old KidsHealth > For Parents > Learning, Play, and Your 1- to 3-Month-Old A A A What's in this article? ... start responding even more to you during these months — and will even give you a smile! Babies ...

  2. 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.

  3. [Benefits of a cardiac rehabilitation program on some parameters of corporal composition].

    PubMed

    López Frías, Magdalena; Gómez Martínez, Mar; Ramírez López Frías, Mercedes; De Teresa Galván, Carlos; Díaz Castro, Javier; Nestares, Teresa

    2014-12-01

    The cardiovascular diseases (CVD) are the principal reasons of morbidity and mortality in the world. The cardiac rehabilitation is a program of secondary prevention to complement the effects of the cardiological treatment with the participation of the patient in the control of their habits of life, as a way of promotion of its own cardiovascular health. The aim of the present study is to evaluate the long-term effects of a cardiac rehabilitation program on some parameters of corporal composition in patients that have attended or not, to the phase the III of the program. The study was performed in subjects that suffered a cardiovascular event and they were members of the Association of Cardiac Patients of Granada and Province. All the members were offered the possibility of forming a part of the study. Some parameters of body composition were measured and a nutritional evaluation was performed in all the subjects. The visceral and body fat and, which play a key role in the cardiovascular pathology, are lower in the patients attending to the cardiac rehabilitation program, revealing that are better predictors of the cardiovascular risk. Thanks to the nutritional advice received, an increase in healthy nutrients is observed and the subjects attending to the program feature major phase angle, indicating that they have a better state of hydration, together with a better integrity of the cell membranes and distribution of water between the compartments intra- and extracellular compartments. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  4. A survey of program evaluation practices in family-centered pediatric rehabilitation settings.

    PubMed

    Moreau, Katherine A; Cousins, J Bradley

    2014-04-01

    Program evaluation is becoming increasingly important in pediatric rehabilitation settings that adhere to the family-centered service (FCS) philosophy. However, researchers know little about the specific evaluation activities occurring in these settings or the extent to which evaluators/service providers uphold FCS in their program evaluation activities. Through a questionnaire survey, this study aimed to document evaluators/service providers' perceptions of the level of program evaluation occurring in their Canadian pediatric rehabilitation centers. It also investigated the extent to which evaluators/service providers perceive program evaluation practices at their centers to be consistent with the FCS context of Canadian pediatric rehabilitation settings. The findings suggested that the amount of evaluation activities occurring within the respondents' centers is variable; that the majority of individuals working in program evaluation do not have formal training in it; and that the respondents' centers have limited resources for evaluation. The study also showed that staff members believe their centers' evaluation activities are somewhat consistent with FCS philosophy, but that improvements are needed.

  5. The Transcendental Meditation Program and Rehabilitation at Folsom State Prison

    ERIC Educational Resources Information Center

    Abrams, Allan I.; Siegel, Larry M.

    1978-01-01

    Effects of the Transcendental Meditation program in a maximum security prison were studied via cross-validation design. Meditation and control groups indicated reduction in anxiety, neuroticism, hostility, and insomnia as a function of the treatment. (Author)

  6. The Transcendental Meditation Program and Rehabilitation at Folsom State Prison

    ERIC Educational Resources Information Center

    Abrams, Allan I.; Siegel, Larry M.

    1978-01-01

    Effects of the Transcendental Meditation program in a maximum security prison were studied via cross-validation design. Meditation and control groups indicated reduction in anxiety, neuroticism, hostility, and insomnia as a function of the treatment. (Author)

  7. Standardizing the Analysis of Physical Activity in Patients With COPD Following a Pulmonary Rehabilitation Program

    PubMed Central

    Demeyer, Heleen; Burtin, Chris; Van Remoortel, Hans; Hornikx, Miek; Langer, Daniel; Decramer, Marc; Gosselink, Rik; Janssens, Wim

    2014-01-01

    BACKGROUND: There is a wide variability in measurement methodology of physical activity. This study investigated the effect of different analysis techniques on the statistical power of physical activity outcomes after pulmonary rehabilitation. METHODS: Physical activity was measured with an activity monitor armband in 57 patients with COPD (mean ± SD age, 66 ± 7 years; FEV1, 46 ± 17% predicted) before and after 3 months of pulmonary rehabilitation. The choice of the outcome (daily number of steps [STEPS], time spent in at least moderate physical activity [TMA], mean metabolic equivalents of task level [METS], and activity time [ACT]), impact of weekends, number of days of assessment, postprocessing techniques, and influence of duration of daylight time (DT) on the sample size to achieve a power of 0.8 were investigated. RESULTS: The STEPS and ACT (1.6-2.3 metabolic equivalents of task) were the most sensitive outcomes. Excluding weekends decreased the sample size for STEPS (83 vs 56), TMA (160 vs 148), and METS (251 vs 207). Using 4 weekdays (STEPS and TMA) or 5 weekdays (METS) rendered the lowest sample size. Excluding days with < 8 h wearing time reduced the sample size for STEPS (56 vs 51). Differences in DT were an important confounder. CONCLUSIONS: Changes in physical activity following pulmonary rehabilitation are best measured for 4 weekdays, including only days with at least 8 h of wearing time (during waking hours) and considering the difference in DT as a covariate in the analysis. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00948623; URL: www.clinicaltrials.gov PMID:24603844

  8. Implementation and Outcomes of a Community-Based Pulmonary Rehabilitation Program in Rural Appalachia

    PubMed Central

    Tommarello, Chaffee; Broce, Mike; Emmett, Mary; Pollard, Cecil

    2017-01-01

    Purpose: To report on the implementation and clinical outcomes of a community-based pulmonary rehabilitation program in rural Appalachia. Methods: Three rural health centers and a large referral hospital worked together to establish pulmonary rehabilitation services based on AACVPR guidelines. Each site hired at least 1 respiratory therapist. To measure clinical outcomes, a retrospective medical record study compared pre- and post-program values for the modified Medical Research Council dyspnea level, 6-minute walk test (6MWT), negative inspiratory force (NIF), respiratory disease knowledge, St George Respiratory Questionnaire (SGRQ), BODE index (body mass index, airflow obstruction, dyspnea and exercise capacity), and smoking status. The percentages of persons completing the program and participating in maintenance exercise after the program were recorded. Results: During the first 20 months of the program, 195 unduplicated persons with qualifying chronic lung diseases started the program. Of these, 111 (57%) completed the program. Mean improvements for all 6 measures were highly significant (P < .001) and compared favorably with published results from hospital-based programs: dyspnea level, −1.2; 6MWT, +259 ft; NIF, +11.3 cm H2O; knowledge test, +1.9; SGRQ, −6.2; BODE index, −1.1. Of the 23 smokers, 5 quit by the end of the program. Conclusions: Community-based pulmonary rehabilitation in rural health centers is feasible and achieves clinical outcomes similar to programs in large hospitals and academic centers. Furthermore, the addition of respiratory therapists to these primary care teams provides important collateral benefits for the evidence-based care of patients with chronic lung diseases. PMID:28306684

  9. Implementation and Outcomes of a Community-Based Pulmonary Rehabilitation Program in Rural Appalachia.

    PubMed

    Doyle, Daniel; Tommarello, Chaffee; Broce, Mike; Emmett, Mary; Pollard, Cecil

    2017-07-01

    To report on the implementation and clinical outcomes of a community-based pulmonary rehabilitation program in rural Appalachia. Three rural health centers and a large referral hospital worked together to establish pulmonary rehabilitation services based on AACVPR guidelines. Each site hired at least 1 respiratory therapist. To measure clinical outcomes, a retrospective medical record study compared pre- and post-program values for the modified Medical Research Council dyspnea level, 6-minute walk test (6MWT), negative inspiratory force (NIF), respiratory disease knowledge, St George Respiratory Questionnaire (SGRQ), BODE index (body mass index, airflow obstruction, dyspnea and exercise capacity), and smoking status. The percentages of persons completing the program and participating in maintenance exercise after the program were recorded. During the first 20 months of the program, 195 unduplicated persons with qualifying chronic lung diseases started the program. Of these, 111 (57%) completed the program. Mean improvements for all 6 measures were highly significant (P < .001) and compared favorably with published results from hospital-based programs: dyspnea level, -1.2; 6MWT, +259 ft; NIF, +11.3 cm H2O; knowledge test, +1.9; SGRQ, -6.2; BODE index, -1.1. Of the 23 smokers, 5 quit by the end of the program. Community-based pulmonary rehabilitation in rural health centers is feasible and achieves clinical outcomes similar to programs in large hospitals and academic centers. Furthermore, the addition of respiratory therapists to these primary care teams provides important collateral benefits for the evidence-based care of patients with chronic lung diseases.

  10. 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…

  11. 34 CFR 371.1 - What is the Vocational Rehabilitation Services Program for American Indians with Disabilities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for American Indians with Disabilities? 371.1 Section 371.1 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES General § 371.1 What is the Vocational Rehabilitation Services Program for American Indians...

  12. 34 CFR 371.1 - What is the Vocational Rehabilitation Services Program for American Indians with Disabilities?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... for American Indians with Disabilities? 371.1 Section 371.1 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES General § 371.1 What is the Vocational Rehabilitation Services Program for American Indians...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the State Vocational Rehabilitation Unit In-Service Training program? 388.1 Section 388.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

  14. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the State Vocational Rehabilitation Unit In-Service Training program? 388.1 Section 388.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

  15. 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…

  16. 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…

  17. 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…

  18. Vocational Rehabilitation Program Standards Evaluation System. Final Report. Volume II: Using the System: An Analytic Paradigm for Management.

    ERIC Educational Resources Information Center

    Dodson, Richard; And Others

    The Program Standards Evaluation System was developed in response to evaluation requirements in the 1973 Rehabilitation Act. The system includes procedures for using standards data to monitor and evaluate vocational rehabilitation (VR) service outcomes and outputs as well as standards on key procedural issues. This report contains the outlines of…

  19. 34 CFR 371.1 - What is the Vocational Rehabilitation Services Program for American Indians with Disabilities?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... for American Indians with Disabilities? 371.1 Section 371.1 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES General § 371.1 What is the Vocational Rehabilitation Services Program for American Indians with...

  20. 34 CFR 371.1 - What is the Vocational Rehabilitation Services Program for American Indians with Disabilities?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... for American Indians with Disabilities? 371.1 Section 371.1 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES General § 371.1 What is the Vocational Rehabilitation Services Program for American Indians with...

  1. 34 CFR 371.1 - What is the Vocational Rehabilitation Services Program for American Indians with Disabilities?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... for American Indians with Disabilities? 371.1 Section 371.1 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES General § 371.1 What is the Vocational Rehabilitation Services Program for American Indians with...

  2. Professional Identity, Professional Associations, and Recruitment: Perspectives of Current Doctoral Students and Recent Graduates of Rehabilitation Programs

    ERIC Educational Resources Information Center

    Fleming, Alison; Phillips, Brian; Manninen-Luse, Melissa; Irizarry, Lesley O.; Hylton, Terrie

    2011-01-01

    This study was an exploratory investigation of the perceptions of current doctoral students and recent graduates from rehabilitation counseling and rehabilitation psychology programs on professional identity, professional associations, and recruitment. These three issues were selected based on the likelihood that students and recent graduates…

  3. Professional Identity, Professional Associations, and Recruitment: Perspectives of Current Doctoral Students and Recent Graduates of Rehabilitation Programs

    ERIC Educational Resources Information Center

    Fleming, Alison; Phillips, Brian; Manninen-Luse, Melissa; Irizarry, Lesley O.; Hylton, Terrie

    2011-01-01

    This study was an exploratory investigation of the perceptions of current doctoral students and recent graduates from rehabilitation counseling and rehabilitation psychology programs on professional identity, professional associations, and recruitment. These three issues were selected based on the likelihood that students and recent graduates…

  4. 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…

  5. Rehabilitation services after total joint replacement in Ontario, Canada: can 'prehabilitation' programs mediate an increasing demand?

    PubMed

    Landry, Michel D; Jaglal, Susan B; Wodchis, Walter P; Cooper, Nicole S; Cott, Cheryl A

    2007-12-01

    Total joint replacements (TJR) have emerged as a critical health policy issue. In particular, Canadian demand for these surgeries is forecast to grow annually by 8.7% in the next decade. Although the medical and surgical aspects of TJR have received considerable attention, very little research has explored the impact of increased TJR on the demand for rehabilitation services. In this study, we conducted seven focus group discussions across the province of Ontario (Canada) with multiple stakeholders (n=50) ranging from clinicians and administrators, to policy makers and researchers. Our results indicate that demand for rehabilitation following TJR is rising sharply and that there are three primary factors affecting such demand: (i) increase in the absolute number of TJR surgeries is increasing demand across the continuum of care; (ii) changing profile of clients whereby 'younger and active' groups are more willing to undergo surgery, and 'older and complex' groups are presenting with increased rates of medical complications and comorbidities; and (iii) widespread use of clinical pathways has increased requirements within the rehabilitation sector, but often without corresponding adjustments in levels of human resources. To align increasing demand with supply in the long term, participants offered strong support for health promotion and prevention programs, but they also highlighted the short-term benefits of implementing 'prehabilitation' programs for clients waiting for surgery. Overall, our results indicate that the demand for rehabilitation services after TJR is increasing and that innovative approaches to care delivery are required to align increasing demand with supply.

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

    PubMed

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

    2013-09-19

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  9. 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

  10. A Motivation Guided Holistic Rehabilitation of the First Programming Course

    ERIC Educational Resources Information Center

    Nikula, Uolevi; Gotel, Orlena; Kasurinen, Jussi

    2011-01-01

    It has been estimated that more than two million students started computing studies in 1999 and 650,000 of them either dropped or failed their first programming course. For the individual student, dropping such a course can distract from the completion of later courses in a computing curriculum and may even result in changing their course of study…

  11. Program of Vocational Rehabilitation for Young Adult Offenders.

    ERIC Educational Resources Information Center

    Pennsylvania State Correctional Inst., Camp Hill.

    Full development of the educational, occupational, and attitudinal abilities of young delinquents admitted to the Camp Hill State Correctional Institute was the object of this Elementary and Secondary Education Act Title I Program. Young adults 15-21 years committed to Camp Hill average 6.1 on the standard educational battery test and their…

  12. Talking Typewriter Training Program in a Rehabilitation Setting.

    ERIC Educational Resources Information Center

    Kupshunas, Sue

    1984-01-01

    As part of a state residential center's 16-week training program to assist blind adults, aged 16-65, in acquiring employability skills, clients receive hands-on training in mastering the IBM Memory 100 Audio Unit typewriter. Training includes assessing prerequisite secretarial skills, using self-instructional materials, and evaluating performance.…

  13. A Motivation Guided Holistic Rehabilitation of the First Programming Course

    ERIC Educational Resources Information Center

    Nikula, Uolevi; Gotel, Orlena; Kasurinen, Jussi

    2011-01-01

    It has been estimated that more than two million students started computing studies in 1999 and 650,000 of them either dropped or failed their first programming course. For the individual student, dropping such a course can distract from the completion of later courses in a computing curriculum and may even result in changing their course of study…

  14. 76 FR 22084 - Applications for New Awards; Rehabilitation Training: Rehabilitation Long-Term Training

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Applications for New Awards; Rehabilitation Training: Rehabilitation Long-Term Training AGENCY: Office of... Information: Rehabilitation Training: Rehabilitation Long- Term Training notice inviting applications for new... Opportunity Description Purpose of Program: The Rehabilitation Long-Term Training program (Training...

  15. Design considerations for a theory-driven exergame-based rehabilitation program to improve walking of persons with stroke.

    PubMed

    Wüest, Seline; van de Langenberg, Rolf; de Bruin, Eling D

    2014-01-01

    Virtual rehabilitation approaches for promoting motor recovery has attracted considerable attention in recent years. It appears to be a useful tool to provide beneficial and motivational rehabilitation conditions. Following a stroke, hemiparesis is one of the most disabling impairments and, therefore, many affected people often show substantial deficits in walking abilities. Hence, one of the major goals of stroke rehabilitation is to improve patients' gait characteristics and hence to regain their highest possible level of walking ability. Because previous studies indicate a relationship between walking and balance ability, this article proposes a stroke rehabilitation program that targets balance impairments to improve walking in stroke survivors. Most currently, available stroke rehabilitation programs lack a theory-driven, feasible template consistent with widely accepted motor learning principles and theories in rehabilitation. To address this hiatus, we explore the potential of a set of virtual reality games specifically developed for stroke rehabilitation and ordered according to an established two-dimensional motor skill classification taxonomy. We argue that the ensuing "exergame"-based rehabilitation program warrants individually tailored balance progression in a learning environment that allows variable practice and hence optimizes the recovery of walking ability.

  16. Acceptance and commitment therapy for chronic pain: evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation.

    PubMed

    Vowles, Kevin E; Witkiewitz, Katie; Sowden, Gail; Ashworth, Julie

    2014-01-01

    There is an emerging body of evidence regarding interdisciplinary acceptance and commitment therapy in the rehabilitative treatment of chronic pain. This study evaluated the reliability and clinical significance of change following an open trial that was briefer than that examined in previous work. In addition, the possible mediating effect of psychological flexibility, which is theorized to underlie the acceptance and commitment therapy model, was examined. Participants included 117 completers of an interdisciplinary program of rehabilitation for chronic pain. Assessment took place at treatment onset and conclusion, and at a 3-month follow-up when 78 patients (66.7%) provided data. At the 3-month follow-up, 46.2% of patients achieved clinically significant change, and 58.9% achieved reliable change, in at least 1 key measure of functioning (depression, pain anxiety, and disability). Changes in measures of psychological flexibility significantly mediated changes in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics. These results add to the growing body of evidence supporting interdisciplinary acceptance and commitment therapy for chronic pain, particularly with regard to the clinical significance of an abbreviated course of treatment. Further, improvements appear to be mediated by changes in the processes specified within the theoretical model. Outcomes of an abbreviated interdisciplinary treatment for chronic pain based on a particular theoretical model are presented. Analyses indicated that improvements at follow-up mediated change in the theorized treatment process. Clinically significant change was indicated in just under half of participants. These data may be helpful to clinicians and researchers interested in intervention approaches and mechanisms of change. Copyright © 2014 American Pain Society. All rights reserved.

  17. Leveling the playing field: the development of a distance education program in rehabilitation counseling.

    PubMed

    Leech, Linda L; Holcomb, John M

    2004-01-01

    This article describes the curriculum design and development of an online Master's degree program in Rehabilitation Counseling at the University of South Carolina. The use of Bloom's Taxonomy as a method for selecting distance education techniques and teaching methods to ensure equivalency of the educational experience to traditional classroom teaching is described. The author presents tables to demonstrate the cognitive competencies, traditional and distance education methods, and use of synchronous and asynchronous methods in reaching desired educational objectives. This process has resulted in the creation of a program that offers distance education options, traditional classroom options, or a blend of approaches. The menu of options has met the unique learning needs of all students and has offered students with disabilities a level playing field on which to build rehabilitation counseling competencies.

  18. 2-year review of a novel vestibular rehabilitation program in Montreal and Laval, Quebec.

    PubMed

    Dannenbaum, Elizabeth; Rappaport, Jamie M; Paquet, Nicole; Visintin, Martha; Fung, Joyce; Watt, Douglas

    2004-02-01

    To evaluate the benefits of a vestibular rehabilitation program (VRP) in the Montreal-Laval area. The VRP was conceptualized by a panel of experts including otolaryngologists, physiotherapists, and researchers from McGill University and its teaching hospitals. From February 1999 to December 2001, 117 patients were seen, and 88 of them completed the VRP. The VRP has been established at the Jewish Rehabilitation Hospital in Laval, PQ, to provide specialized rehabilitation to clients suffering from vertigo, dizziness, and/or impaired balance owing to lesions or disorders of the vestibular system. Presence or absence of nystagmus or vertigo during the Dix-Hallpike test, Dizziness Handicap Inventory (DHI), and Dynamic Gait Index (DGI). Thirty-five patients with benign paroxysmal positional vertigo of the posterior canal were treated with canalith repositioning manoeuvres. All of the patients (100%) had absence of nystagmus or vertigo after one to four treatment sessions. Forty-six patients with vestibular deficits or dizziness-disequilibrium completed the VRP, which consisted mainly of individualized eye-head and balance home exercise programs. At the end of the VRP, there was a significant decrease in DHI score (31 vs 57; p < .01) and a significant increase in DGI score (18.4 vs 22.6; p < .01). A range of modest to major improvements was shown by comparing initial and discharge scores of patients who had completed vestibular rehabilitation. The VRP appears to be beneficial for patients with a variety of vestibular disorders. Further research is needed to continue optimizing vestibular rehabilitation.

  19. 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

    2016-05-27

    The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. We shall focus on assistance, training of health-providers, research and the implementation barriers. All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centers were distributed in two groups: RENAPREC-2009 centers that participated in 2015 and the new CRP units. In 2009 there were 14 centers, two of them disappeared and another two did not respond. CRP-units increased 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centers 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 is 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts is 16:1. Cardiac rehabilitation activities and costs varied widely. Patient's 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 centers (38%). CRPs in Mexico are still in the process of maturing. Mexican CRP-centers have several strengths like the quality of the education of the professionals and multidisciplinary programs. However, the lack of reference of patients and the heterogeneity of procedures are still their main weaknesses. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  20. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery in Coronary Heart Disease.

    PubMed

    Mahdavi Anari, Leila; Ghanbari-Firoozabadi, Mahdieh; Ansari, Zahra; Emami, Mahmoud; Vafaii Nasab, Mohammadreza; Nemaiande, Mahdieh; Boostany, Fatemeh; Neishaboury, Mohamadreza

    2015-10-27

    It has been suggested that the autonomic system function and the metabolic syndrome can significantly affect patients' survival. The aim of the current study was to investigate the impact of the cardiac rehabilitation program on the autonomic system balance in patients with coronary artery disease. Patients with a previous diagnosis of coronary artery disease who were referred to the Cardiovascular Rehabilitation Center of Afshar Hospital (Yazd, Iran) between March and November 2011 were enrolled. All the patients participated in rehabilitation sessions 3 times a week for 12 weeks. Heart rate recovery (HRR) was measured as an indicator of the autonomic system balance. In order to calculate HRR, the maximum heart rate during the exercise test was recorded. At the end of the exercise test, the patients were asked to sit down without having a cooldown period and their heart rate was recorded again after 1 minute. The difference between these 2 measurements was considered as HRR. A total of 108 patients, including 86 (79.6%) men and 22 (20.4%) women, completed the rehabilitation course. The mean age of the study participants was 58.25 ± 9.83 years. A statistically significant improvement was observed in HRR (p value = 0.040). Significant declines were also observed in the patients' waist circumference (p value < 0.001) and systolic and diastolic blood pressures (p value = 0.018 and 0.003, respectively). A decreasing trend was observed in the patients' body mass index, but it failed to reach statistical significance (p value = 0.063). No statistically meaningful changes were noted in fasting blood glucose (p value = 0.171), high-density lipoprotein (p value = 0.070), or triglyceride concentrations (p value = 0.149). The cardiac rehabilitation program may help to improve HRR and several components of the metabolic syndrome in patients with coronary heart disease.

  1. "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.

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

    PubMed Central

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

    2016-01-01

    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/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. PMID:27455419

  3. Repair, Evaluation, Maintenance, and Rehabilitation Research Program: Plastic Concrete Cutoff Walls for Earth Dams

    DTIC Science & Technology

    1991-03-01

    During excavation, the panel is filled with a bentonite slurry which penetrates the adjacent soil and forms a filter cake on the sides of the...ment soil . PREFACE The work described in this report was authorized by Headquarters, US Army Corps of Engineers (HQUSACE), as part of the...Geotechnical ( Soil ) Problem Area of the Repair, Evaluation, Maintenance, and Rehabilitation (REMR) Research Program from October 1987 to November 1989. The work

  4. Effect of rehabilitation program on endocrinological parameters in patients with COPD and in healthy subjects.

    PubMed

    Mkacher, Wajdi; Tabka, Zouhair; Chaieb, Faten; Gueddes, Meriem; Zaouali, Monia; Aouichaoui, Chirine; Zbidi, Abdelkrim; Trabelsi, Yassine

    2014-12-01

    Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation and endocrinological disturbance. The aim of this study is to analyze the effect of rehabilitation program on the balance of anabolic versus catabolic hormone in patients with COPD and in healthy subjects. Nineteen patients with COPD and 16 age-matched healthy subjects undertooked exercise training 3 days/week for 8 weeks. Before and after the training program the concentration of growth hormone (GH), Insulin-Like Growth Factor-1 (IGF-1), Insulin-like Growth Factor-Binding Protein 3 (IGF-BP3), testosterone and cortisol in serum were determined. The exercise measurements included a 6-Minute Walking Test (6MWT). After 8 weeks, there was no significant change in lung function in patients with COPD and healthy subjects. Growth hormone, Insulin-like Growth Factor-1 and Insulin-like Growth Factor-Binding Protein 3 increased significantly after rehabilitation training (p < 0.01). The rehabilitation program improves the testosterone/cortisol ratio (T/C ratio) in both groups. There is a significant improvement in the 6-Minute Walking distance (6MWD) in both groups (p < 0.01). Dyspnea and heart rate at rest and at the peak of the 6-Minute Walking Test (6MWT) decreased significantly after training program (p < 0.01). Pulmonary rehabilitation induces an improvement of the anabolic process and reduces proteine distruction by the modifications in endocrinological factors regulating skeletal muscle in patients with COPD.

  5. 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

  6. A multimodal communication program for aphasia during inpatient rehabilitation: A case study.

    PubMed

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

    2014-01-01

    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. 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. 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. 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. 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.

  7. 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.

  8. Upper limb training/assessment program using passive force controllable rehabilitation system.

    PubMed

    Kikuchi, Takehito; Sato, Chihiro; Yamabe, Kazuki; Abe, Isao; Ohno, Tetsuya; Kugimiya, Shintaro; Inoue, Akio

    2017-07-01

    Upper limb rehabilitation training for Hemiplegie patients has been conducted mainly by human therapists. Training methods and conditions depend strongly on their experience because of the wide range of individual differences between patients. The force control and sensing functions of rehabilitation robots are expected to be used for the qualitative assessment of next-generation computational rehabilitation. In this study, we developed a simple exercise machine for upper limbs (SEMUL) using an electro-rheological fluid brake, as a safe brake-type robotic rehabilitation system. We also developed a new upper limb training/assessment program, called "WIPE," for the SEMUL. Furthermore, we conducted clinical tests on twelve subjects (six each for the SEMUL training and for general training). We adopted the ABA design methodology for the clinical research tests. The motor functions of upper limbs were assessed using five clinical scores: Fugl-Meyer Assessment (FMA), Brunnstrome recovery stage, Simple Test for Evaluating Hand Function (STEF), Stroke Impairment Assessment Set (SIAS), and Motor Activity Log. Improvements of the FMA, STEF, and SIAS in the SEMUL training groups were found to be higher than those in the general training groups.

  9. 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

  10. 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.

  11. 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

  12. The quality of life of persons with TBI in the process of a Comprehensive Rehabilitation Program1

    PubMed Central

    Pąchalska, Maria; Mako, Grzegorz; Chantsoulis, Marzena; Knapik, Henryk; Mirski, Andrzej; Mirska, Natalia

    2012-01-01

    Summary Background The aim of the research was to evaluate the effectiveness of the phased rehabilitation program in patients after traumatic brain injury, one developed by the authors and controlled by the strategic plan, pertaining to their quality of life compared to patients treated according to a standard, phased rehabilitation program. Material/Methods The study included 40 patients of post traumatic brain injury treated at the Rehabilitation Clinic of the L. Rydygier Academy of Medical Sciences in Bydgoszcz and the Department of Medical Rehabilitation of the Cracow Rehabilitation Centre. An experimental group included 20 patients rehabilitated by a strategic approach and a control group consisted of 20 patients treated before the introduction of this approach. In assessing the effectiveness of rehabilitation, a structured interview was used with clinical observation and the Battery of Quality of Life Assessment. The study was conducted twice: before and after eight weeks of rehabilitation. Results The quality of life of people after brain injury is affected by self-service difficulties, difficulties in meeting the physiological needs and loss of psychophysical comfort, decreased mobility, impaired cognitive functions and executive and social functions. There is no consistency between the stated (subjective) level of quality of life of the patient, and the depth of objectively measured disability resulting from the injury sustained. Conclusions A rehabilitation program controlled by a strategic plan, in collaboration with the patient treated subjectively is more effective in improving the quality of life, since the cooperating patient is more motivated to carry out individually designed goals. A rehabilitation program based on a strategic plan is worthy of recommendation for the treatment and improvement of patients after cranio-cerebral trauma. PMID:22739733

  13. Paliperidone Palmitate Intramuscular 3-Monthly Formulation: A Review in Schizophrenia.

    PubMed

    Lamb, Yvette N; Keating, Gillian M

    2016-10-01

    A 3-monthly formulation of intramuscular paliperidone palmitate (3-monthly paliperidone palmitate) has recently been approved for the maintenance treatment of schizophrenia in adult patients in the EU (Trevicta(®)), following earlier approval in the USA (Invega Trinza(®)). This narrative review discusses the clinical use of 3-monthly paliperidone palmitate in the maintenance treatment of schizophrenia in adult patients and summarizes its pharmacological properties. The efficacy of the 3-monthly paliperidone palmitate formulation as a maintenance treatment for schizophrenia has been demonstrated in well designed, phase III trials. Three-monthly paliperidone palmitate was more effective than placebo in delaying time to relapse and reducing relapse rates, and was noninferior to 1-monthly paliperidone palmitate in the proportion of patients that remained relapse-free. The 3-monthly formulation was also more effective than placebo in controlling the symptoms of schizophrenia, whilst not differing significantly from the 1-monthly formulation in terms of symptomatic control. Three-monthly paliperidone palmitate was generally well tolerated in clinical trials, with a tolerability profile consistent with that of the 1-monthly formulation. In conclusion, 3-monthly paliperidone palmitate is a useful treatment option for adult patients with schizophrenia who are adequately treated with the 1-monthly formulation, particularly for those who would prefer, or may benefit from, longer dosing intervals.

  14. Final priorities; Rehabilitation Services Administration--Capacity Building Program for Traditionally Underserved Populations--vocational rehabilitation training institute for the preparation of personnel in American Indian Vocation Rehabilitation Services projects. Final priorities.

    PubMed

    2014-08-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces two priorities under the Capacity Building Program for Traditionally Underserved Populations administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2014 and later years. Priority 1 establishes a new vocational rehabilitation (VR) training institute for the preparation of personnel in American Indian Vocational Rehabilitation Services (AIVRS) projects (the Institute). Priority 2 requires a partnership between a four-year institution of higher education (IHE) and a two-year community college or tribal college. This partnership is designed to successfully implement the VR training Institute established in Priority 1. In addition, the partnership agreement required under Priority 2 provides a brief description of how the partnership will be managed, the partners' roles and responsibilities and a strategy for sustaining the partnership after the Federal investment ends.

  15. 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.

  16. An inpatient rehabilitation program utilizing standardized care pathways after paracorporeal ventricular assist device placement in children.

    PubMed

    Hollander, Seth A; Hollander, Amanda J; Rizzuto, Sandra; Reinhartz, Olaf; Maeda, Katsuhide; Rosenthal, David N

    2014-06-01

    Structured rehabilitation programs in adults after ventricular assist device (VAD) placement result in improvements in physical function and exercise capacity, and have been shown to improve survival and accelerate post-transplant recovery. The objective of this study was to determine the safety and feasibility of an acute inpatient rehabilitation program for children utilizing standardized, age-appropriate, family-centered care pathways after paracorporeal VAD placement in both the ICU and acute-care inpatient settings. Between November 12, 2010 and March 15, 2013, 17 patients were referred to therapy after VAD implantation, 14 of whom were medically stable enough to participate. Beginning in the ICU, a structured physical and occupational therapy program was implemented utilizing novel age-appropriate, standardized care pathways for infants (age <1 year) and children (age 1 to 12 years). The infant and child pathways consisted of 8 and 10 goals, respectively. Retrospective review was conducted to ascertain the number of phases achieved per patient. Adverse events, defined as bleeding, physiologic instability, stroke, or device disruption during therapy, were also analyzed. The median age was 1.1 (range 0.5 to 14.4) years in the 14 patients considered medically stable enough to participate in rehabilitation. Nine of them were female. Eight patients participated in the infant standardized care pathway (SCP) and 6 participated in the child SCP. Seven patients were on biventricular support. Twelve patients were transplanted and survived. Two patients died while awaiting transplantation. There were 1,473 total days on the VAD (range 40 to 229 days). The median time to extubation was 2 days (range 1 to 8) and the median ICU stay was 6.5 days (range 3 to 152). Eleven patients achieved all goals of the SCP, including all of the patients in the child group. For the infant group, 5 patients achieved all goals of the SCP (range 5 to 8), and all but 1 patient achieved at

  17. Participant experiences of a community-based maintenance program post-pulmonary rehabilitation.

    PubMed

    Desveaux, Laura; Rolfe, Debbie; Beauchamp, Marla; Goldstein, Roger; Brooks, Dina

    2014-02-01

    The aim of the present study was to describe the perspectives of individuals with chronic obstructive pulmonary disease (COPD) who participated in a minimally supervised maintenance exercise intervention and identify the barriers and facilitators associated with participation. The intervention was delivered in a community center and was designed to maintain exercise capacity and quality of life following discharge from pulmonary rehabilitation. This study utilized qualitative focus groups (FGs) involving individuals with COPD (n = 12) who had been attending the maintenance community program for at least 6 months. All individuals who met the inclusion criteria for the FGs consented to participate. Four themes were identified: (1) issues around attendance; (2) perceived benefits of the program; (3) perceived burdens of the program; and (4) recommendations for program improvement. Participants expressed more benefits than barriers, stating that their experience of improved function and quality of life facilitated their attendance. Barriers included exacerbations, fatigue, access to transportation, and weather. Participants endorsed the benefits of a community-based maintenance exercise program after pulmonary rehabilitation. Minimally supervised community-based programs with access to a case manager may provide a useful approach to enhancing adherence to exercise.

  18. 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.

  19. Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction

    PubMed Central

    Xu, Lin; Cai, Zekun; Xiong, Meihua; Li, Yekuo; Li, Guoying; Deng, Yu; Hau, William Kongto; Li, Shuo; Huang, Wenhua; Qiu, Jian

    2016-01-01

    Abstract Background: The effect of an early short-term home-based cardiac rehabilitation (CR) program on ventricular function in acute myocardial infarction (AMI) patients is not yet clear. The purpose of this study was to evaluate the efficacy of our CR program on the improvement of myocardial function using three-dimensional speckle tracking echocardiography (3D-STE) in AMI patients. Methods: Fifty-two AMI patients were randomly assigned to 2 groups after discharge: the rehabilitation group, which participated in an early, home-based CR program, and the control group, which received only usual care. All subjects in both groups underwent 3D-STE examinations of the left ventricle within 48 hours of percutaneous coronary intervention and again 4 weeks after discharge. Global longitudinal strain (GLS), global radial strain (GRS), global area strain (GAS), global circumferential strain (GCS), left ventricular ejection fraction (LVEF), and segmental strains were computed. The CR program was initially conducted with supervised inpatient training, followed by an unsupervised home-based training program during a 4-week follow-up. Results: We obtained segmental strains from 832 segments, of which 319 were defined as interventional segments, 179 as ischemic segments, and the remaining segments as normal segments. At the 4-week follow-up, when controlling for baseline values, the rehabilitation group showed significant improvements in GLS, GRS, GCS, GAS, LVEF, and in all of the segmental strains of the 3 subgroups compared with the control group (P <0.05). Conclusion: Our study suggests that an early, home-based CR program can greatly improve the ventricular function of AMI patients in a short period of time. PMID:28033254

  20. 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…

  1. Mentoring in healthcare: A rehabilitation hospital's launch of an innovative program for emerging leaders.

    PubMed

    Stuart, Michelle; Wilson, Carol

    2015-01-01

    With enterprise-wide interest by physicians, management, staff, and volunteers in developing future leaders across their organization, this article describes efforts to design, implement, and evaluate an inaugural, 1-year formal mentoring program for the Glenrose Rehabilitation Hospital, Alberta Health Services. Evaluation surveys were analyzed highlighting critical success factors incorporating a broad, diverse mentee/mentor applicant process, well-defined mentee/mentor selection/matching criteria, and use of a formal program to support knowledge acquisition through projects, learning sessions, and presentations.

  2. Skill development and capacity building program for best practices in rehabilitation.

    PubMed

    Solway, Sherra; Velji, Karima

    2010-01-01

    There is a growing body of literature on evidence-based decision-making and best practice development and the skills required for these approaches to influence decisions. A skill development and capacity building (SDCB) program was implemented in 2004 to facilitate the application of clinical best practices in a hospital specializing in adult rehabilitation and complex continuing care. This article describes the pilot program and its evaluation and provides a five-year review of initiatives developed as a result of this program. This innovative program facilitated cross-learning, integration of research, education and practice and brought about positive change for clinical best practice. This program may serve as a model to facilitate best practice and knowledge translation in other healthcare environments by supporting and assisting clinicians in attaining the skills necessary for clinical best practice.

  3. Influence of an extended education program on the knowledge of cardiovascular risk factors among subjects undergoing rehabilitation following acute coronary syndrome.

    PubMed

    Kapko, Wojciech S; Krzych, Łukasz J

    2016-12-01

    Health education is a component of complex cardiac rehabilitation (CCR). To evaluate the influence of an authorial extended educational program on the knowledge of cardiovascular risk factors among subjects undergoing early in-hospital rehabilitation following acute coronary syndrome treated with percutaneous intervention. This prospective study covered 205 consecutive subjects (153 men and 52 women, aged 62 ±9 years) undergoing CCR. They were randomly allocated to the control group (105 patients receiving standard education during CCR) or the study group (100 patients participating in the extended education program). The extended education program was conducted in the 2(nd) and 3(rd) week of CCR and included a package of educational materials and additional lectures. Knowledge of basic rules for secondary cardiac prevention was better in the study group, both on admission and after CCR. Notwithstanding, a positive influence of the extended educational program was found with regard to awareness of recommended blood pressure levels and blood lipid profile (improvement of 15-20% in the study group). At baseline, the knowledge of risk factors was comparable between the groups (the percentage of correct questionnaire answers was 50 ±17% among the controls vs. 49 ±16% in the study group; p = 0.77), but improved significantly after education (52 ±17% among controls vs. 58 ±19% in the study group; p = 0.009) and remained better in the study group after a 3-month follow-up (56 ±19% among controls vs. 64 ±19% in the study group). Extended education during CCR significantly improves the knowledge of cardiovascular risk factors in patients after acute coronary syndrome.

  4. Influence of an extended education program on the knowledge of cardiovascular risk factors among subjects undergoing rehabilitation following acute coronary syndrome

    PubMed Central

    Krzych, Łukasz J.

    2016-01-01

    Introduction Health education is a component of complex cardiac rehabilitation (CCR). Aim To evaluate the influence of an authorial extended educational program on the knowledge of cardiovascular risk factors among subjects undergoing early in-hospital rehabilitation following acute coronary syndrome treated with percutaneous intervention. Material and methods This prospective study covered 205 consecutive subjects (153 men and 52 women, aged 62 ±9 years) undergoing CCR. They were randomly allocated to the control group (105 patients receiving standard education during CCR) or the study group (100 patients participating in the extended education program). The extended education program was conducted in the 2nd and 3rd week of CCR and included a package of educational materials and additional lectures. Results Knowledge of basic rules for secondary cardiac prevention was better in the study group, both on admission and after CCR. Notwithstanding, a positive influence of the extended educational program was found with regard to awareness of recommended blood pressure levels and blood lipid profile (improvement of 15–20% in the study group). At baseline, the knowledge of risk factors was comparable between the groups (the percentage of correct questionnaire answers was 50 ±17% among the controls vs. 49 ±16% in the study group; p = 0.77), but improved significantly after education (52 ±17% among controls vs. 58 ±19% in the study group; p = 0.009) and remained better in the study group after a 3-month follow-up (56 ±19% among controls vs. 64 ±19% in the study group). Conclusions Extended education during CCR significantly improves the knowledge of cardiovascular risk factors in patients after acute coronary syndrome. PMID:28096844

  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. Effectiveness of small-group interactive education vs. lecture-based information-only programs on motivation to change and lifestyle behaviours. A prospective controlled trial of rehabilitation inpatients.

    PubMed

    Reusch, Andrea; Ströbl, Veronika; Ellgring, Heiner; Faller, Hermann

    2011-02-01

    Although patient education may promote motivation to change health behaviours, the most effective method has not yet been determined. This prospective, controlled trial compared an interactive, patient-oriented group program with lectures providing only information. We evaluated motivational stages of change and self-reported behaviours in three domains (sports, diet, relaxation) at four times up to one year (60% complete data) among 753 German rehabilitation inpatients (mean age 50 years, 52% male) with orthopaedic (59%) or cardiologic disorders (10%) or diabetes mellitus (31%). We found improvements between baseline and follow up regarding each outcome (p<.001) in both groups. At the end of rehabilitation, participants of the interactive group, as compared to the lectures, showed more advanced motivation regarding diet (p<.10) and sports (p=.006). Interactive group patients reported healthier diets both after 3 months (p=0.013) and 12 months (p=0.047), more relaxation behaviours (p=.029) after 3 months and higher motivation for sports after 12 months (p=.08). The superior effectiveness of the interactive group was only partly confirmed. This short, 5-session interactive program may not be superior to lectures to induce major sustainable changes in motivation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. The effectiveness and efficacy of an intensive cardiac rehabilitation program in 24 sites.

    PubMed

    Silberman, Anna; Banthia, Rajni; Estay, Ivette S; Kemp, Colleen; Studley, Joli; Hareras, Dennis; Ornish, Dean

    2010-01-01

    The purpose of this study is to test the efficacy and effectiveness of an intensive cardiac rehabilitation program in improving health outcomes in multiple sites. This study employs a nonexperimental (prospective time series) design to investigate changes in cardiovascular disease in 2974 men and women from 24 socioeconomically diverse sites who participated in an intensive cardiac rehabilitation program at baseline, 12 weeks, and 1 year. Paired t-tests were used to assess differences by comparing baseline values to those after 12 weeks, baseline values to those after 1 year, and values after 12 weeks to those after 1 year. Eighty-eight percent of patients remained enrolled in the program after 12 weeks, and 78.1% remained enrolled in the program after 1 year. Patients showed statistically significant improvements after 12 weeks in body mass index (BMI), triglycerides, low density lipoprotein cholesterol, total cholesterol, hemoglobin A1c, systolic blood pressure, diastolic blood pressure, depression, hostility, exercise, and functional capacity. These differences also remained significant after 1 year. There was additional significant improvement between 12 weeks and 1 year only in BMI, high density lipoprotein cholesterol, functional capacity, and hostility, and significant recidivism between 12 weeks and 1 year in all other measures (except triglycerides) and depression, yet improvements from baseline to 1 year remained significant in all measures (except HDL, which was unchanged) (p < .005). This intensive cardiac rehabilitation program was feasible and sustainable for most patients who enrolled and was associated with numerous subjective and objective improvements in health outcomes. It demonstrates that the intervention works when it is administered by staff at multiple clinical/commmunity sites in four different states. These improvements were also seen in patients 65 years of age or older.

  8. Eccentric Training as an Adjunct to Rehabilitation Program for Hereditary Multiple Exostoses: A Case Report.

    PubMed

    Kanik, Zeynep Hazar; Gunaydin, Gurkan; Sozlu, Ugur; Citaker, Seyit; Esen, Erdinc

    2016-02-01

    Hereditary multiple exostoses an autosomal dominant skeletal disorder characterized by multiple cartilage-capped benign exostoses that typically occur in the metaphysis of long bones. The prevalence of hereditary multiple exostoses is estimated to be 1 in 50,000. Although, there have been many studies concerning this rare disorder, no research has yet examined the rehabilitation of hereditary multiple exostoses. The case diagnosed with hereditary multiple exostoses referred to our department with several complaints, namely pain, joint limitations, muscle weakness, and functional insufficiency after arthroscopic distal left femur exostoses excision. The aim of this case report was to present effectiveness of eccentric training as an adjunct to rehabilitation program for hereditary multiple exostoses. According to the results, eccentric training after arthroscopic exostoses excision may help reduce pain, increase range of motion, muscle strength, and functional levels in patients with hereditary multiple exostoses.

  9. Transforming cardiac rehabilitation into broad-based healthy lifestyle programs to combat noncommunicable disease.

    PubMed

    Arena, Ross; Lavie, Carl J; Cahalin, Lawrence P; Briggs, Paige D; Guizilini, Solange; Daugherty, John; Chan, Wai-Man; Borghi-Silva, Audrey

    2016-01-01

    The current incidence and prevalence of noncommunicable diseases (NCDs) is currently a cause for great concern on a global scale; future projections are no less disconcerting. Unhealthy lifestyle patterns are at the core of the NCD crisis; physical inactivity, excess body mass, poor nutrition and tobacco use are the primary lifestyle factors that substantially increase the risk of developing one or more NCDs. We have now come to recognize that healthy lifestyle interventions are a medical necessity that should be prescribed to all individuals. Perhaps the most well-established model for healthy lifestyle interventions in the current healthcare model is cardiac rehabilitation. To have any hope of improving the outlook for NCDs on a global scale, what is currently known as cardiac rehabilitation must transform into broad-based healthy lifestyle programing, with a shifted focus on primordial and primary prevention.

  10. [Reflections on community-based rehabilitation strategy (CBR): the experience of a CBR program in Bolivia].

    PubMed

    Díaz-Aristizabal, Urko; Sanz-Victoria, Silvia; Sahonero-Daza, Milton; Ledesma-Ocampo, Sandra; Cachimuel-Vinueza, Mesías; Torrico, Marisabel

    2012-01-01

    Community-Based Rehabilitation (CBR) is a strategy for community development endorsed by the World Health Organization (WHO), the International Labor Office (ILO) and the United Nations Educational, Scientific and Cultural Organization (UNESCO). It is designed to promote rehabilitation, equal opportunity and social inclusion of Disabled Persons (DP) in their home communities by fostering cooperation among disabled individuals, their families, and other concerned social actors, it encourages community leadership and full social participation by DP through multi-sector cooperation. This article explores the historical antecedents and basic features of CBR strategy through an analysis of a directed culture change initiative developed by a foundation in the Cochabamba administrative region of Bolivia. Especially in intercultural environments, certain aspects of the socio-cultural context may determine whether CBR programs succeed or fail.

  11. [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.

  12. Beyond cognition: a longitudinal investigation of the role of motivation during a vocational rehabilitation program.

    PubMed

    Choi, Kee-Hong; Fiszdon, Joanna M; Bell, Morris D

    2013-03-01

    Studies that have specifically examined the effects of motivation on work have been limited to evaluations of baseline motivation and have not accounted for cognition. These have also not examined whether motivation changes over time. In the current analyses, we examined how baseline motivation and longitudinal changes in motivation, along with the effects of baseline cognition, related to work function in a sample of 123 individuals with schizophrenia or schizoaffective disorder participating in a 26-week vocational rehabilitation program. Our results indicate that cognition at baseline was a significant predictor of work outcomes over time. Baseline motivation and changes in motivation were significantly linked to work outcomes. The impact of motivation remained significant even after accounting for baseline cognition. These findings provide evidence that motivation is malleable during vocational rehabilitation and has an important impact on vocational function above and beyond the impact of cognition.

  13. Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2014. Final rule.

    PubMed

    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.

  14. 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.

  15. [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

  16. 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.

  17. 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.

  18. Listening and speaking ability of Thai deaf children in preschool aural rehabilitation program.

    PubMed

    Lertsukprasert, Krisna; Kasemkosin, Nittaya; Cheewareungroj, Wichit; Kasemsuwan, Lalida

    2010-04-01

    An auditory-oral approach can help deaf children achieve success in oral communication. Many studies confirm that deaf children with access to sound through high-powered and appropriate hearing aids at the youngest age possible have the capability to acquire communication skills similar to their hearingpeers. Evaluate the listening and speaking progress made by 27 Thai hearing-impaired children who attended a preschool aural rehabilitation program, which was established at Audiology and Speech clinic. After hearing aids fitting, deaf children were enrolled to the preschool aural rehabilitation program after receiving their parents consent. Hearing impaired children were divided into groups of 4-6 children with approximately the same level of performance. The listening and speaking performance at the initial period were recorded. Each group participated in the 3-hour-program once a week, included auditory training, conversation (maternal reflexive method), and speech stimulation. The improvements and problems of each child were recorded at the end of session. Listening and speaking performance evaluation were recorded at six months intervals. There were 12 boys and 15 girls. The average hearing loss in the better ear was 104 dBHL, range from 83-117 dBHL, SD = 8.33. The mean age of enrollment was 2 years and 10 months. The majority gradually developed listening skills and speaking ability. There was no relationship between age of enrollment and the listening and speaking ability (p > 0.05). However, listening skills had positive relationship with length of speech (r = 0.685), number of spoken vocabulary (r = 0.665), and speech character (r = 0.598); p < 0.01. Auditory training is an important task to develop listening skills and improve length of speech, speaking vocabulary, and speech character Other benefits from the aural rehabilitation program included monitoring the auditory progression after hearing aid fitting, parents meeting, and promotion a better quality

  19. The effects of a conservative rehabilitation program for multidirectional instability of the shoulder.

    PubMed

    Watson, Lyn; Balster, Simon; Lenssen, Ross; Hoy, Greg; Pizzari, Tania

    2017-09-22

    Conservative management is commonly recommended as the first-line treatment for multidirectional instability (MDI) of the shoulder. Despite this, the evidence for efficacy of treatment is limited, and until recently, guidance for clinicians on conservative rehabilitation programs has been inadequate. This study evaluated the effectiveness of a physiotherapy-led exercise program for participants with MDI. In a single-group study design, 43 participants (16 male, 27 female; mean age, 19.8 years, standard deviation, 4.9 years) diagnosed with MDI undertook a 12-week exercise program. Primary outcome measures were the Melbourne Instability Shoulder Score, Western Ontario Shoulder Instability Index, and Oxford Shoulder Instability Score. Secondary outcomes were strength and scapular position. All measures were taken at baseline and repeated at the conclusion of the program. Test differences before and after rehabilitation were evaluated with dependent t tests and single-group effect size calculations (standardized mean difference [SMD]) to provide a measure of the magnitude of the difference. Large effects were found between pre- and postrehabilitation scores on all functional instability questionnaires, with the Western Ontario Shoulder Instability Index demonstrating the largest effect (SMD, -3.04). Scapular upward rotation improved significantly in the early ranges of abduction (0°-60°), with moderate to large effects (SMDs, 0.54-0.95). All strength measures significantly improved, with large differences identified (SMDs, 0.69-2.08). The identified improvement in functional status, shoulder muscle strength, and scapular positioning after rehabilitation allows greater confidence in the value of conservative management of MDI and informs further research by way of clinical trials in the area. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. 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

  2. Phacomatosis pigmentovascularis type Va in a 3-month old.

    PubMed

    Larralde, Margarita; Santos-Muñoz, Andrea; Rodríguez Cáceres, María; Ciardiullo, Analía

    2008-01-01

    Phacomatosis pigmentovascularis is a rare genodermatosis characterized by a combination of melanocytic nevi and vascular malformations. A new type of phacomatosis pigmentovascularis was recently described which included cutis marmorata telangiectatica congenita and aberrant Mongolian spots and was named type V. We report a 3-month-old girl with diagnosis of phacomatosis pigmentovascularis type V.

  3. Renal nephroblastoma in a 3-month-old golden retriever.

    PubMed

    Montinaro, Vincenzo; Boston, Sarah E; Stevens, Brian

    2013-07-01

    Nephrectomy was performed in a 3-month-old intact female golden retriever dog for a renal nephroblastoma. The dog has remained disease-free for 19 months with nephrectomy alone. The adoption of human Wilms' tumor grading criteria may be useful in determining clinical stage, adjuvant treatment options, and prognosis in this rare disease.

  4. Renal nephroblastoma in a 3-month-old golden retriever

    PubMed Central

    Montinaro, Vincenzo; Boston, Sarah E.; Stevens, Brian

    2013-01-01

    Nephrectomy was performed in a 3-month-old intact female golden retriever dog for a renal nephroblastoma. The dog has remained disease-free for 19 months with nephrectomy alone. The adoption of human Wilms’ tumor grading criteria may be useful in determining clinical stage, adjuvant treatment options, and prognosis in this rare disease. PMID:24155463

  5. Post-traumatic stress in patients with injury-related chronic pain participating in a multimodal pain rehabilitation program

    PubMed Central

    Stålnacke, Britt-Marie; Östman, Anna

    2010-01-01

    Aim: To investigate post-traumatic stress, pain intensity, depression, and anxiety in patients with injury-related chronic pain before and after participating in multimodal pain rehabilitation. Methods: Twenty-eight patients, 21 women and seven men, who participated in the multimodal rehabilitation programs (special whiplash program for whiplash injuries within 1.5 years after the trauma or ordinary program) answered a set of questionnaires to assess post-traumatic stress (Impact of Event Scale [IES], pain intensity [Visual Analogue Scale (VAS)], depression, and anxiety (Hospital Anxiety and Depression Scale [HAD] before and after the programs. Results: Both pain intensity and post-traumatic stress decreased significantly after the rehabilitation programs in comparison with before (VAS: 57.8 ± 21.6 vs. 67.5 ± 21.9; P = 0.009, IES total score 21.8 ± 13.2 vs. 29.5 ± 12.9; P < 0.001). Patients younger than 40 years reported a statistically higher level of post-traumatic stress compared with patients older than 40 years both before (P = 0.037) and after rehabilitation (P = 0.023). No statistically significant differences were found on the HAD scores. Conclusion: The multimodal rehabilitation programs were effective in reducing both pain intensity and post-traumatic stress. The experience of higher levels of post-traumatic stress in younger persons has to be taken into account when managing patients with injury-related chronic pain. PMID:20361062

  6. Psychological changes in alcohol-dependent patients during a residential rehabilitation program

    PubMed Central

    Giorgi, Ines; Ottonello, Marcella; Vittadini, Giovanni; Bertolotti, Giorgio

    2015-01-01

    Background Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse. Materials and methods The sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated. Results The score measured by the Cognitive Behavioral Assessment – Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use. Conclusion This study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this

  7. Psychological changes in alcohol-dependent patients during a residential rehabilitation program.

    PubMed

    Giorgi, Ines; Ottonello, Marcella; Vittadini, Giovanni; Bertolotti, Giorgio

    2015-01-01

    Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive-affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse. The sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment - Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated. The score measured by the Cognitive Behavioral Assessment - Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use. This study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this profile may permit identification of subjects requiring more

  8. 77 FR 8234 - National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research... Disability and Rehabilitation Research-- Disability and Rehabilitation Research Projects and Centers Program-- Disability and Rehabilitation Research Project--Center on Knowledge Translation for Disability and...

  9. Are we there yet? The four-year impact of a VA fellowship program on the recovery orientation of rehabilitation programs.

    PubMed

    Kymalainen, Jennifer A; Henze, Kevin T; Deluca, Melissa; Mitton, Theresa A; Walton, Heather M; Duffy, Patricia; Kapungu, Chivi; Lefebvre, Trudy; Alexander, William H; Pinsky, Jerry

    2010-01-01

    This study represents the first program evaluation of the impact of a Psychosocial Rehabilitation (PSR) fellowship program within the Veterans Health Administration (VHA). Specifically, it examines the recovery orientation of five mental health rehabilitation programs at the Edith Nourse Rogers Memorial VA Medical Center (ENRM VAMC) in Bedford, MA by comparing program stakeholder rating of the "recovery orientation" between the initial data and the four-year follow-up during which the PSR fellowship was in operation. The goal of this fellowship program is to increase the VHA's fidelity to recovery-oriented best practice recommendations. Participants were mental health consumers and staff members within five key psychiatric rehabilitation programs at the ENRM VAMC. Perception of programs' recovery orientation was measured at the start of the fellowship (Time 1) and after the fellowship was in place for four years (Time 2). Results demonstrate that across the entire sample of stakeholders, perceptions of recovery orientation significantly improved from Time 1 to Time 2. Results also reveal a significant overall increase in program recovery orientation over time in three out of the five rehabilitation programs, with years of fellow involvement in particular programs significantly and positively correlating with increases in ratings of program recovery-orientation gains. Implications for using fellowships as agents of program change, and specifically, recovery-oriented change, are discussed.

  10. Impact of an outpatient cardiac rehabilitation program on clinical and analytical variables in cardiovascular disease.

    PubMed

    Roca-Rodríguez, M M; García-Almeida, J M; Ruiz-Nava, J; Alcaide-Torres, J; Saracho-Domínguez, H; Rioja-Vázquez, R; García-Fernández, C; Gómez-González, A; Montiel-Trujillo, A; Tinahones-Madueño, F J

    2014-01-01

    The aim of the study was to determine the effect of lifestyle changes in patients participating in a cardiac rehabilitation program. Patients with cardiovascular disease (N = 59) were enrolled in cardiac rehabilitation, which included nutritional and exercise interventions. All patients completed the program, but only 44 attended the reassessment after 12 months because of work reasons or lack of time or interest. Ergometry before and after cardiac rehabilitation showed significant differences in exercise tolerance time (5.2 ± 1.8 minutes vs 7.1 ± 2.1 minutes; P< .001), metabolic equivalents (6.5 ± 1.8 vs 8.8 ± 2.2; P< .001), and the Börg rating of perceived exertion scale (12 ± 1.8 points vs 13.7 ± 1.6 points; P= .005). At the end of the intervention program, significant improvements were seen in body weight (82.6 ± 15.2 kg vs 80.8 ± 14.3 kg; P< .001), waist circumference (100.3 ± 12.4 cm vs 98.0 ± 11.0 cm; P= .002), and levels of fasting glucose (126.5 ± 44.6 mmol/L vs 109.6 ± 24.8 mmol/L; P< .001), low-density lipoprotein cholesterol (2.7 ± 0.9 mmol/L vs 2.5 ± 0.8 mmol/L; P= .033), and C-reactive protein (5.1 ± 8.7 μg/mL vs 4.1 ± 2.6 μg/mL; P= .008), as well as in adherence to a healthy diet as estimated by the Trichopoulou questionnaire score (7.9 ± 2.3 vs 10.6 ± 1.5; P< .001). Twelve months later, however, many of these benefits had either remained stable or worsened. Cardiac rehabilitation is an appropriate program for the improvement of clinical and analytical variables, such as functional capacity, carbohydrate and lipid metabolism, anthropometric measures, and diet. However, 12 months later, many of these benefits either remained stable or worsened.

  11. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2017. Final rule.

    PubMed

    2016-08-05

    This final rule will update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2017 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS's) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2017. This final rule also revises and updates quality measures and reporting requirements under the IRF quality reporting program (QRP).

  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. Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program.

    PubMed

    Tannuri, Uenis; Barros, Fabio de; Tannuri, Ana Cristina Aoun

    2016-09-01

    The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel. This set of procedures constitutes what is called an Intestinal Rehabilitation Program. This therapy was used in 16 children in periods ranging from 8 months to 7.5 years, with survival in 75% of the cases. Finally, the last resort to be used in children with complete resection of the small bowel is an intestinal transplant. However, to date there is no record of a Brazilian child that has survived this procedure, despite it being attempted in seven patients. We conclude that the results of the intestinal rehabilitation program are encouraging for the continuation of this type of treatment and stimulate the creation of the program in other pediatric care institutions.

  14. 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

  15. [Intestinal failure due to short bowel syndrome: impact of a multidisciplinary intestinal rehabilitation program].

    PubMed

    Molina, María Elena; Bellolio, Felipe; Klaassen, Julieta; Gómez, Javier; Villalón, Constanza; Guerra, Juan Francisco; Zúñiga, Álvaro

    2016-11-01

    In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. To report the results of our program in patients suffering intestinal failure. A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed. Initial work up included prior intestinal surgery, blood tests, endoscopic and imaging studies. Also demographic data, medical and surgical management as well as clinical follow-up, were registered. Data from 14 consecutive patients aged 26 to 84 years (13 women) was reviewed. Mean length of remnant small bowel was 100 cm and they were on parenteral nutrition for a median of eight months. Seven of 14 patients had short bowel secondary to mesenteric vascular events (embolism/thrombosis). Medical management and autologous reconstruction of the bowel included jejuno-colic anastomosis in six, enterorraphies in three, entero-rectal anastomosis in two, lengthening procedures in two, ileo-colic anastomosis in one and reversal Roux-Y gastric bypass in one. Thirteen of 14 patients were weaned off parenteral nutrition. Our Multidisciplinary Intestinal Rehabilitation Program, allowed weaning most of the studied patients off parenteral nutrition.

  16. 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.

  17. 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.

  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.

  19. Mother's stress, mood and emotional involvement with the infant: 3 months before and 3 months after childbirth.

    PubMed

    Figueiredo, Barbara; Costa, Raquel

    2009-06-01

    Adverse effects of maternal anxiety and depression are well documented, namely on the foetus/child behaviour and development, but not as much attention has been given to the mother's emotional involvement with the offspring. To study mother's prenatal and postpartum stress, mood and emotional involvement with the infant, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale and the Mother-to-Infant Bonding Scale were filled in and cortisol levels were measured, 3 months before and 3 months after childbirth, in a sample of 91 Portuguese women. From pregnancy to the postpartum period, mother's cortisol levels, anxiety and emotional involvement toward the child decrease. No significant change was observed regarding mother's depression. Mother's depression predicted a worse emotional involvement before childbirth, while mother's anxiety predicted a worse emotional involvement with the infant after childbirth. Additionally, pregnant women with a worse emotional involvement with the offspring are at risk of poorer emotional involvement with the infant and higher anxiety and depression at 3 months postpartum. It should be given more attention to mother's poor emotional involvement with the offspring during pregnancy, as it interferes with her emotional involvement with the infant and her psychological adjustment 3 months after childbirth.

  20. Increasing the Use of Group Interventions in a Pediatric Rehabilitation Program: Perceptions of Administrators, Therapists, and Parents

    ERIC Educational Resources Information Center

    Camden, Chantal; Tetreault, Sylvie; Swaine, Bonnie

    2012-01-01

    Objectives: To explore perceptions related to increased utilization of group interventions as a part of the service reorganization within a pediatric rehabilitation program. Methods: Individual interviews with program administrators (n = 13) and focus groups with therapists (n = 19) and parents of children with disabilities (n = 5) were conducted.…

  1. Developing an Employability Assessment and Planning Program in Rehabilitation & Educational Settings. Instructor's Resource Manual, Sample Instruments, & Reports.

    ERIC Educational Resources Information Center

    Farley, Roy C.; Bolton, Brian

    This resource manual is one component of an instructional package designed to develop an employability assessment and planning program for use with individuals with disabilities. The resource materials are designed to be used as handouts or as overheads in providing program development training to preservice or inservice rehabilitation specialists…

  2. 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

  3. Stroke Rehabilitation

    MedlinePlus

    ... Skill on the part of the rehabilitation team Cooperation of family and friends. Caring family/friends can ... Opportunities About Funding Funding Types: Know the Differences International Activities Grant Mechanisms Research Program Award (R35) Javits ...

  4. Fractured condyle in a 3-month-old infant.

    PubMed

    Cambell, R L; Moore, R F

    1975-07-01

    A 3-month-old infant sustained trauma to the mandibular symphysis resulting in radiographic evidence of a fracture of the right condylar head. This presented the diffculty of performing a clinical examination and total reliance on history of a trauma and subsequent swelling. Multiple radiographs of the condyles were used to establish the diagnosis and rule out a film artifact. No definitive treatment was required other than muscle exercises and parental instruction as to potential problems.

  5. 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 VO2 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.

  6. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    PubMed

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  7. Implementation of a Multifaceted Interactive Electrodiagnostic Medicine Workshop in a Physical Medicine and Rehabilitation Residency Program.

    PubMed

    Donovan, Jayne; van de Rijn, Marc; McCabe, Elizabeth L; Shih, Shirley; Paganoni, Sabrina

    2017-09-25

    Electrodiagnostic medicine is a required component of Physical Medicine and Rehabilitation residency education, but limited resources exist to guide curriculum development. Our objective was to create a focused workshop to enhance our residency program's electrodiagnostic curriculum. We created two separate 1.5-day workshops, one basic and one advanced, for all residents. Each workshop included didactic sessions, case discussion, question and answer sessions, demonstrations, and hands-on participation with direct supervision and feedback. Presurveys and postsurveys were administered to evaluate the value of the workshops. We also assessed trends in electrodiagnostic self-assessment examination scores. Residents reported clinical electrodiagnostic rotations to be more valuable to their education than previous didactic sessions and independent learning. Self-reported knowledge of electrodiagnostic concepts, resident comfort level in planning, performing, and interpreting studies, and perceived value in independent learning of electrodiagnostic medicine improved after implementation of the workshops. There was a 7% improvement in the American Association of Neuromuscular and Electrodiagnostic Medicine electrodiagnostic self-assessment examination score compared with the previous year and a 15% improvement in the Physical Medicine and Rehabilitation self-assessment examination electrodiagnostic subscore compared with the previous 5 yrs. All participants recommended similar educational experience for other residents. This successful workshop may serve as a resource for other training programs.

  8. The Relationship Between Pain Catastrophizing and Outcomes of a 3-Week Comprehensive Pain Rehabilitation Program.

    PubMed

    Craner, Julia R; Sperry, Jeannie A; Evans, Michele M

    2016-11-01

    OBJECTIVE : Pain catastrophizing is an important predictor of functioning and disability among individuals with chronic pain, and modification of catastrophic interpretations of pain is a proposed treatment mechanism of pain rehabilitation. The purpose of the current study is to examine the relationship between changes in catastrophic thinking and treatment outcomes for a large sample of patients with chronic pain. METHODS : 648 adult patients with chronic pain completed a 3-week intensive outpatient comprehensive pain rehabilitation program. Measures of pain severity, pain-related life interference, depression, and pain catastrophizing were completed at admission and discharge. RESULTS : Consistent with prior research, pain catastrophizing was associated with several negative pain-related outcomes. Results of a within-subjects mediational analysis indicated that pain catastrophizing not only improved during the treatment program, but also accounted for a significant portion of the variance in the reduction of pain severity, pain interference, and depression at the end of treatment. CONCLUSIONS : This study adds further support to the position that pain catastrophizing has a detrimental role in adaptation to chronic pain, and that this construct can be successfully modified in treatment to improve patient outcomes. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. The Impact of Early Regular Cardiac Rehabilitation Program on Myocardial Function after Acute Myocardial Infarction

    PubMed Central

    Kim, Chul; Kim, Duk You

    2011-01-01

    Objective To determine if an early regular cardiac rehabilitation program would have an adverse effect on myocardial function after acute myocardial infarction (AMI). Method Patients who received percutaneous coronary intervention (PCI) after AMI were divided into the exercise group and control group in accordance with their willingness to participate. Patients in the exercise group (n=18) received ECG monitored exercise for six weeks and were instructed to maintain self exercise in their communities for four months. The control group (n=16) patients were just instructed of risk factor control. All the subjects underwent echocardiography at the time of the AMI as well as six months later. The echocardiography parameters, including the left ventricular ejection fraction (LVEF), stroke volume (SV), left ventricular end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD), were measured. Results In the exercise group, the LVEF increased to 59.58±9.24% and 61.58±9.63% after six weeks and six months, respectively (p<0.05), but SV, LVEDD and LVESD did not change (p>0.05). Conclusion Active participation in the cardiac rehabilitation program approximately two weeks after AMI did not have an adverse effect on the size of the left ventricle and myocardial function. PMID:22506170

  10. Economic analysis of a comprehensive pain rehabilitation program: a collaboration between Florida Blue and Mayo Clinic Florida.

    PubMed

    Sletten, Christopher D; Kurklinsky, Svetlana; Chinburapa, Vijit; Ghazi, Salim

    2015-05-01

    The cost of caring for patients with chronic pain conditions poses a significant burden to both the healthcare system and patients. We were interested in analyzing the financial costs and benefits of treating these patients in a comprehensive outpatient pain rehabilitation program. All participants completed the 3-week outpatient Mayo Clinic Florida Pain Rehabilitation Program (PRC) between October 2011 and September 2013. Healthcare costs were compared during the 3-, 6-, 12-, and 18-month periods pre- and post-treatment. The sample included 53 patients. Medical costs decreased by 86, 68, 64, and 90% in the 3-, 6-, 12-, and 18-month post-treatment periods, respectively, when compared with the same pretreatment periods. The appropriate use of a comprehensive outpatient rehabilitation program for chronic pain patients can result in a significant reduction in medical costs. © 2015 The Authors Pain and Medicine Published by Wiley Periodicals, Inc.

  11. 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.

  12. 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

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

    PubMed

    Auriemma, Michael J; Whitehair, Curtis L

    2017-09-04

    From the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only two 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. The objective of this study was to assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings to 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 amongst current residents," "perceived camaraderie amongst faculty and current residents," "perceived quality of current residents," and "perceived work/life balance amongst current residents." While males and females 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 to previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. Prospective PM

  14. 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.

  15. 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

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

    PubMed Central

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

    2016-01-01

    Background 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. Methods 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. Results 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). Conclusions 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

  17. A randomized trial of isokinetic versus isotonic rehabilitation program after arthroscopic meniscectomy.

    PubMed

    Koutras, Georgios; Letsi, Magdalini; Papadopoulos, Pericles; Gigis, Ioannis; Pappas, Evangelos

    2012-02-01

    Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p≤0.003). However, there were no group or group*time effects on any of the outcome variables (p≥0.33). Functional tests were better predictors of isokinetic deficits in the 14(th) compared to the 33(rd) postoperative day. No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were correlations between the hop tests and isokinetic

  18. A RANDOMIZED TRIAL OF ISOKINETIC VERSUS ISOTONIC REHABILITATION PROGRAM AFTER ARTHROSCOPIC MENISCECTOMY

    PubMed Central

    Koutras, Georgios; Letsi, Magdalini; Papadopoulos, Pericles; Gigis, Ioannis

    2012-01-01

    Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. Purpose: The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Methods: Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Results: Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p≤0.003). However, there were no group or group*time effects on any of the outcome variables (p≥0.33). Functional tests were better predictors of isokinetic deficits in the 14th compared to the 33rd postoperative day. Conclusion: No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were

  19. 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.

  20. Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing

    PubMed Central

    Ueki, Jun; Seyama, Kuniaki; Takizawa, Makiko; Yamaguchi, Seiko; Kitahara, Eriko; Fukazawa, Shinji; Takahama, Yukiko; Ichikawa, Masako; Takahashi, Kazuhisa; Fukuchi, Yoshinosuke

    2012-01-01

    Background Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients’ expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide “respiratory conditioning”, a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization. Methods Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation. Results In participants ages 68±7 years, the FEV1% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV1% predicted nor FEV1/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest. Conclusions The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced. PMID:22754664

  1. 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…

  2. Development of the ubiquitous spaced retrieval-based memory advancement and rehabilitation training program.

    PubMed

    Han, Ji Won; Oh, Kyusoo; Yoo, Sooyoung; Kim, Eunhye; Ahn, Ki-Hwan; Son, Yeon-Joo; Kim, Tae Hui; Chi, Yeon Kyung; Kim, Ki Woong

    2014-01-01

    The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0±1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0±4.1; post-USMART, 17.9±4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.

  3. 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

  4. Exploring Product-Specific Attributes of a Community Cardiac Rehabilitation Program in an Asian Urban City.

    PubMed

    Kwan, Yu Heng; Yap, Angela Frances; Tay, Hung Yong; Lim, Cindy; Chan, Sui Yung; Fong, Warren

    2017-05-01

    Cardiac rehabilitation (CR) has been proven to improve long-term outcomes for patients. Despite its benefits, its uptake throughout the world is poor. Factors affecting the motivation and barriers impeding an individual from participating in a CR program have been extensively studied. Nevertheless, knowledge of product-specific factors in affecting participation is lacking. To find out cultural-specific product attributes that are important to those contemplating participation in a community-based CR program using Consolidated criteria for Reporting Qualitative research (COREQ) as an anchor. Participants were recruited from attendees of the CR program at the Singapore Heart Foundation. A literature review was done to identify product-specific attributes that affected participation in CR programs. An interview guide was developed on the basis of the list of product attributes. The analysis was done by two independent analysts using NVivo version 11 (QSR International, Melbourne, Australia) via an inductive approach. Data analysis was carried out with recruitment and interviews ongoing until thematic saturation was reached. In total, 13 male and 9 female participants (16 Chinese, 4 Indian, 1 Malay, and 1 Eurasian) aged between 47 and 89 years were interviewed. A total of 8 categories (System, Infrastructure, Environment, Monitoring, Activity, Program, Staff, and Companionship) with 30 subcategories were identified. New themes that have not been explored by previous studies were discovered under five different categories: System, Infrastructure, Environment, Program, and Companionship. This study allows a better understanding of product-specific factors affecting participation in CR programs and serves as a springboard for further research to improve participation in community-based CR programs. Copyright © 2017. Published by Elsevier Inc.

  5. Specialized core stability exercise: a neglected component of anterior cruciate ligament rehabilitation programs.

    PubMed

    Shi, Dong-liang; Li, Jing-long; Zhai, Hua; Wang, Hui-fang; Meng, Han; Wang, Yu-bin

    2012-01-01

    The incidence of anterior cruciate ligament injury has continued to increase over the last two decades. This injury is associated with abnormal gait patterns and osteoarthritis of the knee. In order to accelerate recovery, the introduction of core stability exercises into the rehabilitation program is proposed. The theory underlying the use of core stability exercise relates to the neuroplasticity that follows anterior cruciate ligament injury. Neuroplasticity in lumbar, thoracic, cervical and brain regions diminish activation in the contralateral thalamus, postparietal cortex, SM1, basal ganglia-external globus pallidus, SII, cingulated motor area, premotor cortex, and in the ipsilateral cerebellum and SM1 and increase activation in pre-SMA, SIIp, and pITG, indicating modifications of the CNS. In addition, the neuroplasticity can regulate the movement of trunk muscles, for example, sternocleidomastoid and lower trapezius muscles. Core stability also demonstrates a negative correlation with the incidence of anterior cruciate ligament injury. Therefore, we propose that core stability exercises may improve the rehabilitation of anterior cruciate ligament injuries by increasing core motor control. Specialized core stability exercises aimed at rectifying biomechanical problems associated with gait and core stability may play a key role in the management of anterior cruciate ligament injury.

  6. Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2015.

    PubMed

    2014-08-06

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2015 as required by the statute. This final rule finalizes a policy to collect data on the amount and mode (that is, Individual, Concurrent, Group, and Co-Treatment) of therapy provided in the IRF setting according to therapy discipline, revises the list of diagnosis and impairment group codes that presumptively meet the "60 percent rule'' compliance criteria, provides a way for IRFs to indicate on the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) form whether the prior treatment and severity requirements have been met for arthritis cases to presumptively meet the "60 percent rule'' compliance criteria, and revises and updates quality measures and reporting requirements under the IRF quality reporting program (QRP). This rule also delays the effective date for the revisions to the list of diagnosis codes that are used to determine presumptive compliance under the "60 percent rule'' that were finalized in FY 2014 IRF PPS final rule and adopts the revisions to the list of diagnosis codes that are used to determine presumptive compliance under the "60 percent rule'' that are finalized in this rule. This final rule also addresses the implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), for the IRF prospective payment system (PPS), which will be effective when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions.

  7. 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

  8. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2018. Final rule.

    PubMed

    2017-08-03

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Social Security Act (the Act), this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2018. This final rule also revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the "60 percent rule," removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions, removes the voluntary swallowing status item (Item 27) from the IRF-PAI, summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS, provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists, adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and revises and updates measures and reporting requirements under the IRF quality reporting program (QRP).

  9. Evaluating Curricular Influence on Preparation for Practice, Career Outcomes, and Job Satisfaction: Results from an Alumni Survey of a 40-Year Rehabilitation and Mental Health Counseling Program

    ERIC Educational Resources Information Center

    Smith, Tammy Jorgensen; Reid, Joan A.; Henry, Ryan G.; Dixon, Charlotte G.; Wright, Tennyson J.

    2013-01-01

    Alumni of a Council on Rehabilitation Education (CORE)-accredited graduate rehabilitation counselor education (RCE) program were surveyed to evaluate career outcomes, job satisfaction, licensure and certification rates, client populations served, and RCE program satisfaction and effectiveness. Results indicate a high level of satisfaction with the…

  10. Journal of Rehabilitation of the Deaf: Deafness; Research and Professional Training Programs on Deafness Sponsored by the Department of Health, Education, and Welfare.

    ERIC Educational Resources Information Center

    Adler, Edna P., Ed.

    Research and professional training programs on deafness sponsored by the Department of Health, Education, and Welfare are introduced and detailed in chart form. The programs are listed according to the Department agencies responsible, including the following divisions of the Social and Rehabilitation Service: the Rehabilitation Services…

  11. Evaluating Curricular Influence on Preparation for Practice, Career Outcomes, and Job Satisfaction: Results from an Alumni Survey of a 40-Year Rehabilitation and Mental Health Counseling Program

    ERIC Educational Resources Information Center

    Smith, Tammy Jorgensen; Reid, Joan A.; Henry, Ryan G.; Dixon, Charlotte G.; Wright, Tennyson J.

    2013-01-01

    Alumni of a Council on Rehabilitation Education (CORE)-accredited graduate rehabilitation counselor education (RCE) program were surveyed to evaluate career outcomes, job satisfaction, licensure and certification rates, client populations served, and RCE program satisfaction and effectiveness. Results indicate a high level of satisfaction with the…

  12. Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity trauma?

    PubMed

    Bedigrew, Katherine M; Patzkowski, Jeanne C; Wilken, Jason M; Owens, Johnny G; Blanck, Ryan V; Stinner, Daniel J; Kirk, Kevin L; Hsu, Joseph R

    2014-10-01

    Orthosis (IDEO) can be successfully implemented at additional military centers in patients > 2 years from injury while sustaining similar improvements in patient outcomes. The ability to translate this integrated orthotic and rehabilitation program into the civilian setting is unknown and warrants further investigation.

  13. An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System.

    PubMed

    Brunani, Amelia; Raggi, Alberto; Sirtori, Anna; Berselli, Maria Elisa; Villa, Valentina; Ceriani, Francesca; Corti, Stefania; Leonardi, Matilde; Capodaglio, Paolo

    2015-05-29

    In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese patients to standardize rehabilitation interventions. After training on the ICF and based on the relevant studies, ICF categories were identified in a formal consensus process by our multidisciplinary team. Thereafter, we defined an individual rehabilitation project based on a structured multi-disciplinary approach to obesity. the proposed IRPOb model identified the specific intervention areas (nutritional, physiotherapy, psychology, nursing), the short-term goals, the intervention modalities, the professionals involved and the assessment of the outcomes. Information was shared with the patient who signed informed consent. The model proposed provides the following advantages: (1) standardizes rehabilitative procedures; (2) facilitates the flow of congruent and updated information from the hospital to outpatient facilities, relatives, and care givers; (3) addresses organizational issues; (4) might serve as a benchmark for professionals who have limited specific expertise in rehabilitation of comorbid obese patients.

  14. An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System

    PubMed Central

    Brunani, Amelia; Raggi, Alberto; Sirtori, Anna; Berselli, Maria Elisa; Villa, Valentina; Ceriani, Francesca; Corti, Stefania; Leonardi, Matilde; Capodaglio, Paolo

    2015-01-01

    Introduction/Objective: In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese patients to standardize rehabilitation interventions. Methods: After training on the ICF and based on the relevant studies, ICF categories were identified in a formal consensus process by our multidisciplinary team. Thereafter, we defined an individual rehabilitation project based on a structured multi-disciplinary approach to obesity. Results: the proposed IRPOb model identified the specific intervention areas (nutritional, physiotherapy, psychology, nursing), the short-term goals, the intervention modalities, the professionals involved and the assessment of the outcomes. Information was shared with the patient who signed informed consent. Conclusions: The model proposed provides the following advantages: (1) standardizes rehabilitative procedures; (2) facilitates the flow of congruent and updated information from the hospital to outpatient facilities, relatives, and care givers; (3) addresses organizational issues; (4) might serve as a benchmark for professionals who have limited specific expertise in rehabilitation of comorbid obese patients. PMID:26035658

  15. 77 FR 34359 - Applications for New Awards: Disability and Rehabilitation Research Projects and Centers Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... Brain Injury Model Systems Centers AGENCY: Office of Special Education and Rehabilitative Services... and Rehabilitation Research Projects (DRRPs)-- Traumatic Brain Injury Model Systems Centers (TBIMS... Brain Injury Model Systems Centers priority is from the notice of final priority for this...

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

    PubMed

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

    2014-11-25

    To assess effects of a two year intensive, multidisciplinary rehabilitation program for patients with early- to mid-stage Huntington's disease. A prospective intervention study. One inpatient rehabilitation center in Norway. 10 patients, with early- to mid-stage Huntington's disease. 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. 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). 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. 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.

  17. Cardiometabolic Health in Submariners Returning from a 3-Month Patrol

    PubMed Central

    Gasier, Heath G.; Young, Colin R.; Gaffney-Stomberg, Erin; McAdams, Douglas C.; Lutz, Laura J.; McClung, James P.

    2016-01-01

    Confined space, limited exercise equipment, rotating shift work and reduced sleep may affect cardiometabolic health in submariners. To test this hypothesis, 53 male U.S. Submariners (20–39 years) were studied before and after a 3-month routine submarine patrol. Measures included anthropometrics, dietary and physical activity, biomarkers of cardiometabolic health, energy and appetite regulation, and inflammation. Before deployment, 62% of submariners had a body fat % (BF%) ≥ 25% (obesity), and of this group, 30% met the criteria for metabolic syndrome. In obese volunteers, insulin, the homeostatic model assessment of insulin resistance (HOMA-IR), leptin, the leptin/adiponectin ratio, and pro-inflammatory chemokines growth-related oncogene and macrophage-derived chemokine were significantly higher compared to non-obese submariners. Following the patrol, a significant mean reduction in body mass (5%) and fat-mass (11%) occurred in the obese group as a result of reduced energy intake (~2000 kJ) during the patrol; and, independent of group, modest improvements in serum lipids and a mean reduction in interferon γ-induced protein 10 and monocyte chemotactic protein 1 were observed. Since 43% of the submariners remained obese, and 18% continued to meet the criteria for metabolic syndrome following the patrol, the magnitude of weight loss was insufficient to completely abolish metabolic dysfunction. Submergence up to 3-months, however, does not appear to be the cause of obesity, which is similar to that of the general population. PMID:26867201

  18. Cognitive rehabilitation for traumatic brain injury: A randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group.

    PubMed

    Salazar, A M; Warden, D L; Schwab, K; Spector, J; Braverman, S; Walter, J; Cole, R; Rosner, M M; Martin, E M; Ecklund, J; Ellenbogen, R G

    2000-06-21

    Traumatic brain injury (TBI) is a principal cause of death and disability in young adults. Rehabilitation for TBI has not received the same level of scientific scrutiny for efficacy and cost-efficiency that is expected in other medical fields. To evaluate the efficacy of inpatient cognitive rehabilitation for patients with TBI. Single-center, parallel-group, randomized trial conducted from January 1992 through February 1997 at a US military medical referral center. One hundred twenty active-duty military personnel who had sustained a moderate-to-severe closed head injury, manifested by a Glasgow Coma Scale score of 13 or less, or posttraumatic amnesia lasting at least 24 hours, or focal cerebral contusion or hemorrhage on computed tomography or magnetic resonance imaging. Patients were randomly assigned to an intensive, standardized, 8-week, in-hospital cognitive rehabilitation program (n=67) or a limited home rehabilitation program with weekly telephone support from a psychiatric nurse (n=53). Return to gainful employment and fitness for military duty at 1-year follow-up, compared by intervention group. At 1-year follow-up, there was no significant difference between patients who had received the intensive in-hospital cognitive rehabilitation program vs the limited home rehabilitation program in return to employment (90% vs 94%, respectively; P=.51; difference, 4% [95% confidence interval ¿CI¿, -5% to 14%]) or fitness for duty (73% vs 66%, respectively; P=. 43; difference, 7% [95% CI, -10% to 24%]). There also were no significant differences in cognitive, behavioral, or quality-of-life measures. In a post-hoc subset analysis of patients who were unconscious for more than 1 hour (n = 75) following TBI, the in-hospital group had a greater return-to-duty rate (80% vs 58%; P=. 05). In this study, the overall benefit of in-hospital cognitive rehabilitation for patients with moderate-to-severe TBI was similar to that of home rehabilitation. These findings emphasize

  19. Relationship between Self-Administered Cues and Rehabilitation Outcomes in Individuals with Aphasia: Understanding Individual Responsiveness to a Technology-Based Rehabilitation Program

    PubMed Central

    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

  20. 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

  1. Physical therapy in Parkinson's disease: an open long-term rehabilitation trial.

    PubMed

    Pellecchia, M T; Grasso, A; Biancardi, L G; Squillante, M; Bonavita, V; Barone, P

    2004-05-01

    The aim of this study was to evaluate the effects of prolonged physical therapy on disability in patients with Parkinson's disease. The study was designed as an open long-term trial over 20 weeks. Twenty slightly to moderately affected parkinsonian patients were included (Hoehn & Yahr stages: 1.5-3). A comprehensive rehabilitation program was applied three times a week in all patients. Pharmacological treatment was kept stable. Evaluations were performed at baseline, at the end of treatment and after 3 months. Following physical rehabilitation, there was a significant improvement in UPDRS (ADL and motor sections) scores, Self-assessment Parkinson's disease Disability Scale, Ten-Meter Walk test and Zung scale for depression. At 3-month follow-up clinical improvements were largely maintained. A sustained improvement of motor skills in PD patients can be achieved with a long-term comprehensive rehabilitation program.

  2. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    PubMed

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  3. A cluster randomized clinical trial comparing functional capacity evaluation and functional interviewing as components of occupational rehabilitation programs.

    PubMed

    Gross, Douglas P; Asante, Alexander K; Miciak, Maxi; Battié, Michele C; Carroll, Linda J; Sun, Ambrose; Mikalsky, Marti; Huellstrung, Rene; Niemeläinen, Riikka

    2014-12-01

    Functional capacity evaluations (FCE) are used to identify work abilities and are commonly integrated into rehabilitation programs. We studied whether integrating FCE into rehabilitation leads to better outcomes for injured workers. A cluster randomised controlled trial was conducted at a workers' compensation rehabilitation facility (registration ISRCTN61284905). Clinicians were randomised into 2 groups: 1 group used FCE while another conducted semi-structured functional interviews. Outcomes included recommendations following assessment, rehabilitation program outcomes including functional work levels and pain intensity, as well as compensation outcomes at 1, 3, and 6 months after assessment. Analysis included Mann-Whitney U, Chi square and t tests. Subjects included 225 claimants of whom 105 were tested with FCE. Subjects were predominantly employed (84 %) males (63 %) with sub-acute musculoskeletal conditions (median duration 67 days). Claimants undergoing FCE had ~15 % higher average functional work levels recommended at time of assessment (Mann-Whitney U = 4,391.0, p < 0.001) but differences at other follow-up times were smaller (0-8 %), in favour of functional interviewing, and not statistically significant. Clinically important improvement during rehabilitation in functional work level (0.9/4, SRM = 0.94), pain intensity (2.0/10, SRM = 0.88) and self-reported disability (21.8/100, SRM = 1.45) were only observed in those undergoing the functional interview. Performance-based FCE integrated into occupational rehabilitation appears to lead to higher baseline functional work levels compared to a semi-structured functional interview, but not improved RTW rates or functional work levels at follow-up. Functional interviewing has potential for efficiency gains and higher likelihood of clinically important improvement following rehabilitation, however further research is needed.

  4. Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors

    PubMed Central

    Takao, Toshifumi; Tanaka, Naoki; Iizuka, Noboru; Saitou, Hideyuki; Tamaoka, Akira; Yanagi, Hisako

    2015-01-01

    [Purpose] Most previous studies have shown that body weight support treadmill training (BWSTT) can improve gait speed poststroke patients. The purpose of this study was to evaluate effectiveness of a short-term intensive program using BWSTT among community dwelling poststroke survivors. [Subjects] Eighteen subjects participated in this study. The treatment group was composed of 10 subjects (2 women; 8 men; mean age, 59.1 ± 12.5 years; time since stroke onset, 35.3 ± 33.2 months), whereas the control group was made up of 8 subjects (3 women; 5 men; mean age, 59.8 ± 6.3 years; time since stroke onset, 39.3 ± 27.3 months). [Methods] The treatment group received BWSTT 3 times a week for 4 weeks (a total of 12 times), with each session lasting 20 minutes. The main outcome measures were maximum gait speed on a flat floor, cadence, and step length. [Results] No differences were observed in the baseline clinical data between the 2 groups. The gait speed in the treatment group was significantly improved compared with that in the control by 2-way ANOVA, while the other parameters showed no significant interaction. [Conclusion] These results suggested that short-term intensive gait rehabilitation using BWSTT was useful for improving gait ability among community dwelling poststroke subjects. PMID:25642063

  5. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2016. Final rule.

    PubMed

    2015-08-06

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2016 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF PPS's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2016. This final rule also finalizes policy changes, including the adoption of an IRF-specific market basket that reflects the cost structures of only IRF providers, a 1-year phase-in of the revised wage index changes, a 3-year phase-out of the rural adjustment for certain IRFs, and revisions and updates to the quality reporting program (QRP).

  6. Bilingual children with primary language impairment: 3 months after treatment.

    PubMed

    Pham, Giang; Ebert, Kerry Danahy; Kohnert, Kathryn

    2015-01-01

    Evidence on the treatment effectiveness for bilingual children with primary language impairment (PLI) is needed to advance both theory and clinical practice. Of key interest is whether treatment effects are maintained following the completion of short-term intense treatments. To investigate change in select language and cognitive skills in Spanish-English bilingual children with PLI 3 months after children have completed one of three experimental treatment conditions. There are two main study aims. First, to determine if skills in Spanish, English and cognitive processing decline, improve or are maintained after treatment has been completed. Second, to determine if differential rates of change are a function of the type of treatment children received. Participants were 48 children, aged 5:6-11:3, who spoke Spanish and English and were diagnosed with moderate to severe PLI. Participants received 6 weeks of treatment focused on English only (EO), bilingual skills in Spanish and English (BI) or nonlinguistic cognitive processing (NCP). Treatment effects reported in a previous study were determined by comparing pre- and post-treatment performance on a variety of language and cognitive measures. Here we re-administered each measure 3 months after completion of the experimental treatments. Hierarchical linear models were calculated for each measure using pre-, post- and follow-up testing scores to estimate change trajectories and compare outcomes between treatment conditions. Participants in all three treatment conditions either maintained skills or showed improvement even after treatment was discontinued for 3 months. Main findings included (1) comparable, positive rates of change on all English language outcomes for EO and BI conditions; (2) maintenance of Spanish language skills, and (3) modest improvements in NCP following the discontinuation of treatment. This study is the first to examine longer-term treatment effects for bilingual school-age children with PLI

  7. 'This is a forever project': supporting lifestyle changes in a regional Queensland community-based cardiac rehabilitation program.

    PubMed

    Madsen, Wendy

    2013-01-01

    Cardiac rehabilitation programs throughout the world have struggled for several years to attract more participants and facilitate behaviour changes in these clients. Over the past few years, there has been an increased level of attention in the role that self-efficacy and social support may play in this respect. The main aim of this study was to explore self-efficacy and social support within a regional, community-based cardiac rehabilitation program that does not adhere to traditional cardiac rehabilitation structures. Twelve participants were interviewed and two major themes emerged from the thematic analysis of the interview transcripts: making personal lifestyle changes; and supportive environment for lifestyle changes. Although this study is exploratory in nature, it has highlighted the significance of social support from within a program as opposed to participants' friends and family, the subject of most social-support research. It also contributes to the challenges others are starting to make regarding the limited timeframes associated with traditional cardiac rehabilitation programs, suggesting more time may be needed to build firmer psychosocial foundations for behaviour change after cardiac events.

  8. Former Prison Inmates' Recidivism Rates: A Content Analysis Study of the Impact of Educational and Rehabilitation Programs

    ERIC Educational Resources Information Center

    Lathrop, Peter J. P., Sr.

    2011-01-01

    This study was an analysis and synthesis of the existing research on prison-based rehabilitative programs and their positive or negative impact on recidivism rates. This study utilizes qualitative, quantitative, and mixed methodologies. This study is a qualitative research in nature in that the analysis of research findings is based on the…

  9. The Effectiveness of a Multidisciplinary Group Rehabilitation Program on the Psychosocial Functioning of Elderly People Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2013-01-01

    Introduction: The pilot study reported here determined the effectiveness of a multidisciplinary group rehabilitation program, Visually Impaired Elderly Persons Participating (VIPP), on psychosocial functioning. Methods: The single-group pretest-posttest pilot study included 29 persons with visual impairments (aged 55 and older) who were referred…

  10. The Effectiveness of a Multidisciplinary Group Rehabilitation Program on the Psychosocial Functioning of Elderly People Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2013-01-01

    Introduction: The pilot study reported here determined the effectiveness of a multidisciplinary group rehabilitation program, Visually Impaired Elderly Persons Participating (VIPP), on psychosocial functioning. Methods: The single-group pretest-posttest pilot study included 29 persons with visual impairments (aged 55 and older) who were referred…

  11. The Comparative Effectiveness of Cognitive Processing Therapy for Male Veterans Treated in a VHA Posttraumatic Stress Disorder Residential Rehabilitation Program

    ERIC Educational Resources Information Center

    Alvarez, Jennifer; McLean, Caitlin; Harris, Alex H. S.; Rosen, Craig S.; Ruzek, Josef I.; Kimerling, Rachel

    2011-01-01

    Objective: To examine the effectiveness of group cognitive processing therapy (CPT) relative to trauma-focused group treatment as usual (TAU) in the context of a Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) residential rehabilitation program. Method: Participants were 2 cohorts of male patients in the same program…

  12. Effectiveness of Written Materials in a Rehabilitative Program for Female Offenders: A Case Study at the Montana Women's Prison

    ERIC Educational Resources Information Center

    Dillon, Laura; Colling, Kyle

    2010-01-01

    This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…

  13. 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.

  14. 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…

  15. Outdoor-Adventure Education as an Ancillary Component in Rehabilitation Programs for the Hearing Impaired: A Pilot Study.

    ERIC Educational Resources Information Center

    Luckner, John L.

    This study investigated the effectiveness of using an outdoor-adventure education program as a method of intervention for enhancing the self-concept of a group of hearing impaired individuals receiving services from the Department of Vocational Rehabilitation. Nine adults (6 male, 3 female) with hearing impairments participated in a 4-day…

  16. Vocational Rehabilitation for Postsecondary Programs that Serve Students Who Are Deaf or Hard of Hearing. NETAC Tip Sheet

    ERIC Educational Resources Information Center

    Northeast Technical Assistance Center (NETAC), Rochester Institute of Technology, 2005

    2005-01-01

    The purpose of the public Vocational Rehabilitation (VR) program is to empower individuals with disabilities to maximize employment, economic self-sufficiency, independence, and inclusion and integration into society. Simply stated, VR provides services to individuals with physical or mental disabilities who need help to qualify for, find, or keep…

  17. Effectiveness of Written Materials in a Rehabilitative Program for Female Offenders: A Case Study at the Montana Women's Prison

    ERIC Educational Resources Information Center

    Dillon, Laura; Colling, Kyle

    2010-01-01

    This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…

  18. Vocational Rehabilitation for Postsecondary Programs that Serve Students Who Are Deaf or Hard of Hearing. NETAC Tip Sheet

    ERIC Educational Resources Information Center

    Northeast Technical Assistance Center (NETAC), Rochester Institute of Technology, 2005

    2005-01-01

    The purpose of the public Vocational Rehabilitation (VR) program is to empower individuals with disabilities to maximize employment, economic self-sufficiency, independence, and inclusion and integration into society. Simply stated, VR provides services to individuals with physical or mental disabilities who need help to qualify for, find, or keep…

  19. Former Prison Inmates' Recidivism Rates: A Content Analysis Study of the Impact of Educational and Rehabilitation Programs

    ERIC Educational Resources Information Center

    Lathrop, Peter J. P., Sr.

    2011-01-01

    This study was an analysis and synthesis of the existing research on prison-based rehabilitative programs and their positive or negative impact on recidivism rates. This study utilizes qualitative, quantitative, and mixed methodologies. This study is a qualitative research in nature in that the analysis of research findings is based on the…

  20. Effects of a Multidisciplinary Rehabilitation Program on Pediatric Obesity: The CEMHaVi Program

    ERIC Educational Resources Information Center

    Vanhelst, Jeremy; Mikulovic, Jacques; Fardy, Paul; Bui-Xuan, Gilles; Marchand, Frederic; Beghin, Laurent; Theunynck, Denis

    2011-01-01

    The objective of this study is to assess the effects of the unique 1-year health-wellness program of exercise and health education for obese youth on body mass index (BMI) and blood pressure. The CEMHaVi program included 74 obese children. Participants, 19 girls and 18 boys, and controls, 17 girls and 20 boys, were assigned to treatment. The…

  1. Effects of a Multidisciplinary Rehabilitation Program on Pediatric Obesity: The CEMHaVi Program

    ERIC Educational Resources Information Center

    Vanhelst, Jeremy; Mikulovic, Jacques; Fardy, Paul; Bui-Xuan, Gilles; Marchand, Frederic; Beghin, Laurent; Theunynck, Denis

    2011-01-01

    The objective of this study is to assess the effects of the unique 1-year health-wellness program of exercise and health education for obese youth on body mass index (BMI) and blood pressure. The CEMHaVi program included 74 obese children. Participants, 19 girls and 18 boys, and controls, 17 girls and 20 boys, were assigned to treatment. The…

  2. Research in Correctional Rehabilitation.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (DHEW), Washington, DC.

    Forty-three leaders in corrections and rehabilitation participated in the seminar planned to provide an indication of the status of research in correctional rehabilitation. Papers include: (1) "Program Trends in Correctional Rehabilitation" by John P. Conrad, (2) "Federal Offenders Rahabilitation Program" by Percy B. Bell and Merlyn Mathews, (3)…

  3. Reversible cerebral vasoconstriction syndrome 3 months after blood transfusion.

    PubMed

    Braun, Charles N; Hughes, Richard L; Bosque, Patrick J

    2012-11-01

    Reversible cerebral vasoconstriction syndrome is characterized by the prolonged but reversible constriction of cerebral arteries accompanied by a sudden onset of severe headache, and is sometimes complicated by subarachnoid hemorrhage or cerebral infarction. It is associated with various clinical conditions and treatments, although the precise pathophysiology is not understood. In particular, several cases of this syndrome have been described to occur in middle-aged women within 1 week of a blood transfusion. We encountered a patient with a reversible cerebral vasoconstriction syndrome who became symptomatic 3 months after a blood transfusion. No other cause for the syndrome was found. This case suggests that the risk for the reversible cerebral vasoconstriction may persist for months after blood transfusion. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Tuberculosis in infants less than 3 months of age.

    PubMed

    Del Rosal Rabes, Teresa; Baquero-Artigao, Fernando; Méndez-Echevarría, Ana María; Mellado Peña, María José

    2017-04-01

    A review was conducted on infants less than 3 months of age diagnosed with tuberculosis between 1978 and 2014. Eight patients were diagnosed (1.4% of paediatric tuberculosis cases): 3 confirmed congenital tuberculosis, 3 suspected (endometrial biopsy was not performed), and 2 postnatal tuberculosis. Tuberculin skin test was negative in two patients. Diagnostic performance of culture (7/7, 100%) and PCR (3/3, 100%) of gastric aspirates was higher than that of acid-fast bacilli smears (5/8, 62%) and IGRA test (1/3, 33%). Three patients developed miliary disease, and one died. In conclusion, tuberculosis in this age group is rare, severe, and difficult to diagnose. In cases lacking known postnatal contacts, maternal genital tuberculosis should be ruled out by endometrial biopsy. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. Barriers for Nonparticipation and Dropout of Women in Cardiac Rehabilitation Programs: A Systematic Review.

    PubMed

    Resurrección, Davinia M; Motrico, Emma; Rigabert, Alina; Rubio-Valera, Maria; Conejo-Cerón, Sonia; Pastor, Luis; Moreno-Peral, Patricia

    2017-08-01

    Cardiovascular disease (CVD) is a major health problem worldwide. Cardiac rehabilitation (CR) programs are effective in reducing mortality and improving the quality of life of patients with CVD. Women are under-represented in CR and have a higher dropout rate than men. We aimed to systematically review the literature on barriers perceived by women with CVD affecting their nonparticipation in and/or dropping out from CR programs. Systematic review was done using MEDLINE, Embase, Scopus, Open Grey, and Cochrane Database from inception to September 2016. Search terms included (1) heart disease and other cardiac conditions, (2) CR and secondary prevention, and (3) nonparticipation in and/or dropout. Databases were searched following the "participants, interventions, comparisons, outcomes, and study design" method. A total of 24 studies (17 descriptive, 6 qualitative, and 1 randomized controlled trial) reporting several barriers were grouped into five broad categories: intrapersonal barriers (self-reported health, health beliefs, lack of time, motivation, and religious reasons); interpersonal barriers (lack of family/social support and work conflicts); logistical barriers (transport, distance, and availability of personal/community resources); CR program barriers (services offered, group format, exercise component, and CR sessions); and health system barriers (lack of referral, cost, negative experiences with the health system, and language). We found differences between the barriers related to nonparticipation in and dropout from CR programs. Women reported multilevel barriers for nonparticipation in and dropout from CR programs. Future clinical guidelines should evaluate and eliminate these barriers to improve adherence to CR programs in women. In addition, understanding the barriers for nonparticipation and dropout may be beneficial for future intervention trials.

  6. Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff.

    PubMed

    Squires, Ray W; Montero-Gomez, Aura; Allison, Thomas G; Thomas, Randal J

    2008-01-01

    Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. At 3 years, aspirin usage was 91%, statin usage 91%, beta-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 +/- 23 mg/dL, systolic blood pressure was 126 +/- 19 mm Hg, and body mass index was 29.0 +/- 5.1 kg/m2. Exercise training averaged 139 +/- 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

  7. Comparing 3-month recall to daily reporting of sexual behaviours.

    PubMed

    Mark, Kristen P; Smith, Rachel V; Young, April M; Crosby, Richard

    2017-05-01

    This study aimed to examine discrepancies between self-report methods and methodological issues related to sexual risk taking. We examined sexual behaviour assessed via 3-month electronic recall and by daily electronic reporting among a large cohort of patients attending STI clinics. STI clinic attenders (N= 628) aged 15 to 60 years reported on demographic information (at baseline), penile-vaginal sex acts, condom-unprotected penile-vaginal sex and STI history using 3-month recall and daily reports. Additionally, interviewer-participant match related to race and gender, as well as study site were considered as covariates. Concordance between recall and daily reports on penile-vaginal sex was moderately strong (Spearman's r (rs)=0.62; p<0.001). Comparison for reports for condom-unprotected penile-vaginal sex resulted in a correlation coefficient of 0.61 (p<0.001), also indicating moderately strong agreement between the two methods. Two generalised logit models were conducted to explain lack of strong concordance in penile-vaginal sex acts and condom-unprotected penile-vaginal sex. The odds of a female reporting higher frequency of sex in daily reports compared with recall were more than two times that of a male. Every five person increase in the number of lifetime sexual partners was associated with five times the odds of a discrepancy in reporting methods. Age was also significantly associated with unequal daily versus recall sex frequency reporting. Shifting focus to methodological considerations of technological reports can help ensure better investment of resources into sexual health research due to greater understanding of the methodological properties of data collection methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Healthcare providers' awareness of the information needs of their cardiac rehabilitation patients throughout the program continuum.

    PubMed

    de Melo Ghisi, Gabriela Lima; Grace, Sherry L; Thomas, Scott; Evans, Michael F; Sawula, Heather; Oh, Paul

    2014-04-01

    To (1) describe cardiac rehabilitation (CR) participant information needs, (2) investigate whether CR providers are cognizant of patient's information needs and preferred delivery formats, and (3) investigate whether patient information needs change over the course of CR. In this cross-sectional study, 306 CR patients and 28 CR providers completed a survey. The survey consisted of the Information Needs in CR (INCR) questionnaire, and items about preferred education delivery formats. Low-income CR participants had significantly greater information needs than high-income participants. CR providers were cognizant of patient information needs, except patients did desire more information on diagnosis and treatment than providers perceived (p<0.01). Books, lectures and discussion were identified as the preferred delivery formats by both patients and providers. There were some significant differences in patient information needs over the course of the program, particularly in relation to concerns and risk factors. CR patients desire information in many areas, particularly regarding emergency/safety and diagnosis/treatment. CR providers were highly cognizant of patient information needs; however, these do change over time. These findings could inform evaluation and improvement of CR education programming, to ensure programs are meeting patient information needs across all stages of recovery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. The Efficacy of a Computer-Assisted Cognitive Rehabilitation Program for Patients with Mild Cognitive Deficits: A Pilot Study.

    PubMed

    Mansbach, William E; Mace, Ryan A; Clark, Kristen M

    2017-01-01

    Background/Study Context: Whereas computer-assisted cognitive rehabilitation (CR) programs show promise as tools for improving cognition in certain populations, there is not a consensus regarding their efficacy. This study focuses on restorative CR, a treatment designed to improve cognitive functioning affected by progressive brain changes due to disease or aging, through computer-assisted cognitive exercises. The purpose of this study was to investigate the efficacy of a computer-assisted restorative CR intervention for improving cognitive functioning in older rehabilitation patients with relatively mild cognitive deficits.

  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. Synergistic effect of a rehabilitation program and treadmill exercise on pain and dysfunction in patients with chronic low back pain.

    PubMed

    Cho, Young-Ki; Kim, Dae-Young; Jung, Sun-Young; Seong, Jun-Hyuk

    2015-04-01

    [Purpose] The present study examined the influence of treadmill exercise added to a low back pain rehabilitation program on low back extensor strength, pain, and dysfunction in chronic low back pain patients. [Subjects and Methods] Twenty men aged 22-36 years with chronic low back pain were randomly divided into experimental and control groups of 10 patients each. Both groups underwent a low back pain rehabilitation program lasting 30 min each, thrice/week for 8 weeks. The experimental group was prescribed an additional 30 min of treadmill exercise without a slope at a speed of 3.0-3.5 km/h, at which patients could walk comfortably. Low back extensor strength was tested using the Medx lumbar extension machine, pain level was tested, using the visual analog scale, and dysfunction was tested, using the Oswestry Low Back Pain Disability Questionnaire. [Results] Changes in low back extensor strength by angle showed significant interaction effects between measurement time and group at 12°, 24°, and 36°. The results of the visual analog scale and Oswestry Questionnaire showed a decreasing trend after the experiment in both groups. However, there was no interaction effect of the additional treadmill exercise in the experimental group. [Conclusion] The combination of a low back pain rehabilitation program and treadmill exercise has a synergistic effect, to some extent, on the improvement of low back extensor strength and should be considered for treatment and rehabilitation of low back pain patients.

  12. 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.

  13. Quality of Life and Awareness of Cardiac Rehabilitation Program in People With Cardiovascular Diseases

    PubMed Central

    2017-01-01

    Objective To evaluate the level of health-related quality of life (HRQoL), life satisfaction, and their present awareness of cardiac rehabilitation (CR) program in people with cardiovascular diseases. Methods A questionnaire survey was completed by 53 patients (mean age, 65.7±11.6 years; 33 men and 20 women) with unstable angina, myocardial infarction, or heart failure. The questionnaire included the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36), life domain satisfaction measure (LDSM), and the awareness and degree of using CR program. Results The average scores of physical component summary (PCS) and mental component summary (MCS) were 47.7±18.5 and 56.5±19.5, respectively. There were significant differences in physical role (F=4.2, p=0.02), vitality (F=10.7, p<0.001), mental health (F=15.9, p<0.001), PCS (F=3.6, p=0.034), and MCS (F=11.9, p<0.001) between disease types. The average LDSM score was 4.7±1.5. Age and disease duration were negatively correlated with multiple HRQoL areas (p<0.05). Monthly income, ejection fraction, and LDSM were positively correlated with several MOS SF-36 factors (p<0.05). However, the number of modifiable risk factors had no significant correlation with medication. Thirty-seven subjects (69.8%) answered that they had not previously heard about CR program. Seventeen patients (32.1%) reported that they were actively participating in CR program. Most people said that a reasonable cost of CR was less than 100,000 Korean won per month. Conclusion CR should focus on improving the physical components of quality of life. In addition, physicians should actively promote CR to cardiovascular disease patients to expand the reach of CR program. PMID:28503458

  14. A flexible format interdisciplinary treatment and rehabilitation program for chronic daily headache: patient clinical features, resource utilization and outcomes.

    PubMed

    Barton, Pamela M; Schultz, Geoffrey R; Jarrell, John F; Becker, Werner J

    2014-09-01

    To describe the demographics, diagnoses, program duration, human resource utilization and outcomes of patients with chronic daily headache treated in an ambulatory, interdisciplinary, flexible format, treatment and rehabilitation program. Research indicates that multidisciplinary care is an effective approach to manage chronic daily headache, but little is known about the resources needed for effective care. The study was a secondary data analysis within a cohort design of previously collected data. Patients completed questionnaires and outcome measures on admission and discharge. Diagnoses were extracted from patient charts by professional health records personnel. A central scheduling database provided patient-specific clinician care hours by discipline and type (direct, indirect, group) as well as overall program duration. One hundred and eighteen patients were studied (mean age 41.1 ± 10.4   [x ± SD], 80% female). Sixty-two patients (52.5%) completed the program ("completers"). Migraine was the most common diagnosis. Thirty-six percent of patients had medication overuse. Average pain, mood, disability, and quality of life were significantly improved in completers (P < .001). They utilized 76 ± 45.1   (x ± SD ) total hours of care delivered over a mean of 129.7 ± 66.1 weeks. Our study provides evidence that ambulatory, interdisciplinary, flexible format, treatment and rehabilitation programs are effective in the treatment of chronic daily headache, and we provide data on the resources used by our program in the treatment and rehabilitation of these patients. © 2014 American Headache Society.

  15. The effectiveness of different combinations of pulmonary rehabilitation program components: a randomized controlled trial.

    PubMed

    Norweg, Anna Migliore; Whiteson, Jonathan; Malgady, Robert; Mola, Ana; Rey, Mariano

    2005-08-01

    To study the short-term and long-term effects of combining activity training or lectures to exercise training on quality of life, functional status, and exercise tolerance. Randomized clinical trial. Outpatient pulmonary rehabilitation center. Forty-three outpatients with COPD. Patients were randomized to one of three treatment groups: exercise training alone, exercise training plus activity training, and exercise training plus a lecture series. The mean treatment period was 10 weeks. The Chronic Respiratory Disease Questionnaire, the modified version of the Pulmonary Functional Status and Dyspnea Questionnaire, and the COPD Self-Efficacy Scale were administered at baseline, and 6, 12, 18, and 24 weeks from the beginning of the rehabilitation program. The 6-min walk test was used to measure exercise tolerance. Benefits of activity training combined with exercise included less dyspnea (p < or = 0.04) and fatigue (p < or = 0.01), and increased activity involvement (p < or = 0.02) and total functional status (p < or = 0.02) in the short term compared to comparison treatment groups for comparatively older participants. Compared to the lecture series adjunct, the activity training adjunct resulted in significantly higher gains in total quality of life (p = 0.04) maintained at 24 weeks. Significantly worse emotional function and functional status resulted from the lecture series adjunct in the oldest participants (p < or = 0.03). Treatment groups did not differ significantly on exercise tolerance or self-efficacy. Evidence for additional benefits of activity-specific training combined with exercise was found. A behavioral method emphasizing structured controlled breathing and supervised physical activity was statistically significantly more effective than didactic instruction in facilitating additional gains and meeting participants' learning needs.

  16. Feasibility of an exercise intervention for fatigued breast cancer patients at a community-based cardiac rehabilitation program

    PubMed Central

    De Jesus, Stefanie; Fitzgeorge, Lyndsay; Unsworth, Karen; Massel, David; Suskin, Neville; Prapavessis, Harry; Sanatani, Michael

    2017-01-01

    Purpose Exercise is beneficial to quality of life after cancer treatment, yet few cancer survivors meet exercise guidelines. Our study sought to determine the feasibility of an oncology rehabilitation exercise program embedded within a cardiac rehabilitation program. Methods Patients who rated their fatigue >4/10 after completion of adjuvant chemotherapy for breast cancer were screened for eligibility and the outcomes were assessed (Piper Fatigue Scale, Functional Assessment of Cancer Therapy-Breast [FACT-B], Edmonton Symptom Assessment System, body composition, stress test, and physical activity measurement [accelerometer]). Participants received individualized exercise prescription. Following the 16-week program, repeat assessment plus patient acceptance and satisfaction survey was completed. The primary end point was the composite of accrual rate >25%, program adherence >80%, and mean compliance with accelerometer use >80%. Results Twenty of 24 screened patients consented to the study and completed the baseline assessment. Adherence was 30.3%. Mean accelerometer use was 3.88/7 days (78%). Fatigue at baseline was rated at 4.82/10, and at 3.59 (p = 0.09) after the intervention. Overall well-being (FACT-B) score changed from 92.7 to 98.3 (p = 0.05). There were no significant changes in body composition (except for bone mineral content), aerobic exercise capacity, or activity patterns. Conclusion Although the primary outcome was not met, our study indicates that an oncology exercise rehabilitation program can be incorporated into an existing cardiac rehabilitation program. Based on feedback received, we propose that in order to achieve exercise goals, frequent, encouraging, and tailored feedback and group sessions to foster a sense of community may additionally be needed to strengthen adherence to a prescribed exercise program. PMID:28228661

  17. Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke

    PubMed Central

    Winstein, Carolee J.; Wolf, Steven L.; Dromerick, Alexander W.; Lane, Christianne J.; Nelsen, Monica A.; Lewthwaite, Rebecca; Cen, Steven Yong; Azen, Stanley P.

    2016-01-01

    IMPORTANCE Clinical trials suggest that higher doses of task-oriented training are superior to current clinical practice for patients with stroke with upper extremity motor deficits. OBJECTIVE To compare the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy (UCC) during stroke rehabilitation. DESIGN, SETTING, AND PARTICIPANTS Phase 3, pragmatic, single-blind randomized trial among 361 participants with moderate motor impairment recruited from 7 US hospitals over 44 months, treated in the outpatient setting from June 2009 to March 2014. INTERVENTIONS Structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program[ASAP]; n = 119); dose-equivalent occupational therapy (DEUCC; n = 120); or monitoring-only occupational therapy (UCC; n = 122). The DEUCC group was prescribed 30 one-hour sessions over 10 weeks; the UCC group was only monitored, without specification of dose. MAIN OUTCOMES AND MEASURES The primary outcome was 12-month change in log-transformed Wolf Motor Function Test time score (WMFT, consisting of a mean of 15 timed arm movements and hand dexterity tasks). Secondary outcomes were change in WMFT time score (minimal clinically important difference [MCID] = 19 seconds) and proportion of patients improving ≥25 points on the Stroke Impact Scale (SIS) hand function score (MCID = 17.8 points). RESULTS Among the 361 randomized patients (mean age, 60.7 years; 56% men; 42% African American; mean time since stroke onset, 46 days), 304 (84%) completed the 12-month primary outcome assessment; in intention-to-treat analysis, mean group change scores (log WMFT, baseline to 12 months) were, for the ASAP group, 2.2 to 1.4 (difference, 0.82); DEUCC group, 2.0 to 1.2 (difference, 0.84); and UCC group, 2.1 to 1.4 (difference, 0.75), with no significant between-group differences (ASAP vs DEUCC:0.14; 95% CI, −0.05 to 0.33; P = .16; ASAP vs UCC: −0.01; 95% CI, −0.22 to 0.21; P = .94; and

  18. Outcomes Following a Vestibular Rehabilitation and Aerobic Training Program to Address Persistent Post-Concussion Symptoms.

    PubMed

    Moore, Brian M; Adams, Joseph T; Barakatt, Edward

    2016-01-01

    To describe changes in adults with persistent symptoms and disability following a concussion after completing a supervised home exercise vestibular rehabilitation (VR) program combined with aerobic training. Participants included 14 consecutive individuals referred for VR within the context of a comprehensive concussion center. Outcome measures were administered at initial evaluation, 3 mos, and 6 mos. Outcome measures included: Rivermead Post-Concussion Questionnaire symptom (RPQ-3) and function (RPQ-13) subcategories, Dizziness Handicap Inventory (DHI), Activities-specific Balance Confidence Scale (ABC), functional gait assessment (FGA), return to work/study (RTW), and return to activity (RTA). At 6 months, all clinical outcome measures were found to be statistically significant or approaching statistical significance: RPQ-3 (p<0.001), RPQ-13 (p<0.004), DHI (p<0.001), ABC (p<0.007), FGA (p<0.001). For return to meaningful activity, associations between time of measure and both RTW (p<0.019) and RTA (p<0.001) were found to be statistically significant or approach statistical significance. Following 6 months of participation in a supervised home exercise VR program with aerobic training, significant improvements were observed in participants' report of concussion-related symptoms, function, and return to meaningful activities.

  19. The modification of criminogenic factors on addicted offenders. The effectiveness of the Reasoning and Rehabilitation Program.

    PubMed

    Wettermann, Anne; Schläfke, Detlef; Fegert, Jörg M

    2012-01-01

    At the Clinic of Forensic Psychiatry in Rostock, Germany, we treat addicted offenders in a closed psychiatric setting. In 2009 we implemented the "Reasoning and Rehabilitation Program" (R & R, Ross & Fabiano, 1986), a cognitive skills program, in our clinic. There are several international studies confirming the efficacy of this training in diminishing recidivism. We examined a sample of 31 inpatients randomly distributed among the experimental (R & R) and the control group. Most of the study participants had committed homicide or other serious violent offenses. Prisoners with schizophrenia, organic mental disorders and mental retardation were excluded from the study. The target skills were assessed by treating psychotherapists, primary nurses and by the patients themselves. Our findings indicated that problem-solving, awareness of consequences, social perspective-taking, cognitive style, the ability to learn by experience, and persistence in the experimental group were significantly improved. The awareness of consequences has changed significantly in the assessment of the treating psychotherapists, the primary nurses, and the offenders themselves. Our current data are similar to our recent work, where we found significant changes in mental flexibility, planning, and problem-solving and positively assessed tendencies in some skills (Wettermann et al., 2012, 2011). Verification of these findings in a larger sample would strengthen the research foundation for this important training to diminish prisoner recidivism. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. A randomized controlled trial of rehabilitation at home after stroke in southwest Stockholm.

    PubMed

    Widén Holmqvist, L; von Koch, L; Kostulas, V; Holm, M; Widsell, G; Tegler, H; Johansson, K; Almazán, J; de Pedro-Cuesta, J

    1998-03-01

    This study describes the methodology, patient outcome, and use of hospital and rehabilitation services at 3 months of a population-based randomized controlled trial. The purpose was to evaluate rehabilitation at home after early supported discharge from the Department of Neurology, Huddinge Hospital, for moderately disabled stroke patients in southwest Stockholm. The patients were eligible if they were continent, independent in feeding, had mental function within normal limits, and had impaired motor function and/or aphasia 1 week after stroke. Patients were randomized either to early supported discharge with continuity of rehabilitation at home for 3 to 4 months or to routine rehabilitation service in a hospital, day care, and/or outpatient care. The home rehabilitation team consisted of two physical therapists, two occupational therapists, and one speech therapist; one of the therapists was assigned as case manager for the patient. The rehabilitation program at home emphasized a task- and context-oriented approach. The activities were chosen on the basis of the patient's personal interests. Spouses were offered education and individual counseling. A total of 81 patients were followed up for a minimum of 3 months. Patient outcome was assessed by the Frenchay Social Activity Index, Extended Katz Index, Barthel Index, Lindmark Motor Capacity Assessment, Nine-Hole Peg Test, walking speed over 10 m, reported falls, and subjective dysfunction according to the Sickness Impact Profile. Patient use of hospital and home rehabilitation service and patient satisfaction with care were studied. Overall there were no statistical significant differences in outcome. Multivariate logistic regression analysis suggested a systematic positive effect for the home rehabilitation group in social activity, activities of daily living, motor capacity, manual dexterity, and walking. A considerable difference in resource use during such a 3-month period was seen. A 52% reduction in

  1. [Childhood craniopharyngioma with hypothalamic obesity - no long-term weight reduction due to rehabilitation programs].

    PubMed

    Sterkenburg, A S; Hoffmann, A; Gebhardt, U; Waldeck, E; Springer, S; Müller, H L

    2014-11-01

    Severe obesity due to hypothalamic involvement has major impact on prognosis in long-term survivors of childhood craniopharyngioma. The long-term effects of rehabilitation efforts on weight development and obesity in these patients are not analyzed up to now. 108 patients with childhood craniopharyngioma recruited in HIT Endo before 2001 were included in the study. Long-term weight development (BMI SDS after >10 yrs follow-up) was analyzed in regard to rehabilitation, which was performed in 31 of 108 (29%) patients (one rehabilitation in 4 patients (13%), more than one in 21 patients (68%), 6 patients unknown) in 13 German rehabilitation -clinics. 84% of patients underwent rehabilitation in order to reduce hypothalamic obesity (BMI>+ 2 SD), whereas 12% of patients were normal weight. Childhood craniopharyngioma pa-tients with rehabilitation presented with higher BMI at diagnosis (median BMI: +1.32 SD; range: -1.08 to + 7.00 SD) and at last evaluation (median BMI: +4.93 SD; range: -0.20 to + 13.13 SD) when compared with patients without rehabilitation (median BMI at diagnosis: +0.24 SD; range: -2.67 to + 6.98 SD; BMI at evaluation: +2.09 SD; range: -1.48 to + 10.23 SD). A long-term weight reducing effect of rehabilitation was no detectable regardless of degree of obesity, frequency of rehabilitation, and hospital of rehabilitation. Treatment options for hypothalamic obesity in terms of rehabilitation are limited. Accordingly, strategies for prevention of hypothalamic lesions and psychosocial effects of rehabilitation are currently in focus for improvement of prognosis in childhood craniopharyngioma patients. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

    PubMed

    Rasekaba, T M; Williams, E; Hsu-Hage, B

    2009-01-01

    Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P < 0.001) 12 months after the introduction of the CDM Program; in contrast, changes in the cumulative indicators were statistically insignificant for the Opt-out Cohort (emergency department presentations decreased by 5%, inpatient admissions decreased by 12%, length of stay increased by 30%; effect size = 0.14-0.40, P > 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

  3. Rehabilitation after total hip arthroplasty: a systematic review of controlled trials on physical exercise programs.

    PubMed

    Di Monaco, M; Vallero, F; Tappero, R; Cavanna, A

    2009-09-01

    Total hip arthroplasty (THA) has revolutionized the care of patients with end-stage joint disease, leading to pain relief, functional recovery, and substantial improvement in quality of life. However, long-term studies indicate persistence of impairment and functional limitation after THA, and the optimal rehabilitation protocols are largely unknown. The aim of this paper was to systematically review the controlled trials published on the effectiveness of physical exercise programs after THA. Nine studies were retrieved from MEDLINE and reviewed. Results show that the physical exercise protocols most frequently used after THA in the early postoperative phase are neither supported nor denied by clinical controlled trials. Convincing evidence for the effectiveness of single interventions in addition to usual exercise programs exists for each of the three following options: treadmill training with partial body-weight support, unilateral resistance training of the quadriceps muscle (operated side), and arm-interval exercises with an arm ergometer. In the late postoperative phase (operation interval > 8 weeks) exercise programs consistently improve both impairment and ability to function. Weight-bearing exercises with hip-abductor eccentric strengthening may be the crucial component of the late-phase protocols. Substantial limitations were found in the nine studies, including small sample size, patient selection, heterogeneity of outcome assessments, and potential sources of variability not investigated. Despite limitations, we conclude that three main suggestions emerge from controlled trials on physical exercise after THA: early postoperative protocols should include additive interventions whose effectiveness has been shown. Late postoperative programs are useful and should comprise weight-bearing exercises with hip-abductor eccentric strengthening.

  4. "A different atmosphere of love": a qualitative study of the experiences of participants in Evangelical substance user rehabilitation programs in the Russian Federation.

    PubMed

    Stoltzfus, Kenneth M; Cecil, David

    2013-04-01

    This article explores the lived experiences of individuals who have participated in faith-based substance user rehabilitation programs in the Russian Federation. The Russian Federation has high rates of alcohol and opioid dependence and a dearth of professional treatment options. In the post-Soviet period, Evangelical Christian groups have developed substance user rehabilitation programs to attempt to address substance use and its related problems. Data were collected during 2010 via focus group interviews with participants in three Evangelical rehabilitation programs in the Volga region of the Russian Federation. Themes emerging from the qualitative data analysis process were classified into three broad categories: Typical Day, Personal Background/Decision to Enter Rehabilitation, and Helpful Aspects of Rehabilitation Process.

  5. 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

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

    PubMed

    Dupeyron, Arnaud; Demattei, Christophe; Kouyoumdjian, Pascal; Missenard, Olivier; Micallef, Jean Paul; Perrey, Stéphane

    2013-09-24

    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. 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. 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. 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.

  7. 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

  8. 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.

  9. Development of a novel 3-month drug releasing risperidone microspheres

    PubMed Central

    Yerragunta, Bhanusree; Jogala, Satheesh; Chinnala, Krishna Mohan; Aukunuru, Jithan

    2015-01-01

    Objective: The purpose of this study was to develop an ideal microsphere formulation of risperidone that would prolong the drug release for 3 months in vivo and avoid the need for co-administration of oral tablets. Materials and Methods: Polycaprolactones (PCL) were used as polymers to prepare microspheres. The research included screening and optimizing of suitable commercial polymers of variable molecular weights: PCL-14000, PCL-45000, PCL-80000 or the blends of these polymers to prepare microspheres with zero-order drug-releasing properties without the lag phase. In the present study, the sustained release risperidone microspheres were prepared by o/w emulsion solvent evaporation technique and the yield was determined. Microspheres were evaluated for their drug content and in vitro drug release. Microspheres prepared using a blend of PCL-45000 and PCL-80000 at a ratio of 1:1 resulted in the release of the drug in a time frame of 90 days, demonstrated zero-order drug release without lag time and burst release. This formulation was considered optimized formulation. Optimized formulation was characterized for solid state of the drug using differential scanning calorimetry, surface morphology using scanning electron microscopy and in vivo drug release in rats. Results: The surface of the optimized formulation was smooth, and the drug changed its physical form in the presence of blends of polymers and upon fabrication of microspheres. The optimized formulation also released the drug in vivo for a period of 90 days. Conclusions: From our study, it was concluded that these optimized microspheres showed great potential for a better depot preparation than the marketed Risperdal Consta™ and, therefore, could further improve patient compliance. PMID:25709335

  10. Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study

    PubMed Central

    2013-01-01

    Background Musculoskeletal disorders (MSDs) are a major reason for impaired work productivity and sick leave. In 2009, a national rehabilitation program was introduced in Sweden to promote work ability, and patients with MSDs were offered multimodal rehabilitation. The aim of this study was to analyse the effect of this program on health related quality of life, function, sick leave and work ability. Methods We conducted a prospective, observational cohort study including 406 patients with MSDs attending multimodal rehabilitation. Changes over time and differences between groups were analysed concerning function, health related quality of life, work ability and sick leave. Regression analyses were used to study the outcome variables health related quality of life (measured with EQ-5D), and sick leave. Results Functional ability and health related quality of life improved after rehabilitation. Patients with no sick leave/disability pension the year before rehabilitation, improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation (p = 0.044). During a period of −/+ four months from rehabilitation start, patients with EQ-5D ≥ 0.5 at rehabilitation start, reduced their net sick leave days with 0.5 days and patients with EQ-5D <0.5 at rehabilitation start, increased net sick leave days with 1.5 days (p = 0.019). Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension, problems with exercise tolerance functions and mobility after rehabilitation. Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D ≥ 0.5 at follow-up. Severe pain after rehabilitation, problems with exercise tolerance functions, born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up. Conclusions Patients with MSDs

  11. Evaluation of the effectiveness of a phonoaudiology program for the rehabilitation of dysphagia in the elderly.

    PubMed

    Santoro, P; e Silva, I L; Cardoso, F; Dias, E; Beresford, H

    2011-01-01

    The object of this study was to evaluate the effectiveness of a phonoaudiology rehabilitation program directed towards the degenerative changes of the neurophysiological mechanisms responsible for the upper digestive system compromised by the age between 80 and 90 years, in a regime of internment in a long permanence institution in the city of Rio de Janeiro, which express, bodily, their difficulty in swallowing food of liquid or pasty consistency. To achieve such an object, the current study was developed in an experimental format or design, comprised of a sample group of 23 elderly subjects, of both genders, undergoing evaluation by the phonoaudiology protocol for evaluating the risk of dysphagia (abbreviated from the Portuguese name: Protocolo de Avaliação do Risco para Disfagia=PARD), pre- and post-intervention procedure. The developed program used the indirect therapy approach based on the adaptive myotherapeutic and myofunctional stimulation, contemplating two isometric and isokinetic orofacial active myotherapeutic exercises, two passive myotherapeutic manipulations for the supra-hyoidal musculature, as well as adaptive cephalic postural maneuvres, associated to the intra-oral olfactive and gustative sensory stimulation. The evolution of the individuals was analyzed before and after the therapy by estimating the capacity of swallowing food in the liquid fluid (LF) consistency, by the paired Student t-test, giving a p=0.01, making the difference of 2.31 between the 2 evaluations statistically significant. The changes produced by the PARD program in the capacity of individuals in swallowing food of a pasty consistency were also significant when analyzing the variance of the results on the 2 instances by using the F-test (pre- and post-intervention difference=4.47, p=0.039). Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Factors Affecting Attendance at an Adapted Cardiac Rehabilitation Exercise Program for Individuals with Mobility Deficits Poststroke.

    PubMed

    Marzolini, Susan; Balitsky, Amaris; Jagroop, David; Corbett, Dale; Brooks, Dina; Grace, Sherry L; Lawrence, Danielle; Oh, Paul I

    2016-01-01

    The aim of this study was to determine the factors affecting attendance at an adapted cardiac rehabilitation program for individuals poststroke. A convenience sample of ambulatory patients with hemiparetic gait rated 20 potential barriers to attendance on a 5-point Likert scale upon completion of a 6-month program of 24 prescheduled weekly sessions. Sociodemographic characteristics, depressive symptoms, cardiovascular fitness, and comorbidities were collected by questionnaire or medical chart. Sixty-one patients attended 77.3 ± 12% of the classes. The longer the elapsed time from stroke, the lower the attendance rate (r = -.34, P = .02). The 4 greatest barriers influencing attendance were severe weather, transportation problems, health problems, and traveling distance. Health problems included hospital readmissions (n = 6), influenza/colds (n = 6), diabetes and cardiac complications (n = 4), and musculoskeletal issues (n = 2). Of the top 4 barriers, people with lower compared to higher income had greater transportation issues (P = .004). Greater motor deficits of the stroke-affected leg were associated with greater barriers related to health issues (r = .7, P = .001). The only sociodemographic factor associated with a higher total mean barrier score was non-English as the primary language spoken at home (P = .002); this factor was specifically related to the barriers of cost (P = .007), family responsibilities (P = .018), and lack of social support (P = .001). No other associations were observed. Barriers to attendance were predominantly related to logistic/transportation and health issues. People who were more disadvantaged socioeconomically (language, finances), and physically (stroke-related deficits) were more affected by these barriers. Strategies to reduce these barriers, including timely referral to exercise programs, need to be investigated. Copyright © 2015 National Stroke Association. Published by

  13. [Retinoblastoma: inventory in Mali and program to develop early diagnosis, treatments and rehabilitation].

    PubMed

    Traore, Fousseyni; Togo, Boubacar; Sylla, Fatoumata; Cheick, Traoré B; Diakité, Abdoul-Aziz; Dicko-Traore, Fatoumata; Sylla, Mariam; Sidibé, Toumani; Doz, François; Harif, M'hamed; Bey, Pierre; Desjardins, Laurence

    2013-02-01

    Retinoblastoma (RB) is a rare embryonic tumour that represents 1/16,000 births in France. In Mali, a study showed the characteristics of a hospital series of cases seen in Bamako in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital and in the Tropical Ophthalmology Institute of Africa (IOTA) between January 2005 and June 2007. Median age was 4 years versus 2 years in France for unilateral disease. Near two third of children with RB had extra-ocular extension at diagnosis, which is now exceptional in France. Only 11% were bilateral versus 35% in France. Cure rate was around 50%, but it is estimated only on the cases arriving in Bamako and with at least 20% lost of follow-up. Cure rate is over 95% in France within an exhaustive register. RB appears as an exemplary tumor and rapid improvements could be obtained in low-income countries with relatively limited means. This is why, the Alliance mondiale contre le cancer (AMCC), the Institut Curie in Paris, which is the reference center in France for RB, and teams in Bamako were proposing a program to help the development of early diagnosis, treatments, including eye preservation, and rehabilitation of children with RB in sub-Saharan Africa in collaboration with the Groupe franco-africain d'oncologie pédiatrique (GFAOP). The official launching of this program was held in Bamako November 4, 2011 for Mali and the surrounding regions. After this first experience, this program is now implemented in other countries.

  14. Benzodiazepine use in patients with chronic pain in an interdisciplinary pain rehabilitation program.

    PubMed

    Cunningham, Julie L; Craner, Julia R; Evans, Michele M; Hooten, W Michael

    2017-01-01

    In the context of widespread opioid use, increased emphasis has been placed on the potentially deleterious effects of concurrent benzodiazepine (BZD) and opioid use. Although use of opioids in chronic pain has been a major focus, BZD use is equally concerning. Thus, the primary aim of this study was to determine the associations between BZD and opioid use in adults with chronic pain upon admission to an outpatient interdisciplinary pain rehabilitation (IPR) program. The study cohort involved 847 consecutive patients admitted to a 3-week outpatient IPR program from January 2013 through December 2014. Study variables included baseline demographic and clinical characteristics, Center for Epidemiologic Studies-Depression Scale, Pain Catastrophizing Scale, and the pain severity subscale of the Multidimensional Pain Inventory. Upon admission, 248 (29%) patients were taking BZDs. Patients using BZDs were significantly more likely to use opioids and to be female. Additionally, patients using BZDs had significantly greater depression, pain catastrophizing, and pain severity scores. In univariable logistic regression analysis, opioid use, female sex, and greater scores of depression, pain catastrophizing, and pain severity were significantly associated with BZD use. In multivariable logistic regression analysis adjusted for age, sex, pain duration, opioid use, depression, pain catastrophizing, and pain severity, only female sex and greater depression scores were significantly associated with BZD use. Among patients participating in an outpatient IPR program, female sex and greater depression scores were associated with BZD use. Results identify a high prevalence of BZD use in patients with chronic pain and reinforce the need to weigh the risks versus benefits when prescribing in this patient population.

  15. Benzodiazepine use in patients with chronic pain in an interdisciplinary pain rehabilitation program

    PubMed Central

    Cunningham, Julie L; Craner, Julia R; Evans, Michele M; Hooten, W Michael

    2017-01-01

    Objectives In the context of widespread opioid use, increased emphasis has been placed on the potentially deleterious effects of concurrent benzodiazepine (BZD) and opioid use. Although use of opioids in chronic pain has been a major focus, BZD use is equally concerning. Thus, the primary aim of this study was to determine the associations between BZD and opioid use in adults with chronic pain upon admission to an outpatient interdisciplinary pain rehabilitation (IPR) program. Methods The study cohort involved 847 consecutive patients admitted to a 3-week outpatient IPR program from January 2013 through December 2014. Study variables included baseline demographic and clinical characteristics, Center for Epidemiologic Studies-Depression Scale, Pain Catastrophizing Scale, and the pain severity subscale of the Multidimensional Pain Inventory. Results Upon admission, 248 (29%) patients were taking BZDs. Patients using BZDs were significantly more likely to use opioids and to be female. Additionally, patients using BZDs had significantly greater depression, pain catastrophizing, and pain severity scores. In univariable logistic regression analysis, opioid use, female sex, and greater scores of depression, pain catastrophizing, and pain severity were significantly associated with BZD use. In multivariable logistic regression analysis adjusted for age, sex, pain duration, opioid use, depression, pain catastrophizing, and pain severity, only female sex and greater depression scores were significantly associated with BZD use. Discussion Among patients participating in an outpatient IPR program, female sex and greater depression scores were associated with BZD use. Results identify a high prevalence of BZD use in patients with chronic pain and reinforce the need to weigh the risks versus benefits when prescribing in this patient population. PMID:28223841

  16. Resident selection for a physical medicine and rehabilitation program: feasibility and reliability of the multiple mini-interview.

    PubMed

    Finlayson, Heather C; Townson, Andrea F

    2011-04-01

    The development of a process to select the best residents for training programs is challenging. There is a paucity of literature to support the implementation of an evidence-based approach or even best practice for program directors and selection committees. Although assessment of traditional academic markers such as clerkship grades and licensing examination scores can be helpful, these measures typically fail to capture performance in the noncognitive domains of medicine. In the specialty of physical medicine and rehabilitation, physician competencies such as communication, health advocacy, and managerial and collaborative skills are of particular importance, but these are often difficult to evaluate in admission interviews. Recent research on admission processes for medical schools has demonstrated reliability and validity of the "multiple mini-interview." The objective of our project was to develop and evaluate the multiple mini-interview for a physical medicine and rehabilitation residency training program, with a focus on assessment of the noncognitive physician competencies. We found that the process was feasible, time efficient, and cost-efficient and that there was good interrater reliability. The multiple mini-interview may be applied to other physical medicine and rehabilitation residency programs. Further research is needed to confirm reliability and determine validity.

  17. Rehabilitation in the Punitive Era: The Gap between Rhetoric and Reality in U.S. Prison Programs.

    PubMed

    Phelps, Michelle S

    2011-03-01

    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.

  18. Athletic trainers' and physical therapists' perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs.

    PubMed

    Hamson-Utley, J Jordan; Martin, Scott; Walters, Jason

    2008-01-01

    Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited. To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes. The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation. Professional member databases of the National Athletic Trainers' Association and the American Physical Therapy Association. Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age = 34.18 +/- 8.32 years, years in profession = 10.67 +/- 7.34) and 356 PTs (age = 38.58 +/- 7.51 years, years in profession = 13.18 +/- 6.17) responded. The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach alphas ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals' education, training experience, and interest. Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P < .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P < .05). Overall, ATs and PTs held positive

  19. Benefits of Centralized Scheduling in a Postacute Residential Rehabilitation Program for People With Acquired Brain Lesions: A Pilot Study.

    PubMed

    Vestri, Alec; Pizzighello, Silvia; Piccoli, Sara; Martinuzzi, Andrea

    2017-04-01

    To determine whether the use of a designated staff person to coordinate and schedule therapy services in a postacute residential rehabilitation program for people with acquired brain lesions results in (1) a higher-intensity treatment and a reduced length of stay; (2) reduced rehabilitation costs; and (3) increased patient and staff satisfaction. This nonrandomized retrospective study from 2009 through 2012 uses data collected relative to 2 different methods of scheduling: (1) self-planning, in which each single team member makes appointments that are then displayed on a shared board; and (2) managed planning, in which appointments are made by a designated staff person. A residential center for people with postacute acquired brain lesions. Patients (N=20) with acquired brain lesions who had similar clinical and demographic characteristics comprised the managed planning group (n=10) and the self-planning group (n=10). Not applicable. Organizational measures (length of stay in rehabilitation, number of treatment hours, total cost of rehabilitation), clinical outcome scales (Disability Rating Scale, FIM, and Barthel Index), perceived quality of treatment by patients (questionnaire), and perceived satisfaction of team members (Job Descriptive Index). All patients improved on all clinical rating scales at the time of discharge (all effect sizes are large). In the managed planning group, the number of treatment hours increased (Cohen's d=2.15), resulting in reduced length of stay (Cohen's d=.95) and cost of rehabilitation (Cohen's d=1.22). In addition, the quality of treatment perceived by the patients and their families increased, while team member satisfaction did not change. The use of a designated staff person to manage therapy services improves efficiency and efficacy of a patient-centered health care system. The proposed scheduling system results in a remarkable cost saving for the National Health System. Copyright © 2017 American Congress of Rehabilitation

  20. 20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Work incentive experiments and rehabilitation... Continuing Or Stopping Disability § 404.1599 Work incentive experiments and rehabilitation demonstration... Disability Amendments of 1980, Pub. L. 96-265, directs the Commissioner to develop and conduct...

  1. 20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Work incentive experiments and rehabilitation... Continuing Or Stopping Disability § 404.1599 Work incentive experiments and rehabilitation demonstration... Disability Amendments of 1980, Pub. L. 96-265, directs the Commissioner to develop and conduct...

  2. 78 FR 16447 - Rehabilitation Continuing Education Program (RCEP) for the Technical Assistance and Continuing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ... vocational rehabilitation (VR) agencies and agency partners that cooperate with State VR agencies in providing VR and other rehabilitation services (e.g., Centers for Independent Living (CILs), Client... following outcomes: Improved quality of VR services, increased effectiveness and efficiency of State VR...

  3. "They Shall Walk Again!" The Physical Rehabilitation Program of the UMWA Welfare and Retirement Fund.

    ERIC Educational Resources Information Center

    Mulcahy, Richard

    1994-01-01

    Discusses the history of the United Mine Workers Welfare and Retirement Fund and its efforts in providing physical rehabilitation and job retraining to disabled miners. Created in 1946, the fund was successful in providing vocational rehabilitation services to over 1,200 miners and could serve as a model of a comprehensive cost-effective approach…

  4. 20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Work incentive experiments and rehabilitation... Continuing Or Stopping Disability § 404.1599 Work incentive experiments and rehabilitation demonstration... beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will...

  5. "They Shall Walk Again!" The Physical Rehabilitation Program of the UMWA Welfare and Retirement Fund.

    ERIC Educational Resources Information Center

    Mulcahy, Richard

    1994-01-01

    Discusses the history of the United Mine Workers Welfare and Retirement Fund and its efforts in providing physical rehabilitation and job retraining to disabled miners. Created in 1946, the fund was successful in providing vocational rehabilitation services to over 1,200 miners and could serve as a model of a comprehensive cost-effective approach…

  6. 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)…

  7. 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.

  8. An explanatory model of functional exercise capacity in patients with systemic sclerosis: considerations for rehabilitation programs

    PubMed Central

    Lopes, Agnaldo José; Ferreira, Arthur de Sá; Lima, Tatiana Rafaela Lemos; Menezes, Sara Lucia Silveira; Guimarães, Fernando Silva

    2016-01-01

    [Purpose] This study aimed to evaluate the impact of lung function and peripheral muscle function on the six-minute walking distance (6MWD) in systemic sclerosis (SS) patients and, thereby, to develop an explanatory model of functional exercise capacity for these individuals. [Methods] In a cross-sectional study, 31 SS patients underwent pulmonary function testing (including spirometry, diffusing capacity for carbon monoxide [DLCO], and respiratory muscle strength), isometric dynamometry with surface electromyography, and the 6MWD. [Results] There was a significant correlation between the 6MWD (% predicted, 6MWD%) and the following parameters: height (r = 0.427) and DLCO (r = 0.404). In contrast, no other independent variable showed a significant correlation with the 6MWD% (r ≤ 0.257). The final prediction model for 6MWD% (adjusted R2 = 0.456, SE of bias=12%) was 6MWD% Gibbons = −131.3 + 1.16 × heightcm + 0.33 × DLCO% predicted. [Conclusion] In SS patients, body height and pulmonary diffusion are the main determinants of the 6MWD. Our results justify further investigation of the performance of SS patients during exercise, which may increase the understanding of the pathophysiological mechanisms involved in the disease. The impact of these findings in SS patients may be useful for evaluating the effects of rehabilitation programs. PMID:27065545

  9. Inpatient cardiac rehabilitation programs' exercise therapy for patients undergoing cardiac surgery: National Korean Questionnaire Survey.

    PubMed

    Seo, Yong Gon; Jang, Mi Ja; Park, Won Hah; Hong, Kyung Pyo; Sung, Jidong

    2017-02-01

    Inpatient cardiac rehabilitation (ICR) has been commonly conducted after cardiac surgery in many countries, and has been reported a lots of results. However, until now, there is inadequacy of data on the status of ICR in Korea. This study described the current status of exercise therapy in ICR that is performed after cardiac surgery in Korean hospitals. Questionnaires modified by previous studies were sent to the departments of thoracic surgery of 10 hospitals in Korea. Nine replies (response rate 90%) were received. Eight nurses and one physiotherapist completed the questionnaire. Most of the education on wards after cardiac surgery was conducted by nurses. On postoperative day 1, four sites performed sitting on the edge of bed, sit to stand, up to chair, and walking in the ward. Only one site performed that exercise on postoperative day 2. One activity (stairs up and down) was performed on different days at only two sites. Patients received education preoperatively and predischarge for preventing complications and reducing muscle weakness through physical inactivity. The results of the study demonstrate that there are small variations in the general care provided by nurses after cardiac surgery. Based on the results of this research, we recommended that exercise therapy programs have to conduct by exercise specialists like exercise physiologists or physiotherapists for patients in hospitalization period.

  10. 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

  11. [Effects of a Four-Week Rehabilitation Program on Motor Performance, Quality of Life and Fatigue in Childhood Cancer Patients and Healthy Siblings].

    PubMed

    Däggelmann, J; Krauth, K A; Mailand, P; Nopper, S; Renniger, M; Bündgen, L; Rustler, V; Bloch, W; Baumann, F T

    2017-04-01

    Aim In Germany all childhood cancer patients and their families are offered the opportunity to participate in a four-week, family-oriented, inpatient rehabilitation program in order to facilitate (re-)integration into everyday life. The aim of this study is to evaluate the effect of this rehabilitation program on motor performance, quality of life (QoL) and fatigue. Methods Motor performance, QoL and fatigue were assessed in 22 childhood cancer patients and 20 healthy siblings at the beginning (t1) and the end (t2) of the four-week rehabilitation program, as well as 6 months later (t3). Results At t1 significant differences between groups were found in motor performance and physical well-being. Improvements in motor performance, QoL and fatigue were found in both groups. Conclusion Different preconditions must be considered. Childhood cancer patients as well as healthy siblings benefit from a family-oriented rehabilitation program.

  12. Horseback riding therapy in addition to conventional rehabilitation program decreases spasticity in children with cerebral palsy: A small sample study.

    PubMed

    Alemdaroğlu, Ebru; Yanıkoğlu, İnci; Öken, Öznur; Uçan, Halil; Ersöz, Murat; Köseoğlu, Belma Füsun; Kapıcıoğlu, Mehmet İsmail Safa

    2016-05-01

    To evaluate the short-term effects of horseback riding therapy in addition to a conventional rehabilitation program in children with cerebral palsy. Nine children receiving horseback riding therapy in addition to conventional rehabilitation (Group 1) and seven children receiving conventional rehabilitation alone (Group 2) were assessed at baseline and 5 weeks later. Assessed were: modified functional reach test (MFRT), hip abduction angle, the Ashworth Scale for hip adductor muscle spasticity, knee distance test, and the Gross Motor Function Classification System (GMFCS). The percentage change in hip adductor spasticity on the Ashworth Scale was 22% in Group 1 and 0% in Group 2 (significant difference; p = 0.016). Comparison of changes on the MFRT, GMFCS, knee distance test and hip abduction angle showed that the differences between Groups 1 and 2 were not significant. In these children, horseback riding therapy in addition to conventional rehabilitation resulted in significant improvement in adductor spasticity on short-term follow-up. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. 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

  14. Does protection motivation theory explain exercise intentions and behavior during home-based cardiac rehabilitation?

    PubMed

    Blanchard, Chris M; Reid, Robert D; Morrin, Louise I; McDonnell, Lisa; McGannon, Kerry; Rhodes, Ryan E; Spence, John C; Edwards, Nancy

    2009-01-01

    Home-based cardiac rehabilitation (CR) programs have been shown to be effective in increasing exercise capacity, which is a significant predictor of longevity for patients with heart disease. However, adherence to these programs has been problematic. Therefore, it is important to identify key theoretical correlates of exercise for these patients that can be used to inform the development of behavioral interventions to help tackle the adherence problem. The purpose of this study was to determine whether protection motivation theory (PMT) explained significant variation in exercise intentions and behavior in patients receiving home-based CR. Patients (N = 76) completed a questionnaire that included PMT constructs at the beginning and midpoint (ie, 3 months) of the program and an exercise scale at 3 and 6 months (ie, at the end of the CR program). Path analyses showed that response efficacy was the sole predictor of 3-month (beta = .53) and 6-month (beta = .32) intentions. However, the indirect effect of baseline response efficacy on 3-month exercise behavior through intention was nonsignificant (beta = -.01), whereas it was significant (beta = .11) for 3-month response efficacy on 6-month exercise behavior. Self-efficacy significantly predicted 3-month (beta = .36) and 6-month (beta = .32) exercise behaviors, whereas 3-month intention significantly predicted 6-month exercise behavior (beta = .23). Coping appraisal variables (ie, response efficacy and self-efficacy) are potentially useful in explaining exercise behavior during home-based CR.

  15. Peak Oxygen Uptake after Cardiac Rehabilitation: A Randomized Controlled Trial of a 12-Month Maintenance Program versus Usual Care

    PubMed Central

    Madssen, Erik; Arbo, Ingerid; Granøien, Ingrid; Walderhaug, Liv; Moholdt, Trine

    2014-01-01

    Background Exercise capacity is a strong predictor of survival in patients with coronary artery disease (CAD). Exercise capacity improves after cardiac rehabilitation exercise training, but previous studies have demonstrated a decline in peak oxygen uptake after ending a formal rehabilitation program. There is a lack of knowledge on how long-term exercise adherence can be achieved in CAD patients. We therefore assessed if a 12-month maintenance program following cardiac rehabilitation would lead to increased adherence to exercise and increased exercise capacity compared to usual care. Materials and Methods Two-centre, open, parallel randomized controlled trial with 12 months follow-up comparing usual care to a maintenance program. The maintenance program consisted of one monthly supervised high intensity interval training session, a written exercise program and exercise diary, and a maximum exercise test every third month during follow-up. Forty-nine patients (15 women) on optimal medical treatment were included following discharge from cardiac rehabilitation. The primary endpoint was change in peak oxygen uptake at follow-up; secondary endpoints were physical activity level, quality of life and blood markers of cardiovascular risk. Results There was no change in peak oxygen uptake from baseline to follow-up in either group (intervention group 27.9 (±4.7) to 28.8 (±5.6) mL·kg (-1) min (−1), control group 32.0 (±6.2) to 32.8 (±5.8) mL·kg (−1) min (−1), with no between-group difference, p = 0.22). Quality of life and blood biomarkers remained essentially unchanged, and both self-reported and measured physical activity levels were similar between groups after 12 months. Conclusions A maintenance exercise program for 12 months did not improve adherence to exercise or peak oxygen uptake in CAD patients after discharge from cardiac rehabilitation compared to usual care. This suggests that infrequent supervised high intensity interval training sessions are

  16. Community perspectives: evaluation of a community-based rehabilitation program in Southern Belize one year post-implementation.

    PubMed

    Magnusson, Dawn; Roe, Monica; Hartman, Jeff

    2017-10-01

    To examine community perspectives regarding the strengths, weaknesses, opportunities, and threats of a community-based rehabilitation (CBR) program in Toledo District, Belize. A participatory approach was implemented using the CBR Matrix as a conceptual framework. Semi-structured interviews were conducted with CBR community partners and program participants living in Toledo District. Respondents were recruited until thematic saturation was achieved (i.e., no new themes were identified from subsequent interviews). Interviews were recorded and transcribed verbatim. Recurring themes were identified using thematic content analysis. Eight CBR community partners and 11 program participants completed interviews. Key strengths of the program included engaging CBR program participants as partners in the decision-making process and raising disability awareness. Key weaknesses of the program included lack of a vocational training program and lack of a systematic approach to identify people with disabilities (PWD) or risk factors for disease and disability. This participatory evaluation provided PWD, their families, and the community the opportunity to express their needs and priorities regarding CBR. Key recommendations included: (1) developing vocational training programs for PWD; (2) expanding collaborations with craftspeople and other community partners throughout Toledo District; (3) continuing the disability awareness program in schools and the broader community; and (4) strengthening community outreach and data collection. Implications for Rehabilitation Persons with disabilities, their families, and community partners should play an active role in the development, implementation, and evaluation of CBR programs to ensure program goals align with community priorities. The CBR evaluation process should strive to include diverse perspectives that represent the most marginalized populations (e.g., individuals with significant disabilities living in geographically remote

  17. Cardiac Rehabilitation

    MedlinePlus

    ... your risk of future heart problems, and to improve your health and quality of life. Cardiac rehabilitation programs increase ... exercise routine at home or at a local gym. You may also continue to ... health concerns. Education about nutrition, lifestyle and weight loss ...

  18. Rehabilitation Aids.

    ERIC Educational Resources Information Center

    National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

    Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers 40 equipment items for rehabilitation and physical therapy programs for all levels of handicapped children. Described are such items as a handygym, a suspension…

  19. Rehabilitation Aids.

    ERIC Educational Resources Information Center

    National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

    Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers 40 equipment items for rehabilitation and physical therapy programs for all levels of handicapped children. Described are such items as a handygym, a suspension…

  20. 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

  1. 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

  2. [Benefits of a home-based pulmonary rehabilitation program for patients with severe chronic obstructive pulmonary disease].

    PubMed

    Regiane Resqueti, Vanessa; Gorostiza, Amaia; Gáldiz, Juan B; López de Santa María, Elena; Casan Clarà, Pere; Güell Rous, Rosa

    2007-11-01

    The benefits of a domiciliary program of pulmonary rehabilitation for patients with severe to very severe chronic obstructive pulmonary disease (COPD) are uncertain. We aimed to assess the short- and medium-term efficacy of such a program in this clinical setting. Patients with severe COPD (stages III-IV, classification of the Global Initiative for Chronic Obstructive Lung Disease) and incapacitating dyspnea (scores 3-5, Medical Research Council [MRC] scale) were randomized to a control or domiciliary rehabilitation group. The 9-week supervised pulmonary rehabilitation program included educational sessions, respiratory physiotherapy, and muscle training in weekly sessions in the patient's home. We assessed the following variables at baseline, 9 weeks, and 6 months: lung function, exercise tolerance (3-minute walk test), dyspnea (MRC score), and health-related quality of life with the Chronic Respiratory Questionnaire (CRQ). Thirty-eight patients with a mean (SD) age of 68 (6) years were enrolled. The mean MRC score was 4 (0.8) and mean forced expiratory volume in 1 second was 29% of reference. Twenty-nine patients completed the study (6 months). Distance covered on the walk test increased significantly in the rehabilitation group (P=.001) and the difference was maintained at 6 months. Dyspnea also improved significantly with rehabilitation (P<.05), but the reduction was not evident at 6 months. Statistically significant improvements in symptoms related to 2 CRQ domains were detected between baseline and 9 weeks: dyspnea (3.1 [0.8] vs 3.6 [0.7]; P=.02) and fatigue (3.7 [0.8] vs 4.2 [0.9]; P=.002). A clinically relevant but not statistically significant change in mastery over disease was detected (from 4.3 to 4.9). All improvements were maintained at 6 months. Home-based pulmonary rehabilitation for patients with severe to very severe COPD and severe functional incapacity leads to improvements in exercise tolerance and health-related quality of life that are

  3. Synergistic effect of a rehabilitation program and treadmill exercise on pain and dysfunction in patients with chronic low back pain

    PubMed Central

    Cho, Young-Ki; Kim, Dae-Young; Jung, Sun-Young; Seong, Jun-Hyuk

    2015-01-01

    [Purpose] The present study examined the influence of treadmill exercise added to a low back pain rehabilitation program on low back extensor strength, pain, and dysfunction in chronic low back pain patients. [Subjects and Methods] Twenty men aged 22–36 years with chronic low back pain were randomly divided into experimental and control groups of 10 patients each. Both groups underwent a low back pain rehabilitation program lasting 30 min each, thrice/week for 8 weeks. The experimental group was prescribed an additional 30 min of treadmill exercise without a slope at a speed of 3.0–3.5 km/h, at which patients could walk comfortably. Low back extensor strength was tested using the Medx lumbar extension machine, pain level was tested, using the visual analog scale, and dysfunction was tested, using the Oswestry Low Back Pain Disability Questionnaire. [Results] Changes in low back extensor strength by angle showed significant interaction effects between measurement time and group at 12°, 24°, and 36°. The results of the visual analog scale and Oswestry Questionnaire showed a decreasing trend after the experiment in both groups. However, there was no interaction effect of the additional treadmill exercise in the experimental group. [Conclusion] The combination of a low back pain rehabilitation program and treadmill exercise has a synergistic effect, to some extent, on the improvement of low back extensor strength and should be considered for treatment and rehabilitation of low back pain patients. PMID:25995585

  4. Relation of Urinary Retention and Functional Recovery in Stroke Patients During Rehabilitation Program

    PubMed Central

    2017-01-01

    Objective To investigate the relationship between urinary retention and short-term functional recovery in subacute stage after stroke. Methods The medical records of 94 patients admitted to the rehabilitation unit of Korea University Guro Hospital were reviewed retrospectively. The postvoid residual urine (PVR) was measured at least once a day using a bladder scan, and urinary retention (UR) was defined when the daily PVR volume consistently checked more than 100 mL. Clinical data and functional outcomes of patients in the rehabilitation ward were collected. Functional outcomes were measured using the Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Functional Ambulation Category (FAC) level, Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) at admission (or transfer) and discharge. The data of patients with and without urinary retention were compared and analyzed. Results Of the 94 participants, 25 patients were classified to the UR group and 69 were classified to the non-UR group. At the initial stage of rehabilitation, the scores of MMSE, BBS, FAC, MBI were significantly worse in the UR group (p<0.05). Both groups showed significant improvements of all functional outcomes after rehabilitation (p<0.05). The non-UR group showed more prominent recovery of BBS, FAC, MBI scores (p<0.05). Conclusion Urinary retention in post-stroke patients is significantly related to the poor functional status at initial stage of rehabilitation, and also to poor recovery after rehabilitation. PMID:28503452

  5. Utility of Walk Tests in Evaluating Functional Status Among Participants in an Outpatient Cardiac Rehabilitation Program.

    PubMed

    Harris, Kristie M; Anderson, Derek R; Landers, Jacob D; Emery, Charles F

    2017-09-01

    Although walk tests are frequently used in cardiac rehabilitation (CR), no prior study has evaluated the capacity of these measures to predict peak oxygen uptake during exercise testing ((Equation is included in full-text article.)O2peak). This study evaluated the interrelationship of objective measures of exercise performance (walk and exercise testing) among patients entering CR as well as a novel measure of functional status assessment for use in CR. Forty-nine patients (33 males) referred to an outpatient CR program were evaluated with objective measures of ambulatory functional status (peak oxygen uptake [(Equation is included in full-text article.)O2peak], 6-minute walk test [6MWT], and 60-ft walk test [60ftWT]). All measures of functional status were moderately to highly intercorrelated (r values from 0.50 to 0.88; P values < .05). The relationship among measures differed by sex, but not by age or diagnosis. Among men, results were generally consistent with the full sample. Among women, the magnitude of correlations was generally lower and there was no relationship between (Equation is included in full-text article.)O2peak and other measures. Measures of functional status, including (Equation is included in full-text article.)O2peak, 6MWT, and 60ftWT, were highly correlated among CR patients, suggesting the plausibility of using them interchangeably to fit the needs of the patient and testing environment. Among women, walk tests may not be appropriate substitutes for (Equation is included in full-text article.)O2peak. Because of the brevity of the 60ftWT, it may be particularly useful for measuring functional status in patients with greater symptoms and those with comorbidities limiting walking.

  6. 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

  7. Effects of a 4-Week Multimodal Rehabilitation Program on Quality of Life, Cardiopulmonary Function, and Fatigue in Breast Cancer Patients

    PubMed Central

    Do, Junghwa; Cho, Youngki

    2015-01-01

    Purpose This study examines the effects of a rehabilitation program on quality of life (QoL), cardiopulmonary function, and fatigue in breast cancer patients. The program included aerobic exercises as well as stretching and strengthening exercises. Methods Breast cancer patients (n=62) who had completed chemotherapy were randomly assigned to an early exercise group (EEG; n=32) or a delayed exercise group (DEG; n=30). The EEG underwent 4 weeks of a multimodal rehabilitation program for 80 min/day, 5 times/wk for 4 weeks. The DEG completed the same program during the next 4 weeks. The European Organization for Research and Treatment of Cancer-Core Quality of Life Questionnaire (EORTC QLQ-C30), EORTC Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption (VO2max), and fatigue severity scale (FSS) were used for assessment at baseline, and at 2, 4, 6, and 8 weeks. Results After 8 weeks, statistically significant differences were apparent in global health, physical, role, and emotional functions, and cancer-related symptoms such as fatigue and pain, nausea, and dyspnea on the EORTC QLQ-C30; cancer-related symptoms involving the arm and breast on the EORTC QLQ-BR23; the predicted VO2max; muscular strength; and FSS (p<0.050), according to time, between the two groups. Conclusion The results of our study suggest that a supervised multimodal rehabilitation program may improve the physical symptoms, QoL, and fatigue in patients with breast cancer. PMID:25834616

  8. Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial.

    PubMed

    da Silva, Flávio S; de Melo, Flávio E S; do Amaral, Marcelo M G; Caldas, Vinícius V A; Pinheiro, Íria Lúcia D; Abreu, Bento J; Vieira, Wouber H

    2015-01-01

    We investigated the role of an evidence-based integrated group rehabilitation program on the treatment of patients with knee osteoarthritis (KOA). This was a two-group, randomized controlled, 8 wk trial with 41 patients with moderate to very severe KOA. Patients were assigned to an intervention group (IG) or control group (CG). After both groups had received a self-management education program, IG participants underwent a rehabilitation program, including educational aspects about KOA followed by exercises. CG participants received only general health orientation about KOA during this period. The outcome measures were the Lequesne algofunctional index; 36-Item Short Form Health Survey (SF-36); and chair-stand, sit-and-reach, timed up-and-go, and 6-minute walk tests. Analysis of covariance revealed significant postintervention improvements of IG participants compared with CG participants (p < 0.05) on Lequesne total score and pain and function subdomains; SF-36 physical function, role physical, bodily pain, general health, vitality, and role emotional subdomains; and performance assessed by chair-stand, timed up-and-go, and 6-minute walk tests. Focusing on the primary outcome (Lequesne total score), the mean +/- standard deviation after 8 wk was 5.50 +/- 2.98 for the IG and 7.87 +/- 3.48 for the CG (p = 0.009). The corresponding effect size (partial eta squared with 90% confidence interval) was 0.23 (0.04-0.42), indicating a large effect. The presented rehabilitation program reduced pain and improved quality of life and function in patients with KOA. ClinicalTrials.gov; Progressive Collective-exercise Program on the Knee Osteoarthritis; NCT01850862; https://clinicaltrials.gov/ct2/show/NCT01850862?term=NCT01850862&rank=1.

  9. Comparison of Cardiac Rehabilitation Programs Combined with Relaxation and Meditation Techniques on Reduction of Depression and Anxiety of Cardiovascular Patients

    PubMed Central

    Delui, Mahdy Hassanzadeh; Yari, Maliheh; khouyinezhad, Gholamreza; Amini, Maral; Bayazi, Mohammad Hosein

    2013-01-01

    Cardiovascular disease (CVD) is a major cause of death in developed countries. Most cardiac rehabilitation programs include psychological interventions. The aim of this study was to determine the effectiveness of rehabilitation techniques in cardiac patients including psychological-physical interventions such as Meditation and Relaxation. We enrolled 45 patients with CVD and depression. The patients were allocated to 3 groups (Relaxation, Meditation and Control). There was a significant reduction on depression, systolic blood pressure and heart rate in the Meditation group compared with the control group. Our findings suggest that meditation techniques have better outcomes in cardiac patients for improving depression, reduction of systolic and diastolic blood pressure, and heart rate than relaxation techniques. PMID:24179555

  10. Spitting in the Ocean: Realistic Expectations of the Impact of Driver Alcohol Education and Rehabilitation Programs on the Problem of Drunk Driving.

    ERIC Educational Resources Information Center

    Waller, Patricia F.

    Alcohol education and rehabilitation programs are widely accepted as an integral part of the enforcement of drunk driving laws; however, careful evaluations of these programs generally fail to show subsequent beneficial effects on traffic crashes. This fact is due in part to the many barriers to conducting sound program evaluations and in part to…

  11. Spitting in the Ocean: Realistic Expectations of the Impact of Driver Alcohol Education and Rehabilitation Programs on the Problem of Drunk Driving.

    ERIC Educational Resources Information Center

    Waller, Patricia F.

    Alcohol education and rehabilitation programs are widely accepted as an integral part of the enforcement of drunk driving laws; however, careful evaluations of these programs generally fail to show subsequent beneficial effects on traffic crashes. This fact is due in part to the many barriers to conducting sound program evaluations and in part to…

  12. Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation: what are the predictors of dropout?

    PubMed

    Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B

    2013-01-01

    To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation (PR) in the rehabilitation center. Adherence (yes/no) to the maintenance program was assessed by a self-reported questionnaire, where adherence was defined as attending the maintenance program 1 year after PR. Early dropouts received a self-reported questionnaire after 6 months and the remaining patients after 12 months. Lung function, exercise capacity, exercise self-efficacy, illness perceptions, health-related quality of life, levels of anxiety and depression, duration of PR, and the number of exacerbations were studied as possible predictors of adherence. Ten patients died or were lost to followup. Of the remaining 60 patients, 73.3% and 63.3% were adherent to the maintenance exercise program after 6 and 12 months, respectively. Forced expiratory volume in 1 second (FEV1) (P = .021), Hospital Anxiety and Depression Scale depression score (P = .025), and duration of PR (P = .018) were significant predictors of adherence to the maintenance program. Adherence to the maintenance exercise program included a 36.7% drop-out rate during the first year after completing PR. Experiencing exacerbations was the most reported reason for dropout. Poorer lung function, shorter initial PR course measured by reviewing patient records, and higher level of depressive symptoms were predictive of drop-out to the maintenance program. Adherence to the maintenance program needs to be improved for patients with lower FEV1, with signs of depression, or with a shorter initial PR course.

  13. Verification of the mediation effect of recovery resilience according to the relation between elderly users’ participation in exercise rehabilitation program and their successful aging

    PubMed Central

    Cho, Min-soo

    2014-01-01

    This study aims to verify the mediation effect of recovery resilience according to the relation between Senior Citizen Community Center (SCCC) elderly users’ participation in exercise rehabilitation programs and their successful aging. Toward that end, 400 65-yr or older participants and non-participants in SCCCs’ exercise rehabilitation programs, living in Incheon, were sampled. Of their answered questionnaires, 35 copies which were deemed low-reliability, duplicated, and inadequately specified were excluded from the analysis. And, the other data were coded through computers, and underwent a descriptive statistical analysis (DSA) and a standard multiple regression analysis (SMRA) using Windows SPSS/PC+21.0 Version statistical program. Thus it was firstly found that elderly people’s participation or non-participation in exercise rehabilitation programs partially influenced their recovery resilience and successful aging. The participants group, compared with the non-participants group, had greater recovery resilience and experienced successful aging. Second, the relation between the degree of participation in exercise rehabilitation programs, recovery resilience and successful aging revealed that the longer and the more frequent the participation in exercise rehabilitation programs was, the greater the recovery resilience was and the more successful aging was. Third, the verification of the mediation effect of recovery resilience in the relation between the program participation degree and the successful aging revealed that, compared with those of the model of direct effects of independent variables and dependent variables, the recovery resilience-mediated model’s verification power and explanation power were greater. PMID:25426471

  14. Verification of the mediation effect of recovery resilience according to the relation between elderly users' participation in exercise rehabilitation program and their successful aging.

    PubMed

    Cho, Min-Soo

    2014-10-01

    This study aims to verify the mediation effect of recovery resilience according to the relation between Senior Citizen Community Center (SCCC) elderly users' participation in exercise rehabilitation programs and their successful aging. Toward that end, 400 65-yr or older participants and non-participants in SCCCs' exercise rehabilitation programs, living in Incheon, were sampled. Of their answered questionnaires, 35 copies which were deemed low-reliability, duplicated, and inadequately specified were excluded from the analysis. And, the other data were coded through computers, and underwent a descriptive statistical analysis (DSA) and a standard multiple regression analysis (SMRA) using Windows SPSS/PC+21.0 Version statistical program. Thus it was firstly found that elderly people's participation or non-participation in exercise rehabilitation programs partially influenced their recovery resilience and successful aging. The participants group, compared with the non-participants group, had greater recovery resilience and experienced successful aging. Second, the relation between the degree of participation in exercise rehabilitation programs, recovery resilience and successful aging revealed that the longer and the more frequent the participation in exercise rehabilitation programs was, the greater the recovery resilience was and the more successful aging was. Third, the verification of the mediation effect of recovery resilience in the relation between the program participation degree and the successful aging revealed that, compared with those of the model of direct effects of independent variables and dependent variables, the recovery resilience-mediated model's verification power and explanation power were greater.

  15. Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

    PubMed

    Hunt, Anne W; De Feo, Luciano; Macintyre, Jennifer; Greenspoon, Dayna; Dick, Talia; Mah, Katherine; Paniccia, Melissa; Provvidenza, Christine; Reed, Nick

    2016-08-17

    Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

  16. 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

  17. Pulmonary rehabilitation in the acute inpatient rehabilitation hospital.

    PubMed

    Glassman, S J

    1998-03-01

    In closing, pulmonary rehabilitation in an inpatient rehabilitation hospital is not a new idea, but is now becoming more popular as the burden of care shifts away from the acute care hospital. Pulmonary rehabilitation has been demonstrated to be cost-effective, improve quality of life, and decrease the number of future hospital days for the patient. A few surveys have shown, however, that only 5% of pulmonary rehabilitation programs serviced inpatients in a rehabilitation hospital, and only 1% of 283 programs had a physiatrist as the medical director of the pulmonary rehabilitation program. Nine percent of programs surveyed serviced inpatients in rehabilitation units within the acute care hospital. Clearly, the majority of pulmonary rehabilitation programs are on an outpatient basis, and many of these are located within the walls of a rehabilitation hospital. Effective pulmonary rehabilitation can be done in the home setting when combined with outpatient therapy visits over a 12-week duration. The spectrum of pulmonary rehabilitation will continue to evolve into the twenty-first century, and clearly the rehabilitation hospital will be part of that change. Whether caring for very elderly COPD patients who are too debilitated to return home from the acute care hospital or managing ventilator-dependent patients with COPD, spinal cord injury, or neuromuscular disease, the IPR team and the rehabilitation hospital will have to demonstrate cost-effective outcomes. Physiatrists should play a major role in this evolution, on both a patient-benefit level and legislative level, to increase awareness of pulmonary rehabilitation.

  18. The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program.

    PubMed

    Scovil, Carol Y; Flett, Heather M; McMillan, Lan T; Delparte, Jude J; Leber, Diane J; Brown, Jacquie; Burns, Anthony S

    2014-09-01

    To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks. Quality improvement. SCI Rehabilitation Center. Inpatients admitted January 2012 to July 2013. Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges. Implementation processes (e.g. staff training) and BPI outcomes (completion rates). Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation). Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education.

  19. The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program

    PubMed Central

    Scovil, Carol Y.; Flett, Heather M.; McMillan, Lan T.; Delparte, Jude J.; Leber, Diane J.; Brown, Jacquie; Burns, Anthony S.

    2014-01-01

    Objectives To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks. Design Quality improvement. Setting SCI Rehabilitation Center. Participants Inpatients admitted January 2012 to July 2013. Interventions Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges. Outcome Measures Implementation processes (e.g. staff training) and BPI outcomes (completion rates). Results Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation). Conclusion Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education. PMID:25029674

  20. Best Practice Models of Effective Vocational Rehabilitation Service Delivery in the Public Rehabilitation Program: A Review and Synthesis of the Empirical Literature

    ERIC Educational Resources Information Center

    Fleming, Allison R.; Del Valle, Roy; Kim, Muwoong; Leahy, Michael J.

    2013-01-01

    Rehabilitation counselors and practitioners are under increased pressure to adopt and pursue evidenced-based practices, and the rehabilitation counseling literature has been criticized for a lack of empirical work providing support for individual-level interventions. The purpose of this literature review was to examine the last 25 years of…