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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

Experiences of women with stress-related ill health in a therapeutic gardening program.

PubMed

Eriksson, Therese; Westerberg, Yvonne; Jonsson, Hans

2011-12-01

Stress-related ill health, e.g. burnout, is of great concern worldwide. Effective rehabilitation programs need to be developed and their therapeutic aspects understood. To explore and describe how women with stress-related ill health who are on sick leave experience the rehabilitation process in a therapeutic garden and how these experiences connect to their everyday lives. This longitudinal study used methods from grounded theory. Five women completed three semi-structured interviews at three weekly intervals during rehabilitation and one interview three months after. Data were analyzed using a constant comparative approach. A secure environment facilitated engagement in activities that provided feelings of enjoyment. These experiences inspired participants to add enjoyable activities in their everyday lives, contributing to occupational balance, despite worries of not be able to continue performing enjoyable activities. Implications. Effective rehabilitation programs need to focus on enjoyable activities in a protective environment to support achievement of occupational balance.

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

PubMed Central

Dylewicz, Piotr

2015-01-01

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

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

PubMed Central

2016-01-01

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

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

PubMed

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

2016-12-01

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

CURRENT CONCEPTS OF PLYOMETRIC EXERCISE.

PubMed

Davies, George; Riemann, Bryan L; Manske, Robert

2015-11-01

As knowledge regarding rehabilitation science continues to increase, exercise programs following musculoskeletal athletic injury continue to evolve. Rehabilitation programs have drastically changed, especially in the terminal phases of rehabilitation, which include performance enhancement, development of power, and a safe return to activity. Plyometric exercise has become an integral component of late phase rehabilitation as the patient nears return to activity. Among the numerous types of available exercises, plyometrics assist in the development of power, a foundation from which the athlete can refine the skills of their sport. Therefore, the purpose of this clinical commentary is to provide an overview of plyometrics including: definition, phases, the physiological, mechanical and neurophysiological basis of plyometrics, and to describe clinical guidelines and contraindications for implementing plyometric programs.

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

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

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

PubMed Central

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

2016-01-01

Currently, one of the main objectives of human–animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6–month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre–program with post–program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre–session with post–session salivary cortisol and alpha–amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty–two institutionalized patients with chronic schizophrenia completed the 6–month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT–treatment group (n = 14) participated in twice–weekly 1–h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT–treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT–treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group’s functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia. PMID:27199859

[Long-term physical activity after a myocardial infarction : a permanent challenge].

PubMed

Tessitore, Elena; Sigaud, Philippe; Meyer, Philippe; Mach, François

2017-05-24

Cardiac rehabilitation is a well-defined multidisciplinary program with the objective to reduce mortality and morbidity, while also improving the exercise capacity and quality of life of the patient following a myocardial infarction. Despite the fact that a cardiovascular rehabilitation program is now recommended by international guidelines for all patients who have suffered from an acute coronary syndrome, only half of all patients actually participate to such a program in Switzerland. Even worse, especially when taking into consideration the population in Geneva, less than 5 % of patients follow a long-term cardiac maintenance program (phase III). Since 2015, our project has been to encourage patients who have completed a phase II cardiac rehabilitation program, to resume regular physical activity in the long term.

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

Does participation in standardized aerobic fitness training during inpatient stroke rehabilitation promote engagement in aerobic exercise after discharge? A cohort study.

PubMed

Brown, Christiane; Fraser, Julia E; Inness, Elizabeth L; Wong, Jennifer S; Middleton, Laura E; Poon, Vivien; McIlroy, William E; Mansfield, Avril

2014-01-01

To determine whether attending an aerobic fitness program during inpatient stroke rehabilitation is associated with increased participation in physical activity after discharge. This was a prospective cohort study. Patients who received inpatient stroke rehabilitation and were discharged into the community (n = 61; mean age, 65 years) were recruited. Thirty-five participants attended a standardized aerobic fitness program during inpatient rehabilitation, whereas 26 did not. The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and adherence to the American College of Sports Medicine (ACSM) guidelines were assessed up to 6 months after discharge. Participants in the fitness group had PASIPD scores and adherence to ACSM guidelines similar to those of participants in the nonfitness group up to 6 months after discharge. There was no significant correlation between volume of exercise performed during the inpatient program and amount of physical activity after discharge. Participation in an inpatient fitness program did not increase participation in physical activity after discharge in individuals with stroke. A new model of care that encourages patients to pursue physical activity after discharge and reduces the potential barriers to participation should be developed.

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

77 FR 3837 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... agency adequate time to digest public comments before it renders a decision. 60 FR 44983, Aug. 29, 1995... Rehabilitation and Improvement Financing Program. OMB Control Number: 2130-0548. Type of Request: Revision of a... Railroad Rehabilitation and Improvement Financing (``RRIF Program''). Under the RRIF program, direct loans...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

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

78 FR 14516 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... Program/Cost Report (RSA 2) collects data on the vocational rehabilitation (VR) and supported employment... (Rehabilitation Act). The RSA-2 captures: administrative expenditures for the VR and SE programs; VR program... for the VR program by number of individuals served; the costs of types of services provided; and a...

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

PubMed

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

2017-12-01

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

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

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

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

Rehabilitation of Ankle and Foot Injuries in Athletes

PubMed Central

Chinn, Lisa; Hertel, Jay

2009-01-01

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

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.

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

PubMed

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

2017-09-12

Geriatric patients with cognitive impairment (CI) show an increased risk for a negative rehabilitation outcome and reduced functional recovery following inpatient rehabilitation. Despite this obvious demand, evidence-based training programs at the transition from rehabilitation to the home environments are lacking. The aim of this study is to evaluate the efficacy of a feasible and cost-effective home-based training program to improve motor performance and to promote physical activity, specifically-tailored for post-ward geriatric patients with CI. A sample of 101 geriatric patients with mild to moderate stage CI following ward-based rehabilitation will be recruited for a blinded, randomized controlled trial with two arms. The intervention group will conduct a 12 week home-based training, consisting of (1) Exercises to improve strength/power, and postural control; (2) Individual walking trails to enhance physical activity; (3) Implementation of patient-specific motivational strategies to promote behavioral changes. The control group will conduct 12 weeks of unspecific flexibility exercise. Both groups will complete a baseline measurement before starting the program, at the end of the intervention, and after 24 weeks for follow-up. Sensor-based as well as questionnaire-based measures will be applied to comprehensively assess intervention effects. Primary outcomes document motor performance, assessed by the Short Physical Performance Battery, and level of physical activity (PA), as assessed by duration of active episodes (i.e., sum of standing and walking). Secondary outcomes include various medical, psycho-social, various PA and motor outcomes, including sensor-based assessment as well as cost effectiveness. Our study is among the first to provide home-based training in geriatric patients with CI at the transition from a rehabilitation unit to the home environment. The program offers several unique approaches, e.g., a comprehensive and innovative assessment strategy and the integration of individually-tailored motivational strategies. We expect the program to be safe and feasible in geriatric patients with CI with the potential to enhance the sustainability of geriatric rehabilitation programs in patients with CI. International Standard Randomized Controlled Trial (# ISRCTN82378327 ). Registered: August 10, 2015.

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

PubMed Central

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

2014-01-01

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

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

ERIC Educational Resources Information Center

Bolton, Brian; Akridge, Robert L.

1995-01-01

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

77 FR 67804 - Agency Information Collection Activities; Comment Request; Application for Client Assistance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-14

...: Interested persons are invited to submit comments on or before January 14, 2013. ADDRESSES: Comments... Education is especially interested in public comment addressing the following issues: (1) is this collection... provided under the Rehabilitation Act including the Vocational Rehabilitation program. Dated: November 8...

Does self-efficacy mediate functional change in older adults participating in an exercise program after hip fracture? A randomized controlled trial.

PubMed

Chang, Feng-Hang; Latham, Nancy K; Ni, Pengsheng; Jette, Alan M

2015-06-01

To examine whether self-efficacy mediated the effect of the Home-based Post-Hip Fracture Rehabilitation program on activity limitations in older adults after hip fracture and whether the mediating effect was different between sex and age groups. Randomized controlled trial. Community. Participants with hip fracture (N=232; mean age ± SD, 79±9.4y) were randomly assigned to intervention (n=120, 51.7%) and attention control (n=112, 48.3%) groups. The 6-month intervention, the Home-based Post-Hip Fracture Rehabilitation, is a functionally oriented, home-based exercise program. Data were collected at baseline, postintervention (6mo), and follow-up (9mo). Activity Measure for Post-Acute Care. The mediating effect of the Home-based Post-Hip Fracture Rehabilitation program on Basic Mobility function through self-efficacy for exercise was significant at 9 months (βindirect=.21). Similarly, the mediating effect of the intervention on Daily Activity function through self-efficacy for exercise was significant at 9 months (βindirect=.49). In subgroup analyses, the mediating effect was significant at 9 months in the younger group (age, ≤79y) in comparison to the older group and was significant in women in comparison to men. Self-efficacy may play a partial mediating role in the effect on some longer-term functional outcomes in the Home-based Post-Hip Fracture Rehabilitation intervention. The results suggest that program components that target self-efficacy should be incorporated in future hip fracture rehabilitation interventions. Age and sex of the targeted participants may also need to be considered when developing interventions. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

34 CFR 361.3 - Authorized activities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Authorized activities. 361.3 Section 361.3 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM General § 361.3...

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

PubMed

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

2017-04-01

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

Efficacy of Mobile Health Care Application and Wearable Device in Improvement of Physical Performance in Colorectal Cancer Patients Undergoing Chemotherapy.

PubMed

Cheong, In Yae; An, So Yeon; Cha, Won Chul; Rha, Mi Yong; Kim, Seung Tae; Chang, Dong Kyung; Hwang, Ji Hye

2018-06-01

The use of a mobile health care application, the delivery of health care or health care-related services through the use of portable devices, to manage functional loss, treatment-related toxicities, and impaired quality of life in cancer patients during chemotherapy through supervised self-management has been increasing. The aim of the present study was to evaluate the efficacy and feasibility of comprehensive mobile health care using a tailored rehabilitation program for colorectal cancer patients undergoing active chemotherapy. A total of 102 colorectal cancer patients undergoing chemotherapy underwent 12 weeks of smartphone aftercare through provision of a mobile application and wearable device that included a rehabilitation exercise program and information on their disease and treatment. The grip strength test, 30-second chair stand test, 2-minute walk test, amount of physical activity (International Physical Activity Questionnaire short-form), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30), and nutritional status (Patient-generated Subjective Global Assessment) were assessed and measured at baseline, at mid-intervention (6 weeks), and at completion of the intervention (12 weeks). The rehabilitation exercise intensity was adjusted by the test results at every assessment and through real-time communication between the patients and clinicians. Of the 102 patients, 75 completed all 12 weeks of the smartphone aftercare rehabilitation program. The lower extremity strength (P < .001) and cardiorespiratory endurance (P < .001) was significantly improved. Fatigue (P < .007) and nausea/vomiting (P < .040) symptoms were significantly relieved after the program. A tailored rehabilitation exercise program provided through a comprehensive mobile health care application was effective in improving patients' physical capacity and treatment-related symptoms even during active chemotherapy. Copyright © 2018 Elsevier Inc. All rights reserved.

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

PubMed

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

2004-09-01

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

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

ERIC Educational Resources Information Center

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

2011-01-01

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

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

PubMed

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

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

Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

PubMed

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

2015-08-01

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

Rehabilitation After International Space Station Flights

NASA Technical Reports Server (NTRS)

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

2003-01-01

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

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

PubMed

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

2017-09-01

Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001). Within an outpatient stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients set were related to their goal satisfaction scores, with impairment-based goals being rated significantly higher than activity-based and participation-based goals. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2016-05-01

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

Benefits and costs of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease - a multi-centre randomised controlled equivalence trial.

PubMed

Holland, Anne E; Mahal, Ajay; Hill, Catherine J; Lee, Annemarie L; Burge, Angela T; Moore, Rosemary; Nicolson, Caroline; O'Halloran, Paul; Cox, Narelle S; Lahham, Aroub; Ndongo, Rebecca; Bell, Emily; McDonald, Christine F

2013-09-08

Pulmonary rehabilitation is widely advocated for people with chronic obstructive pulmonary disease (COPD) to improve exercise capacity, symptoms and quality of life, however only a minority of individuals with COPD are able to participate. Travel and transport are frequently cited as barriers to uptake of centre-based programs. Other models of pulmonary rehabilitation, including home-based programs, have been proposed in order to improve access to this important treatment. Previous studies of home-based pulmonary rehabilitation in COPD have demonstrated improvement in exercise capacity and quality of life, but not all elements of the program were conducted in the home environment. It is uncertain whether a pulmonary rehabilitation program delivered in its entirety at home is cost effective and equally capable of producing benefits in exercise capacity, symptoms and quality of life as a hospital-based program. The aim of this study is to compare the costs and benefits of home-based and hospital-based pulmonary rehabilitation for people with COPD. This randomised, controlled, equivalence trial conducted at two centres will recruit 166 individuals with spirometrically confirmed COPD. Participants will be randomly allocated to hospital-based or home-based pulmonary rehabilitation. Hospital programs will follow the traditional outpatient model consisting of twice weekly supervised exercise training and education for eight weeks. Home-based programs will involve one home visit followed by seven weekly telephone calls, using a motivational interviewing approach to enhance exercise participation and facilitate self management. The primary outcome is change in 6-minute walk distance immediately following intervention. Measurements of exercise capacity, physical activity, symptoms and quality of life will be taken at baseline, immediately following the intervention and at 12 months, by a blinded assessor. Completion rates will be compared between programs. Direct healthcare costs and indirect (patient-related) costs will be measured to compare the cost-effectiveness of each program. This trial will identify whether home-based pulmonary rehabilitation can deliver equivalent benefits to centre-based pulmonary rehabilitation in a cost effective manner. The results of this study will contribute new knowledge regarding alternative models of pulmonary rehabilitation and will inform pulmonary rehabilitation guidelines for COPD.

76 FR 31675 - Agency Information Collection Activities: Notice of Request for Renewal of a Previously Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... Program. Inspections of fracture critical bridges and underwater inspections are also required at... basis for setting initial priorities for the replacement or rehabilitation of bridges under the Highway... rehabilitation. In order to apportion funds for the HBP, the law requires that a cost to replace or rehabilitate...

76 FR 19178 - Agency Information Collection Activities: Notice of Request for Extension of Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... Program. Inspections of fracture critical bridges and underwater inspections are also required at... basis for setting initial priorities for the replacement or rehabilitation of bridges under the Highway... rehabilitation. In order to apportion funds for the HBP, the law requires that a cost to replace or rehabilitate...

A sensorimotor stimulation program for rehabilitation of chronic stroke patients.

PubMed

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

2013-01-01

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

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…

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.

Leisure time physical activity of patients in maintenance cardiac rehabilitation.

PubMed

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

2003-01-01

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

Rehabilitation of the Ankle After Acute Sprain or Chronic Instability.

PubMed

Mattacola, Carl G; Dwyer, Maureen K

2002-12-01

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

Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

PubMed Central

Mattacola, Carl G.; Dwyer, Maureen K.

2002-01-01

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

Evaluation of functional outcomes of physical rehabilitation and medical complications in spinal cord injury victims of the Sichuan earthquake.

PubMed

Li, Yongqiang; Reinhardt, Jan D; Gosney, James E; Zhang, Xia; Hu, Xiaorong; Chen, Sijing; Ding, Mingpu; Li, Jianan

2012-06-01

To characterize a spinal cord injury (SCI) population from the 2008 Sichuan earthquake in China; to evaluate functional outcomes of physical rehabilitation interventions; to assess potential determinants of rehabilitation effectiveness; and to assess medical complications and management outcomes. A total of 51 earthquake victims with SCI were enrolled and underwent rehabilitation programming. Functional rehabilitation outcomes included ambulation ability, wheelchair mobility and activities of daily living (ADL) assessed with the Modified Barthel Index at the beginning and end of rehabilitation. Effectiveness of rehabilitation and the effect of other predictors were evaluated by mixed effects regression. Outcomes of medical complication management were determined by comparison of the incidence of respective complications at the beginning and end of rehabilitation. Ambulation, wheelchair mobility and ADL were significantly improved with rehabilitation programming. Both earlier rescue and earlier onset of rehabilitation were significant positive predictors of rehabilitation effectiveness, whereas delayed onset of rehabilitation combined with prolonged time to rescue resulted in a lesser positive effect. Medical complications were managed effectively in 63% (pressure ulcers) to 85% (deep vein thrombosis) of patients during rehabilitation. Earthquake victims with SCI may achieve significantly improved functional rehabilitation functional outcomes on a formal, institutional-based physical rehabilitation programme.

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

ERIC Educational Resources Information Center

US Department of Education, 2005

2005-01-01

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

Reference system of competence and engagement in adapted physical activities of people with recent spinal cord injury.

PubMed

Gernigon, Christophe; Pereira Dias, Catarina; Riou, François; Briki, Walid; Ninot, Grégory

2015-01-01

This study tested whether persons with Recent Spinal Cord Injury (RSCI) who practice adapted physical activities (APA) and those who do not differ with regard to achievement goals, physical self-perceptions, and global self-esteem. Adults with RSCI in rehabilitation centers voluntarily completed questionnaires of achievement goals and self-esteem. Then, based on whether they engaged or not in APA programs, they were considered participants or non-participants in APA. Compared to participants in APA, non-participants were more oriented toward mastery-avoidance goals and had lower scores of physical self-worth and global self-esteem. No differences were found for other achievement goals and for low-level dimensions of physical self. These findings suggest that mastery-avoidance goals are associated with a maladaptive motivational pattern when intrapersonal comparison conveys a threat for the self. Practical implications for rehabilitation programs for persons with RSCI are offered. Adapted Physical Activities (APA) programs are supervised physical activity programs in which the choice of the activity as well as the frequency, the duration, and the intensity of practice are adapted to the inpatients' capabilities. Attempts to master physical activities can be seen as threatening experiences to be avoided by persons with Recent Spinal Cord Injury (RSCI) in rehabilitation centers. Comparing one's capabilities in physical activities with those of other persons with RSCI is not motivationally detrimental with respect to the practice of these activities. Upon persons with RSCI' arrival in rehabilitation centers, physical educators should promote a friendly competitive climate in the practice of APA to help inpatients recover healthy levels of physical self-perceptions and global self-esteem as well as motivation to exercise.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2011-08-01

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

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

PubMed

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

2015-08-01

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

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.

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

PubMed

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

2018-12-01

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

Exercise self-efficacy and symptoms of depression after cardiac rehabilitation: predicting changes over time using a piecewise growth curve analysis.

PubMed

Howarter, Alisha D; Bennett, Kymberley K; Barber, Carolyn E; Gessner, Stacia N; Clark, Jillian M R

2014-01-01

Cardiac rehabilitation is often recommended after experiencing a cardiac event and has been shown to significantly improve health outcomes among patients. Several psychosocial variables have been linked with cardiac rehabilitation program success, including exercise self-efficacy. However, little is known about temporal patterns in patients' exercise self-efficacy after program completion. This study examined changes in exercise self-efficacy among 133 cardiac rehabilitation patients and whether symptoms of depression impacted the rate of change in exercise self-efficacy. Participants completed questionnaires at the beginning and end of cardiac rehabilitation and at 6-month intervals for 2 years. Growth curve analyses showed that exercise self-efficacy levels were highest at the beginning of cardiac rehabilitation, significantly declined 6 months after cardiac rehabilitation, and leveled off over the next 18 months. Results also showed that baseline depressive symptoms interacted with time: Compared with participants with fewer symptoms, participants high in depressive symptoms began cardiac rehabilitation with lower levels of exercise self-efficacy and evidenced significant declines 6 months after cardiac rehabilitation. At no time were they equal to their counterparts in exercise self-efficacy, and their means were lower 2 years after cardiac rehabilitation than before cardiac rehabilitation. Our findings imply that patients show unrealistic optimism surrounding the ease of initiating and maintaining an exercise program and that integrating efficacy-building activities into cardiac rehabilitation, especially for patients who show signs of distress, is advisable.

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…

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

PubMed

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

2017-03-01

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

Patient Perspectives on Engagement in Recovery after Hip Fracture: A Qualitative Study

PubMed Central

Stott-Eveneshen, Sarah; Fleig, Lena; McAllister, Megan; Ashe, Maureen C.

2017-01-01

Purpose. To understand older adults' engagement in their recovery experience and rehabilitation after a fall-related hip fracture. Method. 50 community-dwelling older adults recovering from a recent (3–12 months) hip fracture (32 women, 18 men) participated in telephone interviews using a semistructured format at 6 and 12 months after recruitment into the study. Interviews were conducted as part of a mixed-methods study designed to test the effect of a postoperative hip fracture management program (B4 Clinic). Results. Three substantive themes were identified in the qualitative data: (1) managing expectations; (2) engaging in physical activity; and (3) there is life after fracture. Participants shared valuable insight into how their expectations for their recovery period compared to their lived experience and the role of physical activity in their ability to return to their prefracture activities. Conclusions. Our findings reflect older adults' expectations for recovery from hip fracture. Encouraging engagement in rehabilitative exercises and addressing expectations prior to hospital discharge may improve patients' adherence to rehabilitation programs, functional outcomes, and postoperative quality of life. Implications for rehabilitation include the necessity for early and ongoing engagement of rehabilitation professionals. PMID:28409031

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

PubMed

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

2017-02-01

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

Increased independence and decreased vertigo after vestibular rehabilitation.

PubMed

Cohen, Helen S; Kimball, Kay T

2003-01-01

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

Update on rehabilitation in multiple sclerosis.

PubMed

Donzé, Cécile

2015-04-01

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

Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: a prospective randomized clinical study.

PubMed

Kim, Seung-Ho; Ha, Kwon-Ick; Jung, Min-Wook; Lim, Moon-Sup; Kim, Young-Min; Park, Jong-Hyuk

2003-09-01

Increased stress within a certain limit enhances ligament healing and improves joint function. In this prospective randomized clinical trial, we compared the clinical results of early motion versus conventional immobilization after arthroscopic Bankart repair in a selected patient population. Prospective randomized clinical trial. We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic recurrent anterior instability of the shoulder. Patients were randomized into 2 groups; group 1 (28 patients; mean age, 28 years) was managed with 3 weeks of immobilization using an abduction sling and conventional rehabilitation program, and group 2 (34 patients; mean age, 29 years) was managed with an accelerated rehabilitation program that consisted of staged range of motion and strengthening exercises from the immediate postoperative day. Selection criteria were nonathletes with recurrent anterior shoulder dislocation and a classic Bankart lesion with a robust labrum limited to 1 cm from the midglenoid notch. The patients were followed up for a mean of 31 months (range, 27 to 45 months; standard deviation, 9 months). Analysis of outcome included pain scores at 6 weeks and at final follow-up evaluation, range of motion, return to activity, recurrence rate, patient satisfaction with each rehabilitation program, and shoulder scores assessed by the American Shoulder and Elbow Surgeons Shoulder Index, the rating system of the University of California at Los Angeles, and another scoring system. The recurrence rate was not different between the 2 groups (P =.842). None of the groups developed recurrent dislocation. Two patients from each group were positive for anterior apprehension signs. Patients who underwent accelerated rehabilitation resumed functional range of motion faster (P <.001) and returned earlier to the functional level of activity (P <.001). Accelerated rehabilitation decreased postoperative pain (P =.013), and more patients were satisfied with this program (P <.001). Shoulder scores, return to activity, pain score, and range of motion were not different between the 2 groups at the final follow-up evaluation (P >.05). Early mobilization of the operated shoulder after arthroscopic Bankart repair does not increase the recurrence rate in a selected group of patients. Although the final outcomes are approximately the same for both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which allows patients an early return to desired activities.

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

PubMed

Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

2017-11-01

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

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

PubMed

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

2013-11-19

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

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.

78 FR 14517 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... reporting of specific data elements by state vocational rehabilitation (VR) agencies to the Rehabilitation... of the Act requires the Commissioner to conduct evaluations of the VR program. The information from...

Convalescence care for seniors of lower Manhattan: an interdisciplinary outreach, rehabilitation, and education model.

PubMed

Moroz, Alex; Schoeb, Veronika; Fan, Grace; Vitale, Kenneth; Lee, Mathew

2004-03-01

The purpose of this study was to test the efficacy of an interdisciplinary geriatric outreach, rehabilitation, and education program for seniors. Community-dwelling Chinese seniors in lower Manhattan were recruited through outreach activities (17 educational workshops, three community health fairs, media interviews) and community physician referrals to offer rehabilitation services. The instrument administered at entry and exit included questions about pain intensity, quality of life, activities of daily living (ADLs), and an assessment of a variety of intrinsic and extrinsic barriers to life participation. The sample included 70 seniors (53 women) with a mean age of 70.5 +/- 7.48 years (range 60-93 years old) of whom 86% were Cantonese-speaking Chinese. The barriers-to-life participation assessment revealed cultural, communication, transportation, and physical environmental barriers as well as insufficient financial resources. Thirty-four patients who completed the program showed a significant improvement in quality of life. Patients' reports reflected a high degree of satisfaction with the program. Interdisciplinary team-oriented patient care, including a physiatrist, social worker, and rehabilitation staff, may result in good outcomes and high patient satisfaction in ambulatory community seniors.

A protocol of rehabilitation after ACL reconstruction using a hamstring autograft in the first month after surgery--a preliminary report.

PubMed

Biernat, Ryszard; Wołosewicz, Mariusz; Tomaszewski, Wiesław

2007-01-01

The purpose of this paper is to present a protocol of rehabilitation after ACL reconstruction using a hamstring autograft in the first month after surgery. The program enables the patient to return early to everyday activities (school, sedentary work) without crutches or a stabilizer. The program has been developed in accordance with rehabilitation protocols employed at Karolinska Institute in Sweden and Prof. Shelbourne's Clinic in the USA. The study group included 31 patients (18 men and 13 women). Patients rehabilitated in the Department according to our program achieved stable gait patterns and were able to step up and down within four to seven weeks. Early patient mobilization after ACL reconstruction is possible and does not cause any negative effects provided that the patient, doctor and physiotherapist cooperate very closely.

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

PubMed Central

Kolber, Morey J.

2012-01-01

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

20 CFR 632.79 - Employment activities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... EMPLOYMENT AND TRAINING PROGRAMS Program Design and Management § 632.79 Employment activities. (a) Community... quality, child care, health care, education, crime prevention and control, prisoner rehabilitation..., pollution control, housing and neighborhood improvement, rural development, conservation, beautification...

20 CFR 632.79 - Employment activities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... EMPLOYMENT AND TRAINING PROGRAMS Program Design and Management § 632.79 Employment activities. (a) Community... quality, child care, health care, education, crime prevention and control, prisoner rehabilitation..., pollution control, housing and neighborhood improvement, rural development, conservation, beautification...

A novel virtual motor rehabilitation system for Guillain-Barré syndrome. Two single case studies.

PubMed

Albiol-Pérez, S; Forcano-García, M; Muñoz-Tomás, M T; Manzano-Fernández, P; Solsona-Hernández, S; Mashat, M A; Gil-Gómez, J A

2015-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". For Guillain-Barré patients, motor rehabilitation programs are helpful at the onset to prevent the complications of paralysis and in cases of persistent motor impairment. Traditional motor rehabilitation programs may be tedious and monotonous, resulting in low adherence to the treatments. A Virtual Motor Rehabilitation system has been tested in Guillain-Barré patients to increase patient adherence and to improve clinical results. Two people with Guillain-Barré performed 20 rehabilitation sessions. We tested a novel system based on Motor Virtual Rehabilitation in three periods of time (baseline evaluation, final evaluation, and follow-up. In the training program, the participants carried out a specific treatment using the Active Balance Rehabilitation system (ABAR). The system is composed of customizable virtual games to perform static and dynamic balance rehabilitation. Significant improvements in clinical results were obtained by both participants, with significant results in the static balance clinical test of the Anterior Reach test in the standing position and unipedal stance time. Other significant results were found in dynamic balance clinical tests in the Berg Balance Scale test and the 30-second Sit-to-Stand test. With regard to acceptance of the system, both patients enjoyed the experience, and both patients thought that this system was helpful for their rehabilitation. The results show that Virtual Motor Rehabilitation for Guillain-Barré patients provides clinical improvements in an entertaining way.

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

PubMed

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

2017-05-01

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

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

PubMed

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

2014-01-01

Air pollution in Japan caused respiratory disease, such as chronic bronchitis and asthma, in many individuals in the 1960s. Although air pollution has decreased, many victims of air pollution-related respiratory disease are limited in their activities of daily living because of respiratory symptoms. The purpose of this study was to evaluate the efficacy of pulmonary rehabilitation in victims of air pollution-related chronic bronchitis or asthma. Subjects were enrolled in a 12-week (2-week inpatient followed by 10-week outpatient) pulmonary rehabilitation program. The program comprised conditioning, strength training, endurance training, and patient education. We assessed the Modified Medical Research Council (MMRC) dyspnea grade, pulmonary function, peripheral muscle force, incremental shuttle walk distance (ISWD), and physical activity at baseline and immediately after the program. Twenty-nine subjects (mean age 74.2 ± 10.1 years, 11 males) completed the program, including 11 subjects with COPD and 18 subjects with asthma. Following rehabilitation, the participants (n = 29) showed significant improvements in MMRC dyspnea grade, vital capacity % predicted, quadriceps force and ISWD (all P < 0.05). Sub-group analyses revealed that all these variables were significantly improved in subjects with asthma. In contrast, subjects with COPD showed significant improvements only in quadriceps force and ISWD (both P < 0.05). Thus, pulmonary rehabilitation is an effective method of improving exercise capacity and dyspnea in officially acknowledged victims of air pollution-related asthma. In conclusion, we recommend that patients with chronic bronchitis or asthma, resulting from exposure to air pollution, are referred for pulmonary rehabilitation.

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…

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

PubMed

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

2014-01-01

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

Effects of a virtual reality-based exercise program on functional recovery in stroke patients: part 1

PubMed Central

Lee, Kyoung-Hee

2015-01-01

This study aimed to determine the effects of a virtual reality exercise program using the Interactive Rehabilitation and Exercise System (IREX) on the recovery of motor and cognitive function and the performance of activities of daily living in stroke patients. [Subjects] The study enrolled 10 patients diagnosed with stroke who received occupational therapy at the Department of Rehabilitation Medicine of Hospital A between January and March 2014. [Methods] The patients took part in the virtual reality exercise program for 30 minutes each day, three times per week, for 4 weeks. Then, the patients were re-evaluated to determine changes in upper extremity function, cognitive function, and performance of activities of daily living 4 weeks after the baseline assessment. [Results] In the experimental group, there were significant differences in the Korea-Mini Mental Status Evaluation, Korean version of the modified Barthel index, and Fugl-Meyer assessment scores between the baseline and endpoint. [Conclusion] The virtual reality exercise program was effective for restoring function in stroke patients. Further studies should develop systematic protocols for rehabilitation training with a virtual reality exercise program. PMID:26180287

Effects of a virtual reality-based exercise program on functional recovery in stroke patients: part 1.

PubMed

Lee, Kyoung-Hee

2015-06-01

This study aimed to determine the effects of a virtual reality exercise program using the Interactive Rehabilitation and Exercise System (IREX) on the recovery of motor and cognitive function and the performance of activities of daily living in stroke patients. [Subjects] The study enrolled 10 patients diagnosed with stroke who received occupational therapy at the Department of Rehabilitation Medicine of Hospital A between January and March 2014. [Methods] The patients took part in the virtual reality exercise program for 30 minutes each day, three times per week, for 4 weeks. Then, the patients were re-evaluated to determine changes in upper extremity function, cognitive function, and performance of activities of daily living 4 weeks after the baseline assessment. [Results] In the experimental group, there were significant differences in the Korea-Mini Mental Status Evaluation, Korean version of the modified Barthel index, and Fugl-Meyer assessment scores between the baseline and endpoint. [Conclusion] The virtual reality exercise program was effective for restoring function in stroke patients. Further studies should develop systematic protocols for rehabilitation training with a virtual reality exercise program.

Rehabilitation of arm function after stroke. Literature review.

PubMed

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

2009-04-01

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

Rehabilitation Program for the Quality of Life for Individuals on Highly Active Antiretroviral Therapy in KwaZulu-Natal, South Africa: A Short Report

ERIC Educational Resources Information Center

Maharaj, Sonill S.; Chetty, Verusia

2011-01-01

Patients on highly active antiretroviral therapy (HAART) spend less time on vigorous activities due to lower aerobic capacity with functional limitations that can be attributed to a detraining effect, resulting in a poor quality of life (QoL). The overall aims of rehabilitation are to restore, to maintain, and to enhance the QoL and this…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-20

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

A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture

PubMed Central

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

2012-01-01

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

Prediction of Pathologic Fracture Risk in Activities of Daily Living and Rehabilitation of Patients With Metastatic Breast Carcinoma of the Pelvis and Femur

DTIC Science & Technology

2002-08-01

demonstrated in three-dimensional graphics and animations. This computer model will aid in planning of non-operative or operative management, rehabilitation regimens, nursing programs, and patient education .

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

PubMed

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

2014-02-01

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

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

PubMed Central

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

2014-01-01

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

Physical medicine and rehabilitation in the elderly arthritic patient.

PubMed

Schutt, A H

1977-02-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2012-01-01

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

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

PubMed

2017-06-01

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

Benefits of Comprehensive Rehabilitation Therapy in Thymectomy for Myasthenia Gravis: A Propensity Score Matching Analysis.

PubMed

Ambrogi, Vincenzo; Mineo, Tommaso Claudio

2017-02-01

To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching. All patients but 2 were able to complete the intended program. Eighteen patients (41%) experienced mild fatigue (>25 at MG quantitative score). Propensity score selected a group of 17 patients for the matching process. The group of patients who underwent the rehabilitation program showed significant preoperative improvement associated with a reduced operative risk, a decreased early postoperative morbidity, a lower rate of postoperative intensive care unit needed (12% vs 35%; P = 0.01) and a shorter hospital stay (3 vs 5 days; P = 0.04). After the expected perioperative decline, all major myasthenic outcomes demonstrated a significant faster recovery at 3 months. Complete stable remission did not reveal significant differences. Exercise is not necessarily a contraindication in MG, and rehabilitation can be safely performed before and after thymectomy, reducing operative risks and decreasing recovery time. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME OBJECTIVES: Upon completion of this article, the reader should be able to do the following: (1) appreciate the benefits of physical therapy in individuals with myasthenia gravis; (2) describe the benefits of physical therapy on postoperative morbidity in myasthenia gravis patients who undergo thymectomy; and (3) incorporate appropriate rehabilitation into the treatment plan of patient with myasthenia gravis. AdvancedACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

[Different Health Impairments at the Beginning of Medical Rehab: Possibilities of more Flexibility using the Example of Rehab Aftercare].

PubMed

Walther, A L; Deck, R

2015-08-01

The aftercare-program new credo was developed interdisciplinary and with practical orientation for rehabilitation patients with chronic back pain. The concept focuses on rehabilitation aftercare from the beginning of rehabilitation treatment and includes a long-term support of rehabilitation patients after inpatient rehabilitation. A multi-center, controlled longitudinal study demonstrated that participants in the intervention group (IG) implemented significantly better rehabilitation contents and objectives in everyday life and had significant better long-term effects. Anyway, there are participants who don't benefit from the new credo as they begin rehabilitation treatment with low impairments. Assuming that rehabilitation patients with lower impairments need a less comprehensive rehabilitation aftercare compared to those with higher impairments, a follow-up study including a flexible aftercare strategy was conducted. Thereby it is investigated whether the IG achieves more sustainable effects despite of less aftercare compared to the control group (CG) without the aftercare program. A prospective controlled longitudinal study in 2 rehabilitation clinics with 3 points of measurement was conducted. The flexibilization of the aftercare program was based on the level of impairment in the main outcome variable functional limitation in activities of daily living (FFbH-R) and restriction in participation (IMET) at the beginning of rehabilitation. Both questionnaires have been used in numerous studies successfully. Rehabilitation patients with low impairments received only the elements of the new credo during inpatient rehabilitation, rehabilitation patients with relevant impairments received the entire new credo over a period of 12 month after inpatient rehabilitation. The effects were evaluated with data from the CG of the primary study [Deck et al., 2012]. This sample was also divided according to their impairments. Rehabilitation patients with no relevant impairments were included in the analysis (IG N=81, KG N=157). Regarding the long-term effects for the primary outcome variable FFbH-R a significant positive intragroup-effect was detected for the IG, the CG reached the initial value 12 month after inpatient rehabilitation. For the IMET a significant intragroup-effect is also visible in the IG, the CG does not change over the period of time. For both primary outcomes, there are no significant interaction effects to be observed. With respect to the secondary outcomes, in the IG significant small to moderate intragroup-effects were determined in all outcomes, the CG achieved for half of those outcomes significant small intragroup-effects. Rehabilitation patients, who begin rehabilitation with rather low impairments perpetuate their rehabilitation effects with an even reduced aftercare. Aftercare-programs should therefore be adapted to the individual needs. Rehabilitation patient, who start the rehabilitation with relative good health, seem not to have an added value from an intensive aftercare-program. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed Central

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

2011-01-01

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

Internet Interventions for Hearing Loss.

PubMed

Thorén, Elisabet Sundewall; Öberg, Marie; Andersson, Gerhard; Lunner, Thomas

2015-09-01

The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed. Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group. The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve. The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

Effects of a brief, pedometer-based behavioral intervention for individuals with COPD during inpatient pulmonary rehabilitation on 6-week and 6-month objectively measured physical activity: study protocol for a randomized controlled trial.

PubMed

Geidl, Wolfgang; Semrau, Jana; Streber, René; Lehbert, Nicola; Wingart, Silke; Tallner, Alexander; Wittmann, Michael; Wagner, Rupert; Schultz, Konrad; Pfeifer, Klaus

2017-08-29

Pulmonary rehabilitation programs often fail to substantially enhance long-term physical activity in patients with chronic obstructive pulmonary disease (COPD). The reasons for successful physical activity changes in patients with COPD are not well understood. The need to better understand the determinants of physical activity in patients with COPD and effective rehabilitation strategies to improve physical activity is evident. The STAR study (Stay Active after Rehabilitation) investigates, in a randomized controlled trial, the additional effect of a pedometer-based behavior-change intervention during inpatient pulmonary rehabilitation on objectively measured physical activity 6 weeks and 6 months post rehabilitation. The intervention uses the behavior-change techniques (1) instruction on how, where and when to perform the behavior, (2) prompt goal setting for physical activity, (3) prompt self-monitoring of behavior, and (4) feedback on behavior. The primary outcome of physical activity will be measured using a physical activity monitor (Actigraph wGT3X-BT) for a period of 7 days, firstly 2 weeks before rehabilitation begins (t0) as well as 6 weeks and 6 months after rehabilitation (t3, t4). Additionally, to predict physical activity progression after rehabilitation, a complex personal diagnostics battery, including questionnaires as well as functional assessments, is to be carried out at the start and end of rehabilitation (t1, t2). This battery is based on the foundational ideas of the Physical Activity-Related health Competence model. Five hundred and two patients with COPD, aged 18 years or older and admitted for an approved pulmonary rehabilitation, will be enrolled in the STAR study. The STAR study is designed as a randomized controlled trial to gain a better understanding of the personal determinants of physical activity in patients with COPD and to evaluate a pedometer-based physical activity-change intervention in the context of inpatient pulmonary rehabilitation. The results enable the future identification of patients with COPD who will find it difficult to engage in long-term physical activity after rehabilitation. Based on this, intervention strategies to promote physical activity in the content of pulmonary rehabilitation can be optimized. Clinicaltrials.gov, ID: NCT02966561 . Registered retrospectively after the start of the recruitment in June 2016 on 22 November 2016. All protocol modifications will be registered in the trial registry.

[Early interdisciplinary geriatric rehabilitation after hip fracture : Effective concept or just transfer of costs?].

PubMed

Lögters, T; Hakimi, M; Linhart, W; Kaiser, T; Briem, D; Rueger, J; Windolf, J

2008-09-01

Modern strategies for postoperative care of patients with hip fractures include early discharge from the acute care hospital to inpatient interdisciplinary rehabilitation facilities. Whether these programs are effective for the patients and improve their long-term outcomes or if they simply transfer costs, with a reduction of the inpatient days in the acute care hospital, is currently under discussion. This prospective study included 282 patients with hip fracture admitted to our trauma center were included into the prospective study. The mean patient age was 86+/-8 (65-110) years. All patients were treated operatively. After a mean of 12+/-9 days, the patients underwent inpatient interdisciplinary geriatric rehabilitation for a mean of 27+/-13 (4-103) days. The primary outcome measure was their activities of daily living (Barthel index) before, at the end of rehabilitation, and 1 year after trauma. In addition, patient-related variables were correlated with the Barthel index. With discharge from the acute care hospital, the Barthel index was 42+/-20 points and it increased during rehabilitation to 65+/-26 points. One year later the Barthel index was 67+/-28 points. Ninety percent of patients improved their Barthel index during rehabilitation. Within 1 year, 40% of patients deteriorated in their activities of daily living. Fifty one percent of patients were reintegrated back to their homes. Patients who lived at home before trauma and were reintegrated back to their homes had a significant higher Barthel index (75+/-24) 1 year after trauma than patients who were living in a nursing care facility before the trauma (Barthel index 52+/-27). The variables of age, level of cognition, and type of fracture had no influence on the long-term outcome. An extension of rehabilitation above the mean time period did not improve the sustainable clinical outcome. Postoperative inpatient rehabilitation programs enhance short-term activities of daily living. In particular, patients who lived at home before the trauma and were reintegrated back home benefited in perpetuity from geriatric rehabilitation. A policy for early discharge to geriatric rehabilitation is associated with extension of overall hospital stay. This association along with the related increased health care costs should be weighed against the sociofunctional effectiveness of these programs.

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

PubMed

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

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

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

PubMed

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

2009-01-01

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

Features extraction of EMG signal using time domain analysis for arm rehabilitation device

NASA Astrophysics Data System (ADS)

Jali, Mohd Hafiz; Ibrahim, Iffah Masturah; Sulaima, Mohamad Fani; Bukhari, W. M.; Izzuddin, Tarmizi Ahmad; Nasir, Mohamad Na'im

2015-05-01

Rehabilitation device is used as an exoskeleton for people who had failure of their limb. Arm rehabilitation device may help the rehab program whom suffers from arm disability. The device that is used to facilitate the tasks of the program should improve the electrical activity in the motor unit and minimize the mental effort of the user. Electromyography (EMG) is the techniques to analyze the presence of electrical activity in musculoskeletal systems. The electrical activity in muscles of disable person is failed to contract the muscle for movements. In order to prevent the muscles from paralysis becomes spasticity, the force of movements should minimize the mental efforts. Therefore, the rehabilitation device should analyze the surface EMG signal of normal people that can be implemented to the device. The signal is collected according to procedure of surface electromyography for non-invasive assessment of muscles (SENIAM). The EMG signal is implemented to set the movements' pattern of the arm rehabilitation device. The filtered EMG signal was extracted for features of Standard Deviation (STD), Mean Absolute Value (MAV) and Root Mean Square (RMS) in time-domain. The extraction of EMG data is important to have the reduced vector in the signal features with less of error. In order to determine the best features for any movements, several trials of extraction methods are used by determining the features with less of errors. The accurate features can be use for future works of rehabilitation control in real-time.

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

PubMed

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

2004-01-01

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

42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-prescribed exercise means physical activity, including aerobic exercise, prescribed and supervised by a... components: (1) Physician-prescribed exercise. This physical activity includes techniques such as exercise... program for COPD and certain other chronic respiratory diseases designed to optimize physical and social...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

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

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)…

Early Incorporation of an Evidence-Based Aquatic-Assisted Approach to Arthroscopic Rotator Cuff Repair Rehabilitation: Prospective Case Study.

PubMed

Burmaster, Chris; Eckenrode, Brian J; Stiebel, Matthew

2016-01-01

Both traditional and progressive rotator cuff repair rehabilitation protocols often delay active motion of the shoulder for 6 weeks or more. The early inclusion of a comprehensive aquatic-assisted exercise program presents a unique approach to postoperative management. The purpose of this case study is to describe a comprehensive evidence-based, aquatic-assisted rehabilitation program following arthroscopic rotator cuff repair. A 73-year-old woman with a nonretracted, medium-size, full-thickness tear (2.5 cm) of the supraspinatus tendon underwent arthroscopic rotator cuff repair and was referred for postoperative physical therapy. The rehabilitation program was initiated at 2 weeks postoperatively and consisted of concurrent land- and aquatic-based interventions over 6 weeks for a total of 18 physical therapy visits. Improvements were made in all 5 patient-reported outcome measures that were recorded weekly over the course of care. Improvements reached or exceeded minimal detectable change levels for the Shoulder Pain and Disability Index and the Penn Shoulder Score. Her numeric pain rating scale score at rest decreased from 4/10 at the initial evaluation to 2/10 at 8 weeks postoperatively and with activity decreased from 9/10 to 6/10. Shoulder strength and range of motion values also exhibited improvement over the course of care. No adverse events occurred during the case study. This case study illustrates the safe inclusion of low-stress aquatic exercises as an early adjunct to traditional land-based rotator cuff repair rehabilitation programs in small- to medium-size repairs. Further studies are needed to determine the long-term effectiveness of adding aquatic therapy to traditional postoperative programs. © 2016 American Physical Therapy Association.

Cost-Utility Analysis of a Cardiac Telerehabilitation Program: The Teledialog Project.

PubMed

Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper; Hansen, John; Nielsen, Gitte; Spindler, Helle; Dinesen, Birthe

2016-07-01

Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months. The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form Health Survey. The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life-years (QALYs) gain was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than €400,000 per QALY gained. Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself was not costly (less than €500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.

Using standardized fishery data to inform rehabilitation efforts

USGS Publications Warehouse

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

2016-01-01

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

34 CFR 359.10 - What types of projects are authorized under this program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... rehabilitation services to individuals with spinal cord injuries; and (b) Conduct spinal cord research, including clinical research and the analysis of standardized data in collaboration with other related projects... REHABILITATION RESEARCH: SPECIAL PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES What Kinds of Activities...

Specialized Centres and the Local Home Community: Children with Disabilities Need Them Both.

ERIC Educational Resources Information Center

Serpell, Robert

1986-01-01

Community based rehabilitation for disabled persons in developing nations is contrasted with institutionally based rehabilitation. A strategy is proposed which combines the two approaches and includes greater economic realism, design of advanced training programs, provision of reliable transportation, and more outreach and follow-up activities by…

Effects of Home-Based Versus Clinic-Based Rehabilitation Combining Mirror Therapy and Task-Specific Training for Patients With Stroke: A Randomized Crossover Trial.

PubMed

Hsieh, Yu-Wei; Chang, Ku-Chou; Hung, Jen-Wen; Wu, Ching-Yi; Fu, Mu-Hui; Chen, Chih-Chi

2018-04-25

We investigated the treatment effects of a home-based rehabilitation program compared with clinic-based rehabilitation in patients with stroke. A single-blinded, 2-sequence, 2-period, crossover-designed study. Rehabilitation clinics and participant's home environment. Individuals with disabilities poststroke. During each intervention period, each participant received 12 training sessions, with a 4-week washout phase between the 2 periods. Participants were randomly allocated to home-based rehabilitation first or clinic-based rehabilitation first. Intervention protocols included mirror therapy and task-specific training. Outcome measures were selected based on the International Classification of Functioning, Disability and Health. Outcomes of impairment level were the Fugl-Meyer Assessment, Box and Block Test, and Revised Nottingham Sensory Assessment. Outcomes of activity and participation levels included the Motor Activity Log, 10-meter walk test, sit-to-stand test, Canadian Occupational Performance Measure, and EuroQoL-5D Questionnaire. Pretest analyses showed no significant evidence of carryover effect. Home-based rehabilitation resulted in significantly greater improvements on the Motor Activity Log amount of use subscale (P=.01) and the sit-to-stand test (P=.03) than clinic-based rehabilitation. The clinic-based rehabilitation group had better benefits on the health index measured by the EuroQoL-5D Questionnaire (P=.02) than the home-based rehabilitation group. Differences between the 2 groups on the other outcomes were not statistically significant. The home-based and clinic-based rehabilitation groups had comparable benefits in the outcomes of impairment level but showed differential effects in the outcomes of activity and participation levels. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of Standardized Home Training in Patients with Cognitive Impairment following Geriatric Rehabilitation: A Randomized Controlled Pilot Study.

PubMed

Hauer, Klaus; Ullrich, Phoebe; Dutzi, Ilona; Beurskens, Rainer; Kern, Sylvia; Bauer, Jürgen; Schwenk, Michael

2017-01-01

Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation. A randomized controlled, single-blinded intervention trial (RCT) with wait list control design was used. Geriatric patients (n = 34; age: 81.9 ± 5.7 years) with cognitive impairment (MMSE: 18.8 ± 4.7), identified by predefined in- and exclusion criteria, were consecutively recruited from a geriatric rehab ward. Patients in the intervention group (IG, n = 17) performed a 6-week strength and functional home training. The control group (CG, n = 17) started an identical training 6 weeks later with an initial usual care period during the intervention for the IG. Functional performance (Short Physical Performance Battery; SPPB), clinically relevant functional deficits (Performance Oriented Assessment; POMA), and physical activity (Assessment of Physical Activity For Older Persons questionnaire; APAFOP) represented primary outcome measurements complemented by additional secondary outcome parameters. The IG significantly increased functional performances in SPPB (total score: p = 0.012; chair rise: p = 0.007, balance: p = 0.066), reduced gait and balance deficits in POMA (total score: p = 0.006; balance: p = 0.034; gait: p = 0.019), and increased physical activity (APAFOP; p = 0.05) compared to the CG. Effect sizes showed medium to large effects for significant parameters (eta2 = 0.14-0.45). Training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (eta2 = 0.06-0.23). Results of this pilot study show that a feasible and easy to handle, home-based rehabilitation program increased functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment, in particular when the post-ward training onset was not postponed. © 2017 S. Karger AG, Basel.

CURRENT CONCEPTS IN MUSCLE STRETCHING FOR EXERCISE AND REHABILITATION

PubMed Central

2012-01-01

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

Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players.

PubMed

Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

2016-02-01

This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field.

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

PubMed

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

2011-01-01

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

Fitness Programs for the Aged: A Study of College and University Involvement.

ERIC Educational Resources Information Center

Price, William F.; Lyon, Lesley B.

1983-01-01

A national survey identified innovative physical fitness programs for older adults at colleges and universities. Survey results concerning program area, type of activities, target population, and whether programs focus on the healthy elderly or on rehabilitation are reported. (PP)

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

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

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 improvement. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Therapeutic recreation treatment time during inpatient rehabilitation

PubMed Central

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

2011-01-01

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

Psychological benefits of virtual reality for patients in rehabilitation therapy.

PubMed

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

2009-05-01

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

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

PubMed

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

2008-10-01

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

National approaches to promote sports and physical activity in adults with disabilities: examples from the Netherlands and Canada.

PubMed

Hoekstra, Femke; Roberts, Lynn; van Lindert, Caroline; Martin Ginis, Kathleen A; van der Woude, Lucas H V; McColl, Mary Ann

2018-01-15

This study described how the Dutch and Canadian governments promote high performance sports, recreational sports, and physical activity (PA) among adults with disabilities on a national level. An internet-based study was conducted to identify and select relevant documents and websites containing information about the national approach to promote disability sports and physical activities in the Netherlands and Canada. Both governments promote high performance sports in similar ways, but use different strategies to promote recreational sports and physical activities. The Dutch approach is characterized by using time-limited programs focusing on enhancement of sports infrastructure and inter-sector collaboration in which municipalities have key roles. The Canadian government promotes recreational sports in disabled populations by supporting programs via bilateral agreements with provinces and territories. Furthermore, the level of integration of disability sports into mainstream sports differs between countries. The findings of this study may inspire policy makers from different countries to learn from one another's policies in order to optimize national approaches to promote disability sports and PA on all levels. Implications for rehabilitation It is recommended for policy makers of national governments to develop and implement policy programs that promote sports and physical activities among people with disabilities because of its potential impact on functioning, participation, quality of life, and health. Insight into national approaches to promote sport and physical activities is relevant for rehabilitation practice to understand ongoing opportunities for people with disabilities to stay physically active after rehabilitation through participation in home and/or community-based sport and physical activities. It seems worthwhile to integrate activities to promote sport and physical activities in rehabilitation in such a way that it fits with the current governmental approach. It is recommended to set up international collaborations to develop and share knowledge about effective and sustainable national approaches to promote sports and physical activities among people with disabilities.

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

PubMed

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

2017-01-01

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

White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 7. The clinical field of competence: PRM in practice.

PubMed

2018-04-01

In the context of the White Book on Physical and Rehabilitation Medicine (PRM) in Europe this paper deals with the scope and competencies of PRM starting from its definition as the "medicine of functioning." PRM uses the rehabilitative health strategy as its core strategy together with the curative strategy. According to the complexity of disabling health conditions, PRM also refers to prevention and maintenance and provides information to the patients and other caregivers. The rehabilitation process according to the so-called rehabilitation cycle including an assessment and definition of the (individual) rehabilitation goals, assignment to the rehabilitation program evaluation of individual outcomes. PRM physicians treat a wide spectrum of diseases and take a transversal across most of the medical specialties. They also focus on many functional problems such as immobilization, spasticity, pain syndromes, communication disorders, and others. The diagnosis in PRM is the interaction between the medical diagnosis and a PRM-specific functional assessment. The latter is based on the ICF conceptual framework, and obtained through functional evaluations and scales: these are classified according to their main focus on impairments, activity limitations or participation restrictions; environmental and personal factors are included as barriers or facilitators. Interventions in PRM are either provided directly by PRM physicians or within the PRM team. They include a wide range of treatments, including medicines, physical therapies, exercises, education and many others. Standardized PRM programs are available for many diseases and functional problems. In most cases rehabilitation is performed in multi-professional teams working in a collaborative way, as well as with other disciplines under the leadership of a PRM physician and it is a patient-centered approach. Outcomes of PRM interventions and programs, showed reduction of impairments in body functions, activity limitations, and impacting on participation restrictions, and also reduction in costs as well as decrease in mortality for certain groups of patients.

38 CFR 21.7112 - Programs of education combining two or more types of courses.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Programs of education... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7112 Programs of...

38 CFR 21.7112 - Programs of education combining two or more types of courses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Programs of education... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7112 Programs of...

38 CFR 21.7112 - Programs of education combining two or more types of courses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Programs of education... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7112 Programs of...

38 CFR 21.7112 - Programs of education combining two or more types of courses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Programs of education... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7112 Programs of...

38 CFR 21.7112 - Programs of education combining two or more types of courses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Programs of education... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7112 Programs of...

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

PubMed

2014-06-05

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

78 FR 34901 - Final Priority; National Institute on Disability and Rehabilitation Research-Advanced...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Institute on Disability and Rehabilitation Research--Advanced Rehabilitation Research Training Program... priority for the Advanced Rehabilitation Research Training (ARRT) program under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and...

38 CFR 21.7110 - Selection of a program of education.

Code of Federal Regulations, 2010 CFR

2010-07-01

... education. 21.7110 Section 21.7110 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Programs of Education § 21.7110 Selection of a program of education. (a...

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

Framing new pathways in transformative exercise for individuals with existing and newly acquired disability

PubMed Central

Rimmer, James; Lai, Byron

2017-01-01

Abstract Purpose: This paper describes a continuum of customized exercise options for people with an existing and newly acquired disability or diagnosis referred to as the Transformative Exercise Framework. Background: The period directly after rehabilitation is a critical juncture where many individuals return to life with high rates of sedentary behavior. After rehabilitation discharge, people with newly acquired disability or diagnoses often never make the transition into usage of community-based exercise services that are tailored, safe and effective. Methods: Narrative review. Results: The Transformative Exercise Framework supports a patient-to-participant, rehab-to-wellness model that emphasizes a linkage between physical and occupational therapists and community-based exercise trainers. The four focus areas – Rehabilitation, Condition-specific Exercise, Fitness and Lifetime Physical Activity – emphasize a range of options for people with newly acquired disability and diagnoses, or for people with existing disability and/or chronic health conditions who have a new injury, secondary condition or are severely deconditioned. Conclusion: The concept of transformative exercise is to support people with disabilities and diagnoses with a seamless restore–improve–prevent continuum of programs and services. This continuum connects individuals to rehabilitation and exercise professionals in a dynamic framework, which maximizes the expertise of both sets of professionals and provides the most effective interventions to achieve the greatest gains in health and function and/or to avoid future health decline.Implications for RehabilitationPatients discharged from rehabilitation should be transformed into participants in lifelong physical activity through a continuum of health services, which we refer to as Transformative Exercise.Transformative exercise is a continuum of individually tailored exercise strategies/programs that aims to improve the function of underperforming systems, which inhibit community and/or lifelong physical activity participation.The Transformative Exercise Framework can be used by a therapist or exercise trainer to design a program that maximizes performance and time and is based on a specific process for identifying short and long term goals. PMID:26161458

Framing new pathways in transformative exercise for individuals with existing and newly acquired disability.

PubMed

Rimmer, James; Lai, Byron

2017-01-01

This paper describes a continuum of customized exercise options for people with an existing and newly acquired disability or diagnosis referred to as the Transformative Exercise Framework. The period directly after rehabilitation is a critical juncture where many individuals return to life with high rates of sedentary behavior. After rehabilitation discharge, people with newly acquired disability or diagnoses often never make the transition into usage of community-based exercise services that are tailored, safe and effective. Narrative review. The Transformative Exercise Framework supports a patient-to-participant, rehab-to-wellness model that emphasizes a linkage between physical and occupational therapists and community-based exercise trainers. The four focus areas - Rehabilitation, Condition-specific Exercise, Fitness and Lifetime Physical Activity - emphasize a range of options for people with newly acquired disability and diagnoses, or for people with existing disability and/or chronic health conditions who have a new injury, secondary condition or are severely deconditioned. The concept of transformative exercise is to support people with disabilities and diagnoses with a seamless restore-improve-prevent continuum of programs and services. This continuum connects individuals to rehabilitation and exercise professionals in a dynamic framework, which maximizes the expertise of both sets of professionals and provides the most effective interventions to achieve the greatest gains in health and function and/or to avoid future health decline. Implications for Rehabilitation Patients discharged from rehabilitation should be transformed into participants in lifelong physical activity through a continuum of health services, which we refer to as Transformative Exercise. Transformative exercise is a continuum of individually tailored exercise strategies/programs that aims to improve the function of underperforming systems, which inhibit community and/or lifelong physical activity participation. The Transformative Exercise Framework can be used by a therapist or exercise trainer to design a program that maximizes performance and time and is based on a specific process for identifying short and long term goals.

78 FR 35009 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation... Education. ACTION: Notice. Overview Information National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering...

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

PubMed

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

2012-11-01

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

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

PubMed

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

2013-08-01

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

A rehabilitation program based on music practice for patients with unilateral spatial neglect: a single-case study.

PubMed

Guilbert, Alma; Clément, Sylvain; Moroni, Christine

2017-02-01

Two major limitations of unilateral spatial neglect (USN) rehabilitation methods are actually reported: a lack of long-term efficiency and a lack of generalization to daily life. The aim of our case study was to underline how a multisensory method-music practice-could avoid these limitations. Mrs BV suffered from a chronic severe USN. She had rehabilitation sessions of music practice over 8 weeks. An improvement of her USN was found on paper-pencil tests but also in daily activities. Benefits subsisted 4 months after rehabilitation. Music practice seemed to avoid the major limitations of USN rehabilitations and could represent a promising tool.

The economic burden of blindness in Pakistan: a socio-economic and policy imperative for poverty reduction strategies.

PubMed

Awan, Haroon; Malik, Sadia Mariam; Khan, Niaz Ullah

2012-01-01

State and nonstate health programs in developing countries are often influenced by priorities that are defined in the Millennium Development Goals (MDGs). In the wake of recessionary pressures, policy makers in the health sector are often seen to divert significant budgets to some specific health programs and make only token allocations for other health problems that are important but do not fall under the traditional MDG box of health priorities. This paper illustrates the economic argument for investment in one such program: The eye health program and employs a country case study of Pakistan to demonstrate that there are significant economic gains that are being foregone by not addressing the needs of the blind in poverty reduction strategies. By applying appropriate growth and discounting factors and using the average wage rate, the paper estimates the total productivity gains that are realizable over a period of 10 years if the blind population in Pakistan is rehabilitated and their carers released to participate in the mainstream economic activity. Our findings indicate that significant productivity gains accumulated over 10 years, range from Rs. 61 billion (US$ 709 million) to Rs. 421 billion (US$ 4.9 billion) depending upon whether the entire blind population or only those affected by a specific cause are rehabilitated. The per annum productivity gains of rehabilitating the entire blind population represents 0.74% of the current gross domestic product of Pakistan, which is higher than the total public spending on health. In order to reap these benefits, the subsequent absorption of the rehabilitated blind and their carers into mainstream economic activity is as important as their effective rehabilitation.

The economic burden of blindness in Pakistan: A socio-economic and policy imperative for poverty reduction strategies

PubMed Central

Awan, Haroon; Malik, Sadia Mariam; Khan, Niaz Ullah

2012-01-01

State and nonstate health programs in developing countries are often influenced by priorities that are defined in the Millennium Development Goals (MDGs). In the wake of recessionary pressures, policy makers in the health sector are often seen to divert significant budgets to some specific health programs and make only token allocations for other health problems that are important but do not fall under the traditional MDG box of health priorities. This paper illustrates the economic argument for investment in one such program: The eye health program and employs a country case study of Pakistan to demonstrate that there are significant economic gains that are being foregone by not addressing the needs of the blind in poverty reduction strategies. By applying appropriate growth and discounting factors and using the average wage rate, the paper estimates the total productivity gains that are realizable over a period of 10 years if the blind population in Pakistan is rehabilitated and their carers released to participate in the mainstream economic activity. Our findings indicate that significant productivity gains accumulated over 10 years, range from 61 billion (US$ 709 million) to 421 billion (US$ 4.9 billion) depending upon whether the entire blind population or only those affected by a specific cause are rehabilitated. The per annum productivity gains of rehabilitating the entire blind population represents 0.74% of the current gross domestic product of Pakistan, which is higher than the total public spending on health. In order to reap these benefits, the subsequent absorption of the rehabilitated blind and their carers into mainstream economic activity is as important as their effective rehabilitation. PMID:22944742

Guidelines for postdoctoral training in rehabilitation psychology.

PubMed

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

2012-11-01

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

Osteogenesis imperfecta: rehabilitation approach with infants and young children.

PubMed

Binder, H; Hawks, L; Graybill, G; Gerber, N L; Weintrob, J C

1984-09-01

A rehabilitation approach, consisting of initial handling and positioning followed by functional and formal strengthening exercises, was developed for the child with severe progressive osteogenesis imperfecta (OI). The program was developed because of the increased life expectancy for infants and children with severe progressive OI, combined with the lack of published reports dealing with their rehabilitation. The program can be followed easily by parents or therapists with regular monitoring by a psychiatrist. The goals are to improve the life span as well as the quality of life of these children by preventing the following: (1) positional contractures and deformities, (2) muscle weakness and osteoporosis, and (3) malalignment of the lower extremity joints prohibiting weight-bearing. Implementation of the program requires full cooperation of the parents. The initial results in four children between the ages of 3 and 11 years are encouraging. The benefits of increased strength and mobility leading to more age-appropriate activities and behaviors outweigh the only observed negative result, that is trauma-related lower extremity fractures in children with milder disease, and therefore greater mobility and higher activity levels.

77 FR 39224 - Notice of Proposed Information Collection Requests; Office of Special Education and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

..., Rehabilitation Services Administration (RSA)-2 collects data on the vocational rehabilitation (VR) and supported... Rehabilitation Program/Cost Report (RSA-2) collects data on the vocational rehabilitation (VR) and supported... (Rehabilitation Act). The RSA-2 captures: administrative expenditures for the VR and SE programs; VR program...

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

PubMed

Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Functional Diagnosis as a Tool in Rehabilitation: A Comparison of Teachers and Other Employees.

ERIC Educational Resources Information Center

Berg, John E.; Berg, Ottar; Reiten, Tor; Kostveit, Svein

1998-01-01

A study compared 100 Norwegian teachers with a matched group of non-teachers who were attending a four-week vocational rehabilitation program on work environment, family relations, health, personal economy, and leisure-time activity. Teachers scored significantly lower than nonteachers on the family relations axis and on a sum score of all…

38 CFR 21.402 - Responsibilities of the Veterans' Advisory Committee on Rehabilitation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... shall be incorporated in the Secretary's annual report submitted to the Congress under 38 U.S.C. 529. In..., United States Code. (b) Submission of an annual report. The committee shall: (1) Submit to the Secretary an annual report on the rehabilitation programs and activities of the VA; and (2) Submit such other...

38 CFR 21.402 - Responsibilities of the Veterans' Advisory Committee on Rehabilitation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... shall be incorporated in the Secretary's annual report submitted to the Congress under 38 U.S.C. 529. In..., United States Code. (b) Submission of an annual report. The committee shall: (1) Submit to the Secretary an annual report on the rehabilitation programs and activities of the VA; and (2) Submit such other...

38 CFR 21.402 - Responsibilities of the Veterans' Advisory Committee on Rehabilitation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall be incorporated in the Secretary's annual report submitted to the Congress under 38 U.S.C. 529. In..., United States Code. (b) Submission of an annual report. The committee shall: (1) Submit to the Secretary an annual report on the rehabilitation programs and activities of the VA; and (2) Submit such other...

38 CFR 21.402 - Responsibilities of the Veterans' Advisory Committee on Rehabilitation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... shall be incorporated in the Secretary's annual report submitted to the Congress under 38 U.S.C. 529. In..., United States Code. (b) Submission of an annual report. The committee shall: (1) Submit to the Secretary an annual report on the rehabilitation programs and activities of the VA; and (2) Submit such other...

38 CFR 21.402 - Responsibilities of the Veterans' Advisory Committee on Rehabilitation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... shall be incorporated in the Secretary's annual report submitted to the Congress under 38 U.S.C. 529. In..., United States Code. (b) Submission of an annual report. The committee shall: (1) Submit to the Secretary an annual report on the rehabilitation programs and activities of the VA; and (2) Submit such other...

Effects of rehabilitation services on anxiety, depression, care-giving burden and perceived social support of stroke caregivers.

PubMed

Karahan, Ali Yavuz; Kucuksen, Sami; Yilmaz, Halim; Salli, Ali; Gungor, Tayfun; Sahin, Muhammed

2014-01-01

Few data are available on the specific care giving-related problems of stroke patient's caregivers and factors that influence the burden of these caregivers. To study the influences of the active rehabilitation process on anxiety, depression, care burden and perceived social support level of stroke patients caregivers. A prospective clinical trial. Patients and caregivers entering a rehabilitation program at a university hospital in Turkey. Ninety patients with a first episode of stroke and 90 caregivers responsible for their care were recruited for our study. Patients and caregivers were assessed before and after the active rehabilitation process. The functional disability level of the patients was assessed by Functional Independence Measure (FIM). The Beck Anxiety Scale (BAS) and the Beck Depression Scale (BDS) were used for anxiety and depression assessment, the Zarit Care Burden Scale (ZCBS) for care burden assessment and the Multi-Dimensional Scale of Perceived Social Support (MDSPSS) for perceived social support assessment. A statistically significant rise is observed in the special person sub-assessment of MDSPSS in both female and male caregivers. Also, a significant decrease in care burden, anxiety and depression levels of caregivers was noted after the rehabilitation program (p < 0.05). Caregivers accept the rehabilitation period as important social support in addition to the support provided by family and friends. Also, our positive results were associated with an improvement in the patients' functional level and an increase in the acquisition of knowledge and skill required of caregivers in order to provide care during rehabilitation. The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with stress effectively.

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,…

Rehabilitation and future participation of youth following spinal cord injury: caregiver perspectives.

PubMed

House, L A; Russell, H F; Kelly, E H; Gerson, A; Vogel, L C

2009-12-01

Cross-sectional survey. To examine caregivers' perspectives on the effectiveness of rehabilitative support experienced by youth with spinal cord injury (SCI) during acute rehabilitation and after community reintegration in terms of their community participation. Data collection took place at the three Shriners SCI hospitals: Chicago, Philadelphia, and Northern California. A total of 132 primary caregivers of youth with SCI completed a survey on what their child had experienced during and after rehabilitation to enhance their community participation. Caregivers found technical support from staff (41%), motivation and encouragement from staff (25%), and education (17%) to be the most important factors during rehabilitation for encouraging their child's future participation in school or community activities. Caregivers found involvement in activities (30%), personal resilience (22%) and interactions with others with disabilities (13%) to be important experiences since rehabilitation in terms of their child's participation in school and community activities. Caregivers who responded that something they experienced during rehabilitation was helpful to participation had children who had been injured longer and who were older at time of injury. In addition, caregivers who reported that something they have experienced since their child's rehabilitation has been helpful in terms of participation also had children who were older at time of injury. Findings from this study can be used to help professionals tailor rehabilitation programs to better meet the needs of youth with SCI and their families, thereby increasing chances of successful reintegration back into their communities.

23 CFR 661.15 - What are the eligible activities for IRRBP funds?

Code of Federal Regulations, 2010 CFR

2010-04-01

... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.15 What are the eligible activities for... replace, rehabilitate, seismically retrofit, paint, apply calcium magnesium acetate, sodium acetate...

23 CFR 661.15 - What are the eligible activities for IRRBP funds?

Code of Federal Regulations, 2013 CFR

2013-04-01

... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.15 What are the eligible activities for... replace, rehabilitate, seismically retrofit, paint, apply calcium magnesium acetate, sodium acetate...

23 CFR 661.15 - What are the eligible activities for IRRBP funds?

Code of Federal Regulations, 2011 CFR

2011-04-01

... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.15 What are the eligible activities for... replace, rehabilitate, seismically retrofit, paint, apply calcium magnesium acetate, sodium acetate...

23 CFR 661.15 - What are the eligible activities for IRRBP funds?

Code of Federal Regulations, 2012 CFR

2012-04-01

... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.15 What are the eligible activities for... replace, rehabilitate, seismically retrofit, paint, apply calcium magnesium acetate, sodium acetate...

23 CFR 661.15 - What are the eligible activities for IRRBP funds?

Code of Federal Regulations, 2014 CFR

2014-04-01

... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.15 What are the eligible activities for... replace, rehabilitate, seismically retrofit, paint, apply calcium magnesium acetate, sodium acetate...

[Adding the perspective of emotion on cognitive rehabilitation].

PubMed

Nakagome, Kazuyuki

2011-01-01

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

Hemiplegic shoulder pain: associated factors and rehabilitation outcomes of hemiplegic patients with and without shoulder pain.

PubMed

Karaahmet, Ozgur Zeliha; Eksioglu, Emel; Gurcay, Eda; Karsli, Pınar Bora; Tamkan, Ugur; Bal, Ajda; Cakcı, Aytul

2014-01-01

To analyze the incidence of and the factors associated with shoulder pain in people with hemiplegia and to understand the effect of rehabilitation programs on the parameters of motor function and activity limitations in patients with and without hemiplegic shoulder pain. Patients in the initial 6-month period after stroke who were hospitalized in the physical medicine and rehabilitation clinic were included in the study. Patients were considered early rehabilitation entrants if they were admitted in the first 0 to 30 days after a stroke and late rehabilitation entrants if they were admitted 30 to 120 days after a stroke. Demographic and clinical features, complications, and medical histories of the patients were recorded. Upper extremity Fugl-Meyer Motor Assessment (FMA), Frenchay Arm Test (FAT), and Functional Independence Measure (FIM) were applied to the patients on admission, at discharge, and after 1 month of follow-up. Twenty-one (38%) patients did not have shoulder pain, and 34 (62%) patients had decreased shoulder pain. Immobilization, duration of disease, and late rehabilitation were shown to be effective treatments for shoulder pain. The major risk factors were disease duration and poor initial motor function. In both groups, the FMA, FAT, and FIM scores showed significant changes. This improvement did not differ between the 2 groups. Duration of disease and low motor functional capacities have the most important impact on shoulder pain. In patients with and without shoulder pain, a systematic rehabilitation program is beneficial with respect to motor function and daily living activities.

34 CFR 385.1 - What is the Rehabilitation Training program?

Code of Federal Regulations, 2011 CFR

2011-07-01

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

34 CFR 385.1 - What is the Rehabilitation Training program?

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

PubMed

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

2016-06-01

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

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

PubMed

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

2017-12-01

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

Cardiac rehabilitation and exercise training in secondary coronary heart disease prevention.

PubMed

Lavie, Carl J; Milani, Richard V

2011-01-01

Substantial evidence indicates that increased levels of physical activity, exercise training, and overall cardiorespiratory fitness provide protection in primary and secondary coronary heart disease (CHD) prevention. Clearly, cardiac rehabilitation and exercise training (CRET) programs have been greatly underused in patients with CHD. We review the benefits of formal CRET programs on CHD risk factors including exercise capacity, obesity indices, plasma lipids, inflammation, and psychosocial stress as well as overall morbidity and mortality. These data support the fact that patients with CHD, especially after major CHD events, need routine referral to CRET programs; and patients should be vigorously encouraged to attend these valuable programs. Copyright © 2011. Published by Elsevier Inc.

Exercise at Home

MedlinePlus

... Treatment & Programs Health Information Doctors & Departments Clinical Research & Science Education & ... Exercise and staying active are an important part of rehabilitation for chronic disease. Below are ...

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

PubMed

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

2012-02-01

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

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

PubMed

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

2015-04-01

In adults undergoing inpatient rehabilitation, does additional after-hours rehabilitation decrease length of stay and improve functional outcome, activities of daily living performance and physical activity? Systematic review with meta-analysis of randomised trials. Adults participating in an inpatient rehabilitation program. Additional rehabilitation provided after hours (evening or weekend). Function was measured with tests such as the Motor Assessment Scale, 10-m walk test, the Timed Up and Go test, and Berg Balance Scale. Performance on activities of daily living was measured with the Barthel index or the Functional Independence Measure. Length of stay was measured in days. Physical activity levels were measured as number of steps or time spent upright. Standardised mean differences (SMD) or mean differences (MD) were used to combine these outcomes. Adverse events were summarised using relative risks (RR). Study quality was assessed using PEDro scores. Seven trials were included in the review. All trials had strong methodological quality, scoring 8/10 on the PEDro scale. Among the measures of function, only balance showed a significant effect: the MD was 14 points better (95% CI 5 to 23) with additional after-hours rehabilitation on a 0-to-56-point scale. The improvement in activities of daily living performance with additional after-hours rehabilitation was of borderline statistical significance (SMD 0.10, 95% CI 0.00 to 0.21). Hospital length of stay did not differ significantly (MD -1.8 days, 95% CI -5.1 to 1.6). Those receiving additional rehabilitation had significantly higher step counts and spent significantly more time upright. Overall, the risk of adverse events was not increased by the provision of after-hours or weekend rehabilitation (RR 0.87, 95% CI 0.70 to 1.10). Additional after-hours rehabilitation can increase physical activity and may improve activities of daily living, but does not seem to affect the hospital length of stay. PROSPERO CRD42014007648. [Scrivener K, Jones T, Schurr K, Graham PL, Dean CM (2015) After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review.Journal of Physiotherapy61: 61-67]. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

1994 Student Writing Contest Winner

PubMed Central

Waller, Heather D.

1995-01-01

This case study describes the history, diagnosis, rehabilitation, and prognosis of an isolated posterior cruciate ligament (PCL) rupture seen in a collegiate soccer player. The occurrence of an isolated PCL rupture is rare in athletics. An accurate diagnosis is important and can be obtained by using techniques such as: passive tests, active tests, X rays, and magnetic resonance imaging. Rehabilitation from this injury is controversial because of the lack of documentation clearly showing the natural pathology of a PCL-deficient knee. There is research indicating that if chronic joint degeneration occurs, it will most likely be medial compartment or patellofemoral arthritis. Currently, the options are reconstructive surgery or participation in a nonoperative rehabilitation program. Because of this athlete's strength, age, and the nature of his sport, reconstructive surgery was not chosen. The rehabilitation program was progressive and modeled after the five stages of rehabilitation as described by Prentice. It emphasized strengthening the quadriceps and increasing hamstring flexibility. The athlete experienced minimal pain and inflammation after the injury. Results of rehabilitation were outstanding. The athlete was released for return to full contact 4–1/2 weeks postinjury. He demonstrated excellent performance without any abnormal knee symptoms. The ratio of quadriceps to hamstring strength was bilaterally stabilized to 87%, and the ratio of quadriceps strength of the injured knee to the healthy knee was 102% when the athlete returned to sports activities. The athlete will have to wait to see if the chronic damage that may develop will be symptomatic. PMID:16558303

78 FR 69398 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving... Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Minority... the capacity of minority entities to conduct high-quality disability and rehabilitation research by...

At the sources of one's well-being: early rehabilitation for employees with symptoms of distress.

PubMed

Kuoppala, Jaana; Kekoni, Jouni

2013-07-01

To examine the effects of a new multifaceted early rehabilitation program on employee well-being targeted on distressed employees in small-to-medium sized workplaces. Fifty-two employees (92% women; age: 34 to 66 years) participated in five biweekly sessions with one follow-up day at 6 months. Rehabilitation professionals specially trained for the mindfulness method covered topics from health, nutrition, sleep, physical activity to stress management. Employees were divided by their well-being level at baseline into "healthy" and "symptomatic" groups. Main outcomes were job, mental, and physical well-being. Well-being among the symptomatic employees reached that of the healthy ones at baseline. Also, the healthy participants benefited from the program to a small degree. The preliminary findings of this new program are promising although more research is needed on its effects and cost-effectiveness.

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

Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy.

PubMed

Preston, Nick; Weightman, Andrew; Gallagher, Justin; Holt, Raymond; Clarke, Michael; Mon-Williams, Mark; Levesley, Martin; Bhakta, Bipinchandra

2016-01-01

We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Nine boys and two girls with cerebral palsy (6-12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB-BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2 min, p = 0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p = 0.424; COPM, p = 0.484) but we found significant improvements in hand speed (p = 0.028), smoothness (p = 0.005) and accuracy (p = 0.007). School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity. Implications for Rehabilitation School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology. Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance). The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

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

A qualitative study adopting a user-centered approach to design and validate a brain computer interface for cognitive rehabilitation for people with brain injury.

PubMed

Martin, Suzanne; Armstrong, Elaine; Thomson, Eileen; Vargiu, Eloisa; Solà, Marc; Dauwalder, Stefan; Miralles, Felip; Daly Lynn, Jean

2017-07-14

Cognitive rehabilitation is established as a core intervention within rehabilitation programs following a traumatic brain injury (TBI). Digitally enabled assistive technologies offer opportunities for clinicians to increase remote access to rehabilitation supporting transition into home. Brain Computer Interface (BCI) systems can harness the residual abilities of individuals with limited function to gain control over computers through their brain waves. This paper presents an online cognitive rehabilitation application developed with therapists, to work remotely with people who have TBI, who will use BCI at home to engage in the therapy. A qualitative research study was completed with people who are community dwellers post brain injury (end users), and a cohort of therapists involved in cognitive rehabilitation. A user-centered approach over three phases in the development, design and feasibility testing of this cognitive rehabilitation application included two tasks (Find-a-Category and a Memory Card task). The therapist could remotely prescribe activity with different levels of difficulty. The service user had a home interface which would present the therapy activities. This novel work was achieved by an international consortium of academics, business partners and service users.

The Civil Rights of Students with Hidden Disabilities under Section 504 of the Rehabilitation Act of 1973.

ERIC Educational Resources Information Center

Fund for the Improvement of Postsecondary Education (ED), Washington, DC.

The pamphlet outlines provisions of Section 504 of the Rehabilitation Act of 1973, which protects the rights of persons with handicaps in programs and activities that receive federal financial assistance, including individuals with disabilities that may not be apparent. The pamphlet answers questions about the civil rights of students with hidden…

Free Appropriate Public Education for Students with Disabilities: Requirements under Section 504 of the "Rehabilitation Act of 1973." Revised

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

Section 504 of the "Rehabilitation Act of 1973" protects the rights of individuals with disabilities in programs and activities that receive federal funds. The Section 504 regulation requires a school district to provide a "free appropriate public education" (FAPE) to each qualified person with a disability who is in the school…

24 CFR 882.401 - Eligible properties.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DISABILITIES PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Special Procedures for Moderate Rehabilitation... for inclusion under the Moderate Rehabilitation Program. Existing structures of various types may be...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-08

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

Establishing a Drug Rehabilitation Center in a Prison Setting.

ERIC Educational Resources Information Center

Page, Richard C.

The implementation of a drug treatment center in a prison environment is described. Such topics as the program initiation, selection of residents, early program operation are discussed. Program activities such as regular group counseling and rational therapy were developed to assist residents in the resolution of personal problems and interactions…

Short- and long-term effects of the modified swedish version of the Active Communication Education (ACE) program for adults with hearing loss.

PubMed

Oberg, Marie; Bohn, Therese; Larsson, Ulrika

2014-10-01

In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the original ACE program were modified. The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39-82 yr old. Design was a between-group and within-group intervention study. The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions. The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group. The outcomes were measured before initiation of the program, 3 wk after program completion, and 6 mo after program completion and included communication strategy use, activity and participation, health-related quality of life, and anxiety and depression. In addition, outcomes were measured after program completion using the International Outcome Inventory-Alternative Interventions, a modified version of the Client Oriented Scale of Improvement, and qualitative feedback was obtained about the response to the program and actions taken as a result of participation. The treatment effects were examined using repeated-measures analyses of variance. Statistically significant effects were found for communication strategy use, activity and participation, and psychosocial well-being. Statistically significant effects were found for gender and degree of hearing loss, indicating that women and those with mild hearing loss significantly improved communication strategies. It is suggested that the program be implemented as part of regular audiological rehabilitation and offered in an early stage of rehabilitation. American Academy of Audiology.

Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility

NASA Astrophysics Data System (ADS)

Musumeci, Alfredo; Pranovi, Giulia; Masiero, Stefano

2018-05-01

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical—PCS-12—and mental health component—MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability.

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

PubMed

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

2016-08-01

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

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

NASA Astrophysics Data System (ADS)

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

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

75 FR 21282 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

75 FR 2119 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

75 FR 21278 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Research and Training... Disability and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this...

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

PubMed

Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

2018-04-01

The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

38 CFR 21.4154 - Report of activities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs State Approving... performed and the determination made in supervising and ascertaining the qualifications of educational...

38 CFR 21.4154 - Report of activities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs State Approving... performed and the determination made in supervising and ascertaining the qualifications of educational...

78 FR 2664 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... with disabilities from underserved populations; (4) identify research gaps; (5) identify mechanisms for... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving... Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Minority...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

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

75 FR 27741 - National Institute on Disability and Rehabilitation Research (NIDRR); Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR); Disability and Rehabilitation Research Projects and Centers Program; Rehabilitation Research and Training... Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this notice announces a...

Increasing physical activity in patients with mental illness--A randomized controlled trial.

PubMed

Göhner, Wiebke; Dietsche, Christine; Fuchs, Reinhard

2015-11-01

The objective of the study was to evaluate whether a motivational-volitional intervention program offered in addition to an existing sport program during stationary treatment is capable of establishing a post-stationary increase in physical activity in persons with mental illness. N=112 in-patients were initially randomly assigned to the control group (CG; standard rehabilitation) or intervention group (IG; standard rehabilitation plus intervention). Assessments were conducted at four measurement points. At 6 months follow up, the level of exercise in the IG was 95 min/week higher than in the CG (p=.02). The participants of the IG were able to increase their level of goal intention until 6 months follow up (t2: p=.03; t4: p=.005); levels of self-efficacy of the IG increased during intervention (t2: p=.001). Changes in volitional aspects were significant over time (t1-t3), but not specifically for the IG. The intervention was effective at increasing the level of physical activity in patients with mental illness who were initially minimally active. Our results suggest that it could be of great use to place the emphasis of a physical activity-enhancing intervention on its motivational effect since volitional aspects are already taken into sufficient account in standard rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cognitive training on stroke patients via virtual reality-based serious games.

PubMed

Gamito, Pedro; Oliveira, Jorge; Coelho, Carla; Morais, Diogo; Lopes, Paulo; Pacheco, José; Brito, Rodrigo; Soares, Fabio; Santos, Nuno; Barata, Ana Filipa

2017-02-01

Use of virtual reality environments in cognitive rehabilitation offers cost benefits and other advantages. In order to test the effectiveness of a virtual reality application for neuropsychological rehabilitation, a cognitive training program using virtual reality was applied to stroke patients. A virtual reality-based serious games application for cognitive training was developed, with attention and memory tasks consisting of daily life activities. Twenty stroke patients were randomly assigned to two conditions: exposure to the intervention, and waiting list control. The results showed significant improvements in attention and memory functions in the intervention group, but not in the controls. Overall findings provide further support for the use of VR cognitive training applications in neuropsychological rehabilitation. Implications for Rehabilitation Improvements in memory and attention functions following a virtual reality-based serious games intervention. Training of daily-life activities using a virtual reality application. Accessibility to training contents.

Application of the Transtheoretical Model to Exercise Behavior and Physical Activity in Patients after Open Heart Surgery.

PubMed

Huang, Hsin-Yi; Lin, Yu-Shan; Chuang, Yi-Cheng; Lin, Wei-Hsuan; Kuo, Li Ying; Chen, Jui Chun; Hsu, Ching Ling; Chen, Bo Yan; Tsai, Hui Yu; Cheng, Fei Hsin; Tsai, Mei-Wun

2015-05-01

To assess exercise behavior and physical activity levels after open heart surgery. This prospective cohort study included 130 patients (70.8% male, aged 61.0 ± 12.2 years, 53.8% coronary bypass grafting) who underwent open heart surgery. The exercise behavior and physical activity of these patients were assessed at the 3- and 6-month follow-up appointments. Additional interviews were also conducted to further assess exercise behavior. Physical activity duration and metabolic equivalents were calculated from self-reported questionnaire responses. Moreover, possible related demographic factors, clinical features, participation in cardiac rehabilitation programs, and physical activity levels were additionally evaluated. Six months after hospital discharge, most patients were in the action (39.2%) and maintenance (37.7%) stages. Other subjects were in the precontemplation (11.5%), contemplation (5.4%), and preparation (6.2%) stages. The average physical activity level was 332.6 ± 377.1 min/week and 1198.1 ± 1396.9 KJ/week. Subjects in the action and maintenance stages exercised an average of 399.4 ± 397.6 min/week, significantly longer than those in other stages (116.2 ± 176.2 min/week, p = 0.02). Subjects that participated in outpatient cardiac rehabilitation programs after discharge may have the better exercise habit. Gender had no significant effect on exercise behavior 6 months after hospital discharge. Most subjects following open heart surgery may maintain regular exercise behavior at 6 months after hospital discharge. Physical activity levels sufficient for cardiac health were achieved by subjects in the active and maintenance stages. Outpatient cardiac rehabilitation programs are valuable for encouraging exercise behavior after heart surgery. Exercise behavior; Open heart surgery; Physical activity; Transtheoretical model.

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

PubMed

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

2010-07-01

To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P < 0.01). Total hours of physical therapy and occupational therapy services per patient day were 1.2 in skilled nursing facilities and 2.0 in inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P < 0.01). Patients in inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

Outcomes of hip resurfacing in a professional dancer: a case report.

PubMed

Dunleavy, Kim

2012-02-01

A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with hip osteoarthritis. A more aggressive rehabilitation program than the typical total hip arthroplasty protocol is needed for active individuals. This case report describes interventions used to maximize function in a 46-year-old professional dancer after hip resurfacing with a progressive therapeutic exercise program. Exercise choices were selected to address dance-specific requirements while respecting healing of the posterior capsular incision. Strengthening focused on hip abduction, extension, and external rotation. Precautions included avoiding gluteal stretching until 6 months. Pelvic alignment and weight-bearing distribution were emphasized. The patient was able to return to rehearsal by 7 months, at which time strength was equivalent to the unaffected leg. Range of motion reached unaffected side values at week 8 for internal rotation, week 11 for extension, week 13 for adduction, and week 28 for flexion. External rotation and abduction were still limited at 1 year, which influenced pelvic alignment with resultant pain on the unaffected side. Functional and impairment outcomes are presented with timelines to provide a basis for postoperative benchmarks for active clients after hip resurfacing. Although this case report presents a dance-specific program, exercise progressions for other active individuals may benefit from similar exercise intensity and sports-specific focus. Future rehabilitation programs should take into account possible flexion and external rotation range limitations and the need for gluteal muscle strengthening along with symmetry and pelvic alignment correction. Long-term studies investigating intensity of rehabilitation are warranted for patients intending to participate in higher level athletic activity.

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

PubMed

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

2014-01-01

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

78 FR 34897 - Final Priorities; National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

....133E-8.] Final Priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers AGENCY: Office... under the Disability and Rehabilitation Research Projects and Centers Program administered by the...

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.

34 CFR 105.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... 504 of the Rehabilitation Act of 1973 to prohibit discrimination on the basis of handicap in programs...

34 CFR 105.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... 504 of the Rehabilitation Act of 1973 to prohibit discrimination on the basis of handicap in programs...

34 CFR 105.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... 504 of the Rehabilitation Act of 1973 to prohibit discrimination on the basis of handicap in programs...

34 CFR 105.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... 504 of the Rehabilitation Act of 1973 to prohibit discrimination on the basis of handicap in programs...

34 CFR 105.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... 504 of the Rehabilitation Act of 1973 to prohibit discrimination on the basis of handicap in programs...

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…

Rehabilitation Strategies for the Athletic Individual with Early Knee Osteoarthritis.

PubMed

Jayabalan, Prakash; Ihm, Joseph

2016-01-01

Knee osteoarthritis (OA) is a major cause of disability in the United States. The condition has most commonly been associated with elderly sedentary individuals; however, it also can affect those who participate in regular athletic activities. The diagnosis and management of these individuals can be challenging because of both their higher level of physical activity and their overall athletic goals. Treatment requires an appropriate exercise regimen, rehabilitation program, and education of both the athlete and the coach. The focus of our article is to provide an up-to-date overview of the evaluation and management of the athletic individual who presents with symptomatic early knee OA, in particular, the nonsurgical rehabilitation treatment options available to the practitioner and the evidence to support these recommendations.

Refining a measure of brain injury sequelae to predict postacute rehabilitation outcome: rating scale analysis of the Mayo-Portland Adaptability Inventory.

PubMed

Malec, J F; Moessner, A M; Kragness, M; Lezak, M D

2000-02-01

Evaluate the psychometric properties of the Mayo-Portland Adaptability Inventory (MPAI). Rating scale (Rasch) analysis of MPAI and principal component analysis of residuals; the predictive validity of the MPAI measures and raw scores was assessed in a sample from a day rehabilitation program. Outpatient brain injury rehabilitation. 305 persons with brain injury. A 22-item scale reflecting severity of sequelae of brain injury that contained a mix of indicators of impairment, activity, and participation was identified. Scores and measures for MPAI scales were strongly correlated and their predictive validities were comparable. Impairment, activity, and participation define a single dimension of brain injury sequelae. The MPAI shows promise as a measure of this construct.

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

PubMed

Meng, Karin; Peters, Stefan; Faller, Hermann

2017-06-01

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

Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation.

PubMed

Vriezekolk, Johanna E; Geenen, Rinie; van den Ende, Cornelia H M; Slot, Helma; van Lankveld, Wim G J M; van Helmond, Toon

2012-05-01

To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases. Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction. The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale). Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high. Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

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

PubMed

Krauth, Christian; Bartling, Tim

2017-04-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

PubMed

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

2017-10-01

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

Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation.

PubMed

Jackson, James C; Ely, E Wesley; Morey, Miriam C; Anderson, Venice M; Denne, Laural B; Clune, Jennifer; Siebert, Carol S; Archer, Kristin R; Torres, Renee; Janz, David; Schiro, Elena; Jones, Julie; Shintani, Ayumi K; Levine, Brian; Pun, Brenda T; Thompson, Jennifer; Brummel, Nathan E; Hoenig, Helen

2012-04-01

Millions of patients who survive medical and surgical general intensive care unit care every year experience newly acquired long-term cognitive impairment and profound physical and functional disabilities. To overcome the current reality in which patients receive inadequate rehabilitation, we devised a multifaceted, in-home, telerehabilitation program implemented using social workers and psychology technicians with the goal of improving cognitive and functional outcomes. This was a single-site, feasibility, pilot, randomized trial of 21 general medical/surgical intensive care unit survivors (8 controls and 13 intervention patients) with either cognitive or functional impairment at hospital discharge. After discharge, study controls received usual care (sporadic rehabilitation), whereas intervention patients received a combination of in-home cognitive, physical, and functional rehabilitation over a 3-month period via a social worker or master's level psychology technician utilizing telemedicine to allow specialized multidisciplinary treatment. Interventions over 12 wks included six in-person visits for cognitive rehabilitation and six televisits for physical/functional rehabilitation. Outcomes were measured at the completion of the rehabilitation program (i.e., at 3 months), with cognitive functioning as the primary outcome. Analyses were conducted using linear regression to examine differences in 3-month outcomes between treatment groups while adjusting for baseline scores. Patients tolerated the program with only one adverse event reported. At baseline both groups were well-matched. At 3-month follow-up, intervention group patients demonstrated significantly improved cognitive executive functioning on the widely used and well-normed Tower test (for planning and strategic thinking) vs. controls (median [interquartile range], 13.0 [11.5-14.0] vs. 7.5 [4.0-8.5]; adjusted p < .01). Intervention group patients also reported better performance (i.e., lower score) on one of the most frequently used measures of functional status (Functional Activities Questionnaire at 3 months vs. controls, 1.0 [0.0 -3.0] vs. 8.0 [6.0-11.8], adjusted p = .04). A multicomponent rehabilitation program for intensive care unit survivors combining cognitive, physical, and functional training appears feasible and possibly effective in improving cognitive performance and functional outcomes in just 3 months. Future investigations with a larger sample size should be conducted to build on this pilot feasibility program and to confirm these results, as well as to elucidate the elements of rehabilitation contributing most to improved outcomes.

34 CFR 385.1 - What is the Rehabilitation Training program?

Code of Federal Regulations, 2012 CFR

2012-07-01

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

34 CFR 385.1 - What is the Rehabilitation Training program?

Code of Federal Regulations, 2013 CFR

2013-07-01

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

SCIRehab Project Series: The Therapeutic Recreation Taxonomy

PubMed Central

Cahow, Claire; Skolnick, Susan; Joyce, Joan; Jug, Julie; Dragon, Charlotte; Gassaway, Julie

2009-01-01

Background/Objective: Outcomes research of therapeutic recreation (TR) activities and interventions for spinal cord injury (SCI) rehabilitation is made more difficult by a lack of uniform descriptions and the absence of a formal treatments classification system (taxonomy). The objective of this study was to describe a taxonomy developed by Certified Therapeutic Recreation Specialists. Methods: TR lead clinicians and researchers from 6 SCI rehabilitation centers developed a TR documentation system to describe the details of each TR session involving patients with SCI enrolled in the SCIRehab study. The SCIRehab study uses the practice-based evidence methodology, a rigorous observational methodology that examines current practice without introducing additional treatments, to capture details of each TR session for 1,500 SCI rehabilitation patients at 6 US inpatient SCI rehabilitation facilities. This may be the first attempt to document the many details of the TR rehabilitation process for patients with SCI. Results: The TR taxonomy consists of 6 activities (eg, leisure education and counseling, outings, and leisure skill work in center) and activity-specific interventions, as well as time spent on each activity. Activity descriptions are enhanced with additional details that focus on assistance needs for each activity, patient ability to direct care, and patient/family involvement, which may help to determine TR activity selection. Conclusion: Development and application of a TR taxonomy, which is comprehensive for patients with SCI and efficient to use, are feasible despite significantly different TR programs at the 6 SCIRehab centers. PMID:19810631

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

PubMed

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

2018-05-01

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

[Third phase of cardiac rehabilitation: a nurse-based "home-control" model].

PubMed

Albertini, Sara; Ciocca, Antonella; Opasich, Cristina; Pinna, Gian Domenico; Cobelli, Franco

2011-12-01

Phase 3 is a critical point for cardiac rehabilitation: many problems don't allow achieving a correct secondary prevention, in particular regarding the relationship between patient and cardiologist. Aiming at ensuring continuity of care of phase 3 cardiac rehabilitation patients, we have developed a telemetric educational program to stimulate in them the will and capacity to become active comanagers of their disease. Nurses specialized in cardiac rehabilitation, with the collaboration of the general practitioners, contact the patients by scheduled phone calls to collect questionnaires about their health status and the result of biochemistry. All the results are analyzed by the nurses and discussed with each patient (educational reinforcement). The effects of this program of comanagement of cardiac disease and secondary prevention are analyzed comparing each patient data at the discharge with data after one year and those coming from our archive (retrospective analysis). The patients enrolled in this study pay much more attention to the amount of food they eat; they tend not to gain weight, and they restart smoking in a reduced proportion compared to patients not enrolled in the study. However, despite having received better information on their cardiac disease, their compliance to physical training, consumption of healthy food, and pharmacological therapy is not improved. This study focuses on the role of a continuous educational program of a cardiac rehabilitation unit after the patient's discharge. This home control program conducted by nurses specialized in cardiac rehabilitation, with the assistance of cardiologists, psychologists and physiotherapists, and in collaboration with the general practitioner, was quite cheap, and helped maximizing the knowledge of the disease and reinforcing correct life style in the patients. The results are not as good as expected, probably because one year does not represent a sufficient time, or because the educational intervention needs to be improved.

Electronic Health Physical Activity Behavior Change Intervention to Self-Manage Cardiovascular Disease: Qualitative Exploration of Patient and Health Professional Requirements.

PubMed

Walsh, Deirdre Mj; Moran, Kieran; Cornelissen, Véronique; Buys, Roselien; Cornelis, Nils; Woods, Catherine

2018-05-08

Cardiovascular diseases are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation. Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based cardiac rehabilitation programs is low, with community-based cardiac rehabilitation rates and individual long-term exercise maintenance even lower. Home-based cardiac rehabilitation programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available. Given the potential that home-based cardiac rehabilitation programs have, it is important to explore how to appropriately design any such intervention in conjunction with key stakeholders. The aim of this study was to engage with individuals with cardiovascular disease and other professionals within the health ecosystem to (1) understand the personal, social, and physical factors that inhibit or promote their capacity to engage with physical activity and (2) explore their technology competencies, needs, and wants in relation to an eHealth intervention. Fifty-four semistructured interviews were conducted across two countries. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Barriers to the implementation of PATHway were also explored specifically in relation to physical capability and safety as well as technology readiness and further mapped onto the COM-B model for future intervention design. Key recommendations included collection of patient data and use of measurements, harnessing hospital based social connections, and advice to utilize a patient-centered approach with personalization and tailoring to facilitate optimal engagement. In summary, a multifaceted, personalizable intervention with an inclusively designed interface was deemed desirable for use among cardiovascular disease patients both by end users and key stakeholders. In-depth understanding of core needs of the population can aid intervention development and acceptability. ©Deirdre MJ Walsh, Kieran Moran, Véronique Cornelissen, Roselien Buys, Nils Cornelis, Catherine Woods. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.05.2018.

Disability and rehabilitation in the dizzy patient.

PubMed

Cohen, Helen S

2006-02-01

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

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

PubMed

Kallhed, Cecilia; Mårtensson, Lena

2018-03-01

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

34 CFR 381.3 - What activities may the Secretary fund?

Code of Federal Regulations, 2010 CFR

2010-07-01

... disabilities who are exiting from public school programs. (4) Coordinating the protection and advocacy program... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION PROTECTION AND ADVOCACY OF... remedies or approaches to ensure the protection of, and advocacy for, the rights of eligible individuals...

34 CFR 361.60 - Matching requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM Financing of State Vocational Rehabilitation Programs § 361.60 Matching requirements. (a) Federal share—(1) General... State under the State plan, including expenditures for the provision of vocational rehabilitation...

A family involvement and patient-tailored health management program in elderly Korean stroke patients' day care centers.

PubMed

Chang, Ae Kyung; Park, Yeon-Hwan; Fritschi, Cynthia; Kim, Mi Ja

2015-01-01

This study aimed to examine the effects of a family involvement and functional rehabilitation program in an adult day care center on elderly Korean stroke patients' perceived health, activities of daily living, instrumental activities of daily living, and cost of health services, and on family caregivers' satisfaction. Using one-group pre- and posttest design, dyads consisting of 19 elderly stroke patients and family caregivers participated in 12-week intervention, including involvement of family caregivers in day care services and patient-tailored health management. Outcomes of patients and caregivers were significantly improved (all p < .001). However, the cost of health services did not decrease significantly. This program improved functional levels and health perception of elderly stroke patients and caregivers' satisfaction. However, results must be interpreted with caution, because this was only a small, single-group pilot study. This program may be effective for elderly stroke patients and their caregivers. © 2013 Association of Rehabilitation Nurses.

Early rehabilitation programs after laparoscopic colorectal surgery: Evidence and criticism

PubMed Central

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

2013-01-01

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

[Physical rehabilitation in multiple sclerosis: general principles and high-tech approaches].

PubMed

Peresedova, A V; Chernikova, L A; Zavalishin, I A

2013-01-01

In a chronic and disabling disease like multiple sclerosis, rehabilitation programs are of major importance for the preservation of physical, physiological, social and professional functioning and improvement of quality of life. Currently, it is generally assumed that physical activity is an important component of non-pharmacological rehabilitation in multiple sclerosis. Properly organized exercise is a safe and efficient way to induce improvements in a number of physiological functions. A multidisciplinary rehabilitative approach should be recommended. The main recommendations for the use of exercise for patients with multiple sclerosis have been listed. An important aspect of the modern physical rehabilitation in multiple sclerosis is the usage of high-tech methods. The published results of robot-assisted training to improve the hand function and walking impairment have been represented. An important trend in the rehabilitation of patients with multiple sclerosis is the reduction of postural disorders through training balance coordination. The role of transcranial magnetic stimulation in spasticity reducing is being investigated. The use of telemedicine capabilities is quite promising. Due to the fact that the decline in physical activity can lead to the deterioration of many aspects of physiological functions and, ultimately, to mobility decrease, further research of the role of physical rehabilitation as an important therapeutic approach in preventing the progression of disability in multiple sclerosis is required.

Socially assistive robotics for post-stroke rehabilitation

PubMed Central

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

2007-01-01

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

Predicting efficacy of robot-aided rehabilitation in chronic stroke patients using an MRI-compatible robotic device.

PubMed

Sergi, Fabrizio; Krebs, Hermano Igo; Groissier, Benjamin; Rykman, Avrielle; Guglielmelli, Eugenio; Volpe, Bruce T; Schaechter, Judith D

2011-01-01

We are investigating the neural correlates of motor recovery promoted by robot-mediated therapy in chronic stroke. This pilot study asked whether efficacy of robot-aided motor rehabilitation in chronic stroke could be predicted by a change in functional connectivity within the sensorimotor network in response to a bout of motor rehabilitation. To address this question, two stroke patients participated in a functional connectivity MRI study pre and post a 12-week robot-aided motor rehabilitation program. Functional connectivity was evaluated during three consecutive scans before the rehabilitation program: resting-state; point-to-point reaching movements executed by the paretic upper extremity (UE) using a newly developed MRI-compatible sensorized passive manipulandum; resting-state. A single resting-state scan was conducted after the rehabilitation program. Before the program, UE movement reduced functional connectivity between the ipsilesional and contralesional primary motor cortex. Reduced interhemispheric functional connectivity persisted during the second resting-state scan relative to the first and during the resting-state scan after the rehabilitation program. Greater reduction in interhemispheric functional connectivity during the resting-state was associated with greater gains in UE motor function induced by the 12-week robotic therapy program. These findings suggest that greater reduction in interhemispheric functional connectivity in response to a bout of motor rehabilitation may predict greater efficacy of the full rehabilitation program.

34 CFR 361.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM General § 361.1 Purpose. Under the State Vocational Rehabilitation Services Program (Program), the Secretary provides grants to...) Designed to assess, plan, develop, and provide vocational rehabilitation services for individuals with...

Seasonal Regulation of Repair Evaluation, Maintenance, and Rehabilitation (REMR) Activities. Repair, Evaluation, Maintenance, and Rehabilitation Research Program

DTIC Science & Technology

1988-08-01

availability and bioaccumulation of heavy metals, petroleum hydrocarbons , synthetic organic compounds, and radionuclides in sediments. Specific...toxins, petroleum pollution, noise, removal of colonized hard substrate, and ~~addition of new hard substrate. Using this information, in addition to...the disturbance. 16. Sedimentation and/or removal of substrate in areas adjacent to structures may affect benthic resources such as mollusc beds

An object-oriented, knowledge-based system for cardiovascular rehabilitation--phase II.

PubMed Central

Ryder, R. M.; Inamdar, B.

1995-01-01

The Heart Monitor is an object-oriented, knowledge-based system designed to support the clinical activities of cardiovascular (CV) rehabilitation. The original concept was developed as part of graduate research completed in 1992. This paper describes the second generation system which is being implemented in collaboration with a local heart rehabilitation program. The PC UNIX-based system supports an extensive patient database organized by clinical areas. In addition, a knowledge base is employed to monitor patient status. Rule-based automated reasoning is employed to assess risk factors contraindicative to exercise therapy and to monitor administrative and statutory requirements. PMID:8563285

Reliability and validity of a treatment adherence measure for child psychiatric rehabilitation.

PubMed

Williams, Nathaniel J; Green, Philip

2012-09-01

Treatment adherence, defined as the degree to which practitioners implemented prescribed program principles and activities and avoided proscribed activities, has been an area of growing interest in mental health services for children with severe emotional and behavioral disorders. This study evaluated the reliability and validity of a treatment adherence measure for child psychiatric rehabilitation (CPSR). Parents of children receiving CPSR (n = 79) or psychotherapy (n = 27) completed the Children's Psychosocial Rehabilitation Treatment Adherence Measure (CTAM) and a measure of 2-week session impact. Psychiatric rehabilitation (PSR) supervisors identified PSR practitioners with reputations for high or low adherence to the model. The CTAM's discriminant validity was assessed by using known-groups procedures and predictive validity by examining its relationship to 2-week session impact. The CTAM demonstrated excellent internal consistency (α = .92), discriminant validity (p = .002, d = .72; p = .021, d = .59), and predictive validity (B = 2.24, SE = .31, p < .001), accounting for 28% of the child-level variance in 2-week session impact. Findings suggest the CTAM is a reliable and valid measure of treatment adherence for CPSR programs with a skill-teaching focus. Providers and agencies should take steps to enhance treatment adherence because it may be an important predictor of children's short-term response to CPSR. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Effectiveness of work-related medical rehabilitation in cancer patients: study protocol of a cluster-randomized multicenter trial.

PubMed

Wienert, Julian; Schwarz, Betje; Bethge, Matthias

2016-07-27

Work is a central resource for cancer survivors as it not only provides income but also impacts health and quality of life. Additionally, work helps survivors to cope with the perceived critical life event. The German Pension Insurance provides medical rehabilitation for working-age patients with chronic diseases to improve and restore their work ability, and support returning to or staying at work, and thus tries to sustainably avoid health-related early retirement. Past research showed that conventional medical rehabilitation programs do not support returning to work sufficiently and that work-related medical rehabilitation programs report higher return-to-work rates across several health conditions, when compared to medical rehabilitation. Therefore, the current study protocol outlines an effectiveness study of such a program for cancer survivors. To evaluate the effectiveness of work-related medical rehabilitation in cancer patients we conduct a cluster-randomized multicenter trial. In total, 504 rehabilitation patients between 18 and 60 years with a Karnofsky Performance Status of ≥70 %, a preliminary positive social-medical prognosis of employability for at least 3 h/day within the next 6 months and an elevated risk of not returning to work will be recruited in four inpatient rehabilitation centers. Patients are randomized to the work-related medical rehabilitation program or the conventional medical rehabilitation program based on their week of arrival at each rehabilitation center. The work-related medical rehabilitation program comprises additional work-related diagnostics, multi-professional team meetings, an introductory session as well as work-related functional capacity training, work-related psychological groups, and social counseling. All additional components are aimed at the adjustment of the patients' capacity in relation to their individual job demands. Role functioning defines the main study outcome and will be assessed with the EORTC-QLQ30. Secondary outcome measures are the remaining scales of the EORTC-QLQ30, fatigue, self-rated work ability, disease coping, participation in working life, realization of work-related goals and therapies during rehabilitation, and treatment satisfaction. A positive evaluation of work-related medical rehabilitation in cancer patients is expected due to the promising findings on the effectiveness of such programs for patients with other health conditions. Results may support the dissemination of work-related medical rehabilitation programs in German cancer rehabilitation. German Clinical Trials Register DRKS00007770 . Registered 13 May 2015.

[Clinical application of functional near-infrared spectroscopy in rehabilitation medicine].

PubMed

Mihara, Masahito; Yagura, Hajime; Hatakenaka, Megumi; Hattori, Noriaki; Miyai, Ichiro

2010-02-01

Functional near-infrared spectroscopy (fNIRS) is an effective tool to non-invasively investigate cerebral oxygenation and hemodynamics. fNIRS as well as other functional neuroimaging techniques including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have been used for investigating the neural mechanisms of functional recovery after a stroke or a traumatic brain injury. fNIRS has several advantages over other neuroimaging techniques in terms of clinical application in the field of rehabilitation medicine. In addition to its portability and low equipment cost, fNIRS does not require strict motion restriction during measurement, unlike other functional imaging techniques. Therefore, this technique enables the examination of cortical activation during physically dynamic activities, like gait or balance perturbation. Studies using fNIRS have revealed several implications for gait recovery after stroke. These studies have shown that the medial sensorimotor cortex (SMC) and the supplementary motor area (SMA) are mainly involved in steadying gait and that the prefrontal cortex (PFC) is involved in the adjustment of walking speed. In hemiparetic patients, lateralization of SMC activation during gait is reduced, and additional cortical activations in the premotor cortex and PFC during gait became evident after focused rehabilitation for several months. The cortical activation pattern may be modified after different types of rehabilitative interventions. These results imply that fNIRS data is a potential biomarker for functional recovery and the response to rehabilitative interventions. Although further studies are required, fNIRS might provide useful information for customizing rehabilitation programs in order to enhance functional recovery.

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…

Prevalence of musculoskeletal and balance disorders in patients enrolled in phase II cardiac rehabilitation.

PubMed

Goel, Kashish; Shen, Jennifer; Wolter, Anne D; Beck, Kathryn M; Leth, Shawn E; Thomas, Randal J; Squires, Ray W; Perez-Terzic, Carmen M

2010-01-01

To determine the prevalence of musculoskeletal, neurological, and balance problems in patients enrolled in early outpatient (phase II) cardiac rehabilitation. Data were assessed retrospectively for 284 consecutive patients who attended the phase II Mayo Clinic Cardiac Rehabilitation program from April 2005 to August 2006. All participants completed a questionnaire that identified the presence of musculoskeletal pain, history of falls, joint replacements, osteoporosis, neurological disorders, and difficulties in performing activities of daily living. Balance assessment was evaluated using the single leg stance and the tandem gait tests. Of the total study population (mean age, 62.1 +/- 12.3 years), 25% reported musculoskeletal pain. A significantly higher prevalence of pain was noted in women than men (37% vs 20%, P = .004) and in those > 65 years than those < or = 65 years (35% vs 17%, P = .001). Back (29%), knee (17%), and hip (8%) pain were the most common symptoms, in order of decreasing frequency. Pain was worse with any activity in 32% of participants while 16% of participants had worsening at night. An abnormality in balance was present in 58% of the study participants and was significantly more common in women (71%) and those > 65 years (83%). Falls or gait instability or both were reported by 11% of participants. Musculoskeletal and balance limitations are common in persons enrolled in early outpatient cardiac rehabilitation, particularly in women and patients > 65 years. Cardiac rehabilitation programs should screen patients for musculoskeletal limitations and incorporate adaptations for treatment strategies of such patients.

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Towards Participation and Equality: The UN's International Labour Organization.

ERIC Educational Resources Information Center

Konig, A.

1990-01-01

The role of the International Labour Organization (ILO) in vocational rehabilitation and employment for people with disabilities is examined. The ILO's recent emphasis on community-based training and employment programs, social reintegration of disabled citizens through self-employment and union-generating activities, and special programs for…

Lifestyle Improvement Program for Seniors.

ERIC Educational Resources Information Center

Barclay, Ralph

The Wayne State College Lifestyle Improvement Program for Seniors, based on the wellness concept, is designed to facilitate social interaction and health through physical activities. It is adaptable to a variety of individual needs and preferences, including exercises for cardiac rehabilitation patients. Any person over 50 can participate at no…

Work-related medical rehabilitation in patients with musculoskeletal disorders: the protocol of a propensity score matched effectiveness study (EVA-WMR, DRKS00009780).

PubMed

Neuderth, Silke; Schwarz, Betje; Gerlich, Christian; Schuler, Michael; Markus, Miriam; Bethge, Matthias

2016-08-17

Musculoskeletal disorders are one of the most important causes of work disability. Various rehabilitation services and return-to-work programs have been developed in order to reduce sickness absence and increase sustainable return-to-work. As the effects of conventional medical rehabilitation programs on sickness absence duration were shown to be slight, work-related medical rehabilitation programs have been developed and tested. While such studies proved the efficacy of work-related medical rehabilitation compared with conventional medical rehabilitation in well-conducted randomized controlled trials, its effectiveness under real-life conditions has yet to be proved. The cohort study will be performed under real-life conditions with two parallel groups. Participants will receive either a conventional or a work-related medical rehabilitation program. Propensity score matching will be used to identify controls that are comparable to treated work-related medical rehabilitation patients. Over a period of three months, about 18,000 insured patients with permission to undergo a musculoskeletal rehabilitation program will be contacted. Of these, 15,000 will receive a conventional and 3,000 a work-related medical rehabilitation. We expect a participation rate of 40 % at baseline. Patients will be aged 18 to 65 years and have chronic musculoskeletal disorders, usually back pain. The control group will receive a conventional medical rehabilitation program without any explicit focus on work, work ability and return to work in diagnostics and therapy. The intervention group will receive a work-related medical rehabilitation program that in addition to common rehabilitation treatments contains 11 to 25 h of work-related treatment modules. Follow-up data will be assessed three and ten months after patients' discharge from the rehabilitation center. Additionally, department characteristics will be assessed and administrative data records used. The primary outcomes are sick leave duration, stable return to work and subjective work ability. Secondary outcomes cover several dimensions of health, functioning and coping strategies. This study will determine the relative effectiveness of a complex, newly implemented work-related rehabilitation strategy for patients with musculoskeletal disorders. German Clinical Trials Register ( DRKS00009780 , February 10, 2016).

A qualitative examination of perceptions of physical activity guidelines and preferences for format.

PubMed

Berry, Tanya R; Witcher, Chad; Holt, Nicholas L; Plotnikoff, Ronald C

2010-11-01

A descriptive exploratory study was conducted to gain an understanding of public perceptions of physical activity guidelines and to discover what formats appeal to participants. Canada's Physical Activity Guide (CPAG) was used as an example of such guidelines. Data were collected from 22 participants in five focus groups (composed of female undergraduate students, female office workers, male office workers, participants in a Type II diabetes rehabilitation program, and participants in a cardiovascular rehabilitation program). Cross-case qualitative analyses were conducted. Six themes emerged under the general categories of familiarity and preferences for PA promotional materials. In terms of familiarity, participants lacked awareness of CPAG and criticized its format. In terms of preferences, participants encouraged the use of stylistically similar messaging to those used by commercial advertisers, wanted personal stories, Internet-based media, and the use of celebrities' success stories. There was little awareness of CPAG and the current format was unappealing.

[Control of cardiovascular risk factors in coronary patients one year after cardiac rehabilitation].

PubMed

Denolle, T; Dib, M; Brune, M; Nicolas, S; Richard, A; Auguste, V; Bourdet, S; Crozet, A; Marivain, A; Salin, S; Revault d'Allonnes, F

2017-06-01

To assess risk factors monitoring in coronary patients one year after cardiac rehabilitation. From 2015 to 2015, cardiac morbidity, total mortality and risk factors data were collected from a 4-week ambulatory cardiac rehabilitation program with a control one year later and were compared with the results of Euroaspire and Reach studies. Out of 1091 (87%) coronary patients, 746 (68%) were re-examined 12months later (aged 60years (ranging from 20 to 85years), 15% women, 44% hypertensive, 36% smokers, 17% diabetics, 74% with dyslipidemia). At the end of the program, management of CV risk factors was improved (BP ≤ 140/90mmHg and BMI > 30: 80 and 20% vs 65 and 25% at the beginning of the program; LDL < 0.7g/L: 42% and smoking: 4% vs 18% when hospitalized for their cardiac event). Unfortunately, this benefit decreased significantly at one year (BP ≤ 140/90mmHg: 63%, LDL < 0.7g/L: 27%; smoking: 6%) but it remains better than in Euroaspire IV study: 57, 20 et 16% respectively). While 54% had insufficient physical activity before cardiac rehabilitation, they were only 23% at 1-year vs 60% in Euroaspire study. We reported a total mortality of 0.6% vs 2.9% in Reach study and 12% cardiac hospitalization (53% for a new coronary event). Participation of coronary patients in a cardiac rehabilitation program significantly improves management of CV risk factors, morbidity and mortality. However, the control obtained at the end of the program decreases at one year. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

PubMed

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

2016-07-25

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

Meyer Children's Rehabilitation Institute Teaching Program for Young Children. [Prescriptive Teaching Program for Multiply Handicapped Nursery School Children].

ERIC Educational Resources Information Center

LaCrosse, Edward; And Others

The prescriptive teaching program for multiply handicapped nursery school children is presented in three manuals: prescriptive teaching, integration of prescriptions into classroom activities; and equipment and materials. Given in the prescriptive teaching manual are directions for assessing a child's strengths and weaknesses in functioning on a…

DEVELOPMENT OF A PROGRAM TO PREPARE DELINQUENTS, DISADVANTAGED YOUTHS AND SLOW LEARNERS FOR VOCATIONAL EDUCATION. FINAL REPORT.

ERIC Educational Resources Information Center

JEFFERY, C. RAY

THE SOCIAL AND EDUCATIONAL REHABILITATION OF HIGH SCHOOL DROPOUTS WITH DELINQUENT RECORDS WAS ATTEMPTED BY REINFORCING BEHAVIOR ASSOCIATED WITH ACADEMIC REMEDIATION, WORK PREPARATION, AND SOCIAL CONDUCT. OF THE 163 NEGRO YOUTHS WHO PARTICIPATED AT SOME TIME DURING THE PROGRAM, ONLY 42 WERE ACTIVELY PARTICIPATING WHEN THE PROGRAM TERMINATED, AND…

Lean on Wii: physical rehabilitation with virtual reality Wii peripherals.

PubMed

Anderson, Fraser; Annett, Michelle; Bischof, Walter F

2010-01-01

In recent years, a growing number of occupational therapists have integrated video game technologies, such as the Nintendo Wii, into rehabilitation programs. 'Wiihabilitation', or the use of the Wii in rehabilitation, has been successful in increasing patients' motivation and encouraging full body movement. The non-rehabilitative focus of Wii applications, however, presents a number of problems: games are too difficult for patients, they mainly target upper-body gross motor functions, and they lack support for task customization, grading, and quantitative measurements. To overcome these problems, we have designed a low-cost, virtual-reality based system. Our system, Virtual Wiihab, records performance and behavioral measurements, allows for activity customization, and uses auditory, visual, and haptic elements to provide extrinsic feedback and motivation to patients.

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

PubMed

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

2015-03-01

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

Nondiscrimination on the Basis of Handicap in Programs or Activities Receiving Federal Financial Assistance. Title 34, Code of Federal Regulations, Part 104.

ERIC Educational Resources Information Center

Office for Civil Rights (ED), Washington, DC.

This document presents the final regulations of the Office for Civil Rights, Department of Education, concerning nondiscrimination on the basis of handicap in programs or activities receiving federal financial assistance under Section 504 of the Rehabilitation Act of 1973. The first part covers general provisions such as purpose, application,…

Student Reactions to Health Services Rendered by the Sports Medicine Program to Intramural Participants at the University of North Carolina-Chapel Hill.

ERIC Educational Resources Information Center

Violette, Ronald W.

This paper describes the activities of the Division of Sports Medicine at the University of North Carolina. The program works in the areas of (a) prevention, (b) treatment, (c) first aid, and (d) rehabilitation of athletic injuries sustained during intramural activities. The sports medicine staff consists of three full-time physicians, four…

The difference is more than floating: factors affecting breast cancer survivors' decisions to join and maintain participation in dragon boat teams and support groups.

PubMed

McDonough, Meghan H; Patterson, Michelle C; Weisenbach, Beth B; Ullrich-French, Sarah; Sabiston, Catherine M

2018-03-09

Peer support can be helpful in rehabilitation from breast cancer, but participation in peer support groups is low. Groups that provide support opportunities in physical activity contexts are an attractive alternative for some survivors. This study examined survivors' reasons for joining and maintaining participation on a dragon boat team, along with perceptions of barriers and attractions to traditional peer support groups. Seventeen breast cancer survivors were interviewed on five occasions over their first two seasons of a newly formed dragon boating team to explore their perceptions of peer support groups and dragon boating. Data were inductively analyzed using thematic analysis. Categories surrounding physical, psychological, social and community features were identified with several themes emerging within each. Advantages of dragon boating included opportunities to get a combination of physical, psychosocial and community benefits; health improvement and behavior change; and obtaining social support without the focus being on cancer. Peer support groups were identified as having advantages for forming relationships and avoiding barriers associated with physical activity. While neither type of program meets all needs, practical considerations are identified for incorporating advantages of both programs to improve participation. Implications for rehabilitation Further understanding of perceptions, and attractions and challenges to taking part in group programs will inform development of accessible programs that target multiple rehabilitation needs. Physical activity can provide a positive, alternative focus that takes the emphasis off of cancer, which is more accessible to some survivors. Physical activity also provides opportunities to build relationships around a common, positive goal, which can be a foundation for providing support for coping with cancer.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

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

78 FR 22817 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers AGENCY: Office of Special Education and... Research Projects and Centers Program administered by the National Institute on Disability and...

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

PubMed

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

2014-09-01

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

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

PubMed

Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

2018-04-27

BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). CONCLUSIONS Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Six-week physical rehabilitation protocol for anterior shoulder dislocation in athletes

PubMed Central

Gaballah, Ahmed; Zeyada, Mohamed; Elgeidi, Adham; Bressel, Eadric

2017-01-01

Anterior shoulder dislocations are common in young athletes. The mechanism for the first or primary shoulder dislocation may involve a collision or a fall typically with the arm in an abducted and externally rotated position. The aim of this study was to design a physical rehabilitation program using the elastic band and resistive exercise to improve joint strength and range of motion in individuals diagnosed with a first-time shoulder dislocation. Twelve physically active males with a first-time acute shoulder dislocation were asked to volunteer. Participants began a physical rehabilitation program 2 weeks after the shoulder dislocation, which was confirmed by a referring physician. The rehabilitation program was 6 weeks in duration and required the participants to engage in progressive resistive loads/duration using elastic bands and weights 5 days per week. Pretest and posttest measures included shoulder strength and range of motion. All outcome measures were compared between the injured and uninjured shoulder, which served as the control condition in this study. There were statistically significant differences between the injured and uninjured shoulder for measures of strength and range of motion during pretests (P<0.01) but not post-tests (P<0.53). Finally, there were no differences between shoulders in regards to the volume measure suggesting that any changes in muscle atrophy or swelling were not detected. The physical rehabilitation program proposed in this study was effective at improving strength and range of motion in the injured shoulder as evidenced by the similarity in posttest values between the injured and uninjured shoulder. PMID:28702449

Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility.

PubMed

Musumeci, Alfredo; Pranovi, Giulia; Masiero, Stefano

2018-05-11

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical-PCS-12-and mental health component-MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability.

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Electroencephalographic markers of robot-aided therapy in stroke patients for the evaluation of upper limb rehabilitation.

PubMed

Sale, Patrizio; Infarinato, Francesco; Del Percio, Claudio; Lizio, Roberta; Babiloni, Claudio; Foti, Calogero; Franceschini, Marco

2015-12-01

Stroke is the leading cause of permanent disability in developed countries; its effects may include sensory, motor, and cognitive impairment as well as a reduced ability to perform self-care and participate in social and community activities. A number of studies have shown that the use of robotic systems in upper limb motor rehabilitation programs provides safe and intensive treatment to patients with motor impairments because of a neurological injury. Furthermore, robot-aided therapy was shown to be well accepted and tolerated by all patients; however, it is not known whether a specific robot-aided rehabilitation can induce beneficial cortical plasticity in stroke patients. Here, we present a procedure to study neural underpinning of robot-aided upper limb rehabilitation in stroke patients. Neurophysiological recordings use the following: (a) 10-20 system electroencephalographic (EEG) electrode montage; (b) bipolar vertical and horizontal electrooculographies; and (c) bipolar electromyography from the operating upper limb. Behavior monitoring includes the following: (a) clinical data and (b) kinematic and dynamic of the operant upper limb movements. Experimental conditions include the following: (a) resting state eyes closed and eyes open, and (b) robotic rehabilitation task (maximum 80 s each block to reach 4-min EEG data; interblock pause of 1 min). The data collection is performed before and after a program of 30 daily rehabilitation sessions. EEG markers include the following: (a) EEG power density in the eyes-closed condition; (b) reactivity of EEG power density to eyes opening; and (c) reactivity of EEG power density to robotic rehabilitation task. The above procedure was tested on a subacute patient (29 poststroke days) and on a chronic patient (21 poststroke months). After the rehabilitation program, we observed (a) improved clinical condition; (b) improved performance during the robotic task; (c) reduced delta rhythms (1-4 Hz) and increased alpha rhythms (8-12 Hz) during the resting state eyes-closed condition; (d) increased alpha desynchronization to eyes opening; and (e) decreased alpha desynchronization during the robotic rehabilitation task. We conclude that the present procedure is suitable for evaluation of the neural underpinning of robot-aided upper limb rehabilitation.

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

PubMed

Antypas, Konstantinos; Wangberg, Silje C

2014-03-11

An increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual. Our trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version. The study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program. Included in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant (Kolmogorov-Smirnov Z=0.823, P=.38, r=.17). At 3 months after discharge, the tailored intervention group (n=7) had a significantly higher median level of overall physical activity (median 5613.0, IQR 2828.0) than the control group (n=12, median 1356.0, IQR 2937.0; Kolmogorov-Smirnov Z=1.397, P=.02, r=.33). The median adherence was 45.0 (95% CI 0.0-169.8) days for the tailored group and 111.0 (95% CI 45.1-176.9) days for the control group; however, the difference was not significant (P=.39). There were no statistically significant differences between the 2 groups in stage of change, self-efficacy, social support, perceived tailoring, anxiety, or depression. Because of the small sample size and the high attrition rate at the follow-up visits, we cannot make conclusions regarding the efficacy of our approach, but the results indicate that the tailored version of the intervention may have contributed to the long-term higher physical activity maintained after cardiac rehabilitation by participants receiving the tailored intervention compared with those receiving the nontailored intervention. ClinicalTrials.gov: NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6Nch4ldcL).

34 CFR 385.1 - What is the Rehabilitation Training program?

Code of Federal Regulations, 2010 CFR

2010-07-01

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

75 FR 21270 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Information; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and... notice of final priorities for the Disability and Rehabilitation Research Projects and Centers program... priority for the Disability and Rehabilitation Research Projects and Centers Program, published elsewhere...

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. ...

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. ...

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. ...

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. ...

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. ...

The Spanish Family Guidance Center of Miami.

ERIC Educational Resources Information Center

Hispanic Research Center: Research Bulletin, 1979

1979-01-01

Two major programs of the Spanish Family Guidance Center, a facility that addresses the mental health needs of Hispanics in the Greater Miami (Florida) area, are described in this report. One program, the Spanish Drug Rehabilitation Project (completed in 1977), compared a series of activities including: (1) research on the characteristics of…

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

ERIC Educational Resources Information Center

1976

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

Improved Training Method for Rapid Rehabilitation of Amputees

DTIC Science & Technology

2014-03-01

return to active duty or to a productive civilian life. Body This was the third year of a research effort to develop and test a novel training...a velocity standardized to leg length. This test assessment of the rehabilitative program is performed before and after the two week training on the...control group : Comparisons were also made between patients who had not been enrolled in the research study to patients who had participated in the

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

PubMed Central

2013-01-01

Background Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Methods Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Results Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Conclusions Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs. PMID:24112948

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 discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

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

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

PubMed

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

1993-12-01

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

Multivisceral Transplantation Rehabilitation Program-Case Report.

PubMed

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

2018-04-01

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

Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

NASA Astrophysics Data System (ADS)

Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

2016-11-01

Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

Use of Service-Learning to Teach Health Literacy with Online Graduate Nursing Students.

PubMed

George, Tracy P; DeCristofaro, Claire

To meet Healthy People 2020 goals, health literacy must be included in health care program curricula. In a fully online graduate nursing course, an innovative service-learning activity asked students to collaborate in the creation of low-literacy patient education pamphlets for practice partners at a community rehabilitation facility. Involvement with community stakeholders such as support groups and interprofessional team members enhanced interdisciplinary educational outcomes. Through this innovative project-based activity, students were able to meet the clinical education and decision support needs of rehabilitation patients while translating academic coursework to support actual community needs.

Study protocol: EXERcise and cognition in sedentary adults with early-ONset dementia (EXERCISE-ON).

PubMed

Hooghiemstra, Astrid M; Eggermont, Laura H P; Scheltens, Philip; van der Flier, Wiesje M; Bakker, Jet; de Greef, Mathieu H G; Koppe, Peter A; Scherder, Erik J A

2012-08-16

Although the development of early-onset dementia is a radical and invalidating experience for both patient and family there are hardly any non-pharmacological studies that focus on this group of patients. One type of a non-pharmacological intervention that appears to have a beneficial effect on cognition in older persons without dementia and older persons at risk for dementia is exercise. In view of their younger age early-onset dementia patients may be well able to participate in an exercise program. The main aim of the EXERCISE-ON study is to assess whether exercise slows down the progressive course of the symptoms of dementia. One hundred and fifty patients with early-onset dementia are recruited. After completion of the baseline measurements, participants living within a 50 kilometre radius to one of the rehabilitation centres are randomly assigned to either an aerobic exercise program in a rehabilitation centre or a flexibility and relaxation program in a rehabilitation centre. Both programs are applied three times a week during 3 months. Participants living outside the 50 kilometre radius are included in a feasibility study where participants join in a daily physical activity program set at home making use of pedometers. Measurements take place at baseline (entry of the study), after three months (end of the exercise program) and after six months (follow-up). Primary outcomes are cognitive functioning; psychomotor speed and executive functioning; (instrumental) activities of daily living, and quality of life. Secondary outcomes include physical, neuropsychological, and rest-activity rhythm measures. The EXERCISE-ON study is the first study to offer exercise programs to patients with early-onset dementia. We expect this study to supply evidence regarding the effects of exercise on the symptoms of early-onset dementia, influencing quality of life. The present study is registered within The Netherlands National Trial Register (ref: NTR2124).

Study protocol: EXERcise and Cognition In Sedentary adults with Early-ONset dementia (EXERCISE-ON)

PubMed Central

2012-01-01

Background Although the development of early-onset dementia is a radical and invalidating experience for both patient and family there are hardly any non-pharmacological studies that focus on this group of patients. One type of a non-pharmacological intervention that appears to have a beneficial effect on cognition in older persons without dementia and older persons at risk for dementia is exercise. In view of their younger age early-onset dementia patients may be well able to participate in an exercise program. The main aim of the EXERCISE-ON study is to assess whether exercise slows down the progressive course of the symptoms of dementia. Methods/Design One hundred and fifty patients with early-onset dementia are recruited. After completion of the baseline measurements, participants living within a 50 kilometre radius to one of the rehabilitation centres are randomly assigned to either an aerobic exercise program in a rehabilitation centre or a flexibility and relaxation program in a rehabilitation centre. Both programs are applied three times a week during 3 months. Participants living outside the 50 kilometre radius are included in a feasibility study where participants join in a daily physical activity program set at home making use of pedometers. Measurements take place at baseline (entry of the study), after three months (end of the exercise program) and after six months (follow-up). Primary outcomes are cognitive functioning; psychomotor speed and executive functioning; (instrumental) activities of daily living, and quality of life. Secondary outcomes include physical, neuropsychological, and rest-activity rhythm measures. Discussion The EXERCISE-ON study is the first study to offer exercise programs to patients with early-onset dementia. We expect this study to supply evidence regarding the effects of exercise on the symptoms of early-onset dementia, influencing quality of life. Trial registration The present study is registered within The Netherlands National Trial Register (ref: NTR2124) PMID:22897903

Pulmonary Rehabilitation and Palliative Care for the Lung Cancer Patient

PubMed Central

Sun, Virginia; Koczywas, Marianna; Kim, Jae; Raz, Dan; Hurria, Arti; Hayter, Jennifer

2015-01-01

Pulmonary rehabilitation, as a quality of life intervention, has a role to play in palliative care for lung cancer patients. Combining the art and skills of clinical care, physiological, and behavioral tools, pulmonary rehabilitation can serve to rebuild the functional capacity of patients limited by breathlessness and deconditioning. Exercise programs are the primary tool used to restore and rebuild the patient's endurance by challenging the entire pathway of oxygen transport and improving gas exchange. Other tools of pulmonary rehabilitation include breathing retraining, self-management skills, airway clearance techniques, bronchodilitation, smoking cessation and oxygen therapy. Pulmonary rehabilitation is now becoming a part of supportive care for patients undergoing chemotherapy and radiation therapy. The ability to be more active without suffering the consequences of dyspnea on exertion boosts the patient's self-efficacy and allows for an improved quality of life, so that lung cancer patients can participate in their family lives during this therapeutic challenge. PMID:26709350

The Galaxen model--a concept for rehabilitation and prevention in the construction industry.

PubMed

Stenlund, Berndt

2005-01-01

The Galaxen model was developed during the late 1980s to provide rehabilitation and prevention activities in the construction industry. It handles around 1200 workers with long-term sick leave or partial disabilities annually, some 10% of whom annually leave Galaxen for an ordinary job without a wage subsidy. The model includes a decision by a rehabilitation board of representatives from the employers, the trade union, and the regional employment office, a rehabilitation plan, allotment of a case manager, wage subsidies from the State to the company, a search for a suitable job in relation to the partial disability. It also includes a preventive program with emphasis on practical ergonomics. The Galaxen model has proved to be a suitable means of rehabilitating construction workers and returning them to the workforce. The model was developed within the Swedish social security system but could well be adjusted to other contexts.

38 CFR 21.41 - Basic period of eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... period during which an individual may receive a program of vocational rehabilitation benefits and... for a period before discharge does not run while the servicemember remains on active duty, but begins...

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 Sports Phys Ther 2013;43(5):284-299. Epub 13 March 2013. doi:10.2519/jospt.2013.4452 PMID:23485730

Development of a novel haptic glove for improving finger dexterity in poststroke rehabilitation.

PubMed

Lin, Chi-Ying; Tsai, Chia-Min; Shih, Pei-Cheng; Wu, Hsiao-Ching

2015-01-01

Almost all stroke patients experience a certain degree of fine motor impairment, and impeded finger movement may limit activities in daily life. Thus, to improve the quality of life of stroke patients, designing an efficient training device for fine motor rehabilitation is crucial. This study aimed to develop a novel fine motor training glove that integrates a virtual-reality based interactive environment with vibrotactile feedback for more effective post stroke hand rehabilitation. The proposed haptic rehabilitation device is equipped with small DC vibration motors for vibrotactile feedback stimulation and piezoresistive thin-film force sensors for motor function evaluation. Two virtual-reality based games ``gopher hitting'' and ``musical note hitting'' were developed as a haptic interface. According to the designed rehabilitation program, patients intuitively push and practice their fingers to improve the finger isolation function. Preliminary tests were conducted to assess the feasibility of the developed haptic rehabilitation system and to identify design concerns regarding the practical use in future clinical testing.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

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

24 CFR 572.100 - Acquisition and rehabilitation of eligible properties; rehabilitation standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES HOPE FOR HOMEOWNERSHIP OF SINGLE FAMILY HOMES PROGRAM (HOPE 3) Homeownership Program Requirements-Implementation Grants... are unsuitable for the HOPE 3 program. (3) Rehabilitation costs must comply with the cost standards...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

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

Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving or Benefiting from Federal Financial Assistance. Federal Register. Part VI.

ERIC Educational Resources Information Center

Federal Register, 1979

1979-01-01

The document presents the text of a proposed addition (Part 15b) to the rules and regulations of the United States Department of Agriculture, designed to eliminate discrimination on the basis of handicap in any of its programs or activities. Intended to implement Section 504 of the Rehabilitation Act of 1973, Part 15b is subdivided into six…

Effects of Whole-Body Cryotherapy in Comparison with Other Physical Modalities Used with Kinesitherapy in Rheumatoid Arthritis

PubMed Central

Gizińska, Małgorzata; Rutkowski, Radosław; Romanowski, Wojciech; Lewandowski, Jacek; Straburzyńska-Lupa, Anna

2015-01-01

Whole-body cryotherapy (WBC) has been frequently used to supplement the rehabilitation of patients with rheumatoid arthritis (RA). The aim of this study was to compare the effect of WBC and traditional rehabilitation (TR) on clinical parameters and systemic levels of IL-6, TNF-α in patients with RA. The study group comprised 25 patients who were subjected to WBC (−110°C) and 19 patients who underwent a traditional rehabilitation program. Some clinical variables and levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were used to assess the outcomes. After therapy both groups exhibited similar improvement in pain, disease activity, fatigue, time of walking, and the number of steps over a distance of 50 m. Only significantly better results were observed in HAQ in TR group (p < 0.05). However, similar significant reduction in IL-6 and TNF-α level was observed. The results showed positive effects of a 2-week rehabilitation program for patients with RA regardless of the kind of the applied physical procedure. PMID:26576422

Effects of Whole-Body Cryotherapy in Comparison with Other Physical Modalities Used with Kinesitherapy in Rheumatoid Arthritis.

PubMed

Gizińska, Małgorzata; Rutkowski, Radosław; Romanowski, Wojciech; Lewandowski, Jacek; Straburzyńska-Lupa, Anna

2015-01-01

Whole-body cryotherapy (WBC) has been frequently used to supplement the rehabilitation of patients with rheumatoid arthritis (RA). The aim of this study was to compare the effect of WBC and traditional rehabilitation (TR) on clinical parameters and systemic levels of IL-6, TNF-α in patients with RA. The study group comprised 25 patients who were subjected to WBC (-110 °C) and 19 patients who underwent a traditional rehabilitation program. Some clinical variables and levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were used to assess the outcomes. After therapy both groups exhibited similar improvement in pain, disease activity, fatigue, time of walking, and the number of steps over a distance of 50 m. Only significantly better results were observed in HAQ in TR group (p < 0.05). However, similar significant reduction in IL-6 and TNF-α level was observed. The results showed positive effects of a 2-week rehabilitation program for patients with RA regardless of the kind of the applied physical procedure.

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

PubMed

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

2018-05-23

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

Rehabilitation in multiple sclerosis.

PubMed

Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

2017-07-01

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis.

PubMed

Smania, Nicola; Picelli, Alessandro; Romano, Michele; Negrini, Stefano

2008-01-01

Knowledge on mechanisms of neurophysiological control of trunk movement and posture could help in the development of rehabilitation programs and brace treatment in adolescent idiopathic scoliosis (AIS). Reviewing up-to-date research on neurophysiology of movement and posture control with the aim of providing basis for new researches in the field of AIS rehabilitation and background understanding for clinicians engaged in management of AIS. Review of literature. We considered several neurophysiological issues relevant for AIS rehabilitation, namely, the peculiar organization of patterns of trunk muscle recruitment, the structure of the neural hardware subserving axial and arm muscle control, and the relevance of cognitive systems allowing mapping of spatial coordinates and building of body schema. We made clear the reason why trunk control is generally carried out by means of very fast, feedforward or feedback driven patterns of muscle activation which are deeply rooted in our neural control system and very difficult to modify by training. We hypothesized that augmented sensory feedback and strength exercises could be an important stage in a rehabilitation program aimed at hindering, or possibly reversing, scoliosis progression. In this context we considered bracing not only as a corrective biomechanical device but also as a tool for continuous sensory stimulation that could help awareness of body misalignment. Future research aimed at developing strategies of trunk postural control learning is essential in the rehabilitation of adolescent idiopathic scoliosis.

Rehabilitation Medicine Approaches to Pain Management.

PubMed

Cheville, Andrea L; Smith, Sean R; Basford, Jeffrey R

2018-06-01

Rehabilitation medicine offers strategies that reduce musculoskeletal pain, targeted approaches to alleviate movement-related pain, and interventions to optimize patients' function despite the persistence of pain. These approaches fall into four categories: modulating nociception, stabilizing and unloading painful structures, influencing pain perception, and alleviating soft tissue musculotendinous pain. Incorporating these interventions into individualized, comprehensive pain management programs offers the potential to empower patients and limit pain associated with mobility and required daily activities. Rehabilitative approach may be particularly helpful for patients with refractory movement-associated pain and functional vulnerability, and for those who do not wish for, or cannot, tolerate pharmacoanalgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

Use of virtual reality gaming systems for children who are critically ill.

PubMed

Salem, Yasser; Elokda, Ahmed

2014-01-01

Children who are critically ill are frequently viewed as "too sick" to tolerate physical activity. As a result, these children often fail to develop strength or cardiovascular endurance as compared to typically developing children. Previous reports have shown that early participation in physical activity in is safe and feasible for patients who are critically ill and may result in a shorter length of stay and improved functional outcomes. The use of the virtual reality gaming systems has become a popular form of therapy for children with disabilities and has been supported by a growing body of evidence substantiating its effectiveness with this population. The use of the virtual reality gaming systems in pediatric rehabilitation provides the children with opportunity to participate in an exercise program that is fun, enjoyable, playful, and at the same time beneficial. The integration of those systems in rehabilitation of children who are critically ill is appealing and has the potential to offer the possibility of enhancing physical activities. The lack of training studies involving children who are critically ill makes it difficult to set guidelines on the recommended physical activities and virtual reality gaming systems that is needed to confer health benefits. Several considerations should be taken into account before recommended virtual reality gaming systems as a training program for children who are critically ill. This article highlighted guidelines, limitations and challenges that need to be considered when designing exercise program using virtual reality gaming systems for critically ill children. This information is helpful given the popular use of virtual reality gaming systems in rehabilitation, particularly in children who are critically ill.

Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain.

PubMed

Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter; Bojsen-Møller, Jens; Finni, Taija

2014-07-15

High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity and Achilles tendon GU. A longitudinal study design with control (n = 10) and patient (n = 10) groups was used. Surface electromyography (SEMG) from four ankle plantar flexors and GU from the same muscles and the Achilles tendon were measured during submaximal intermittent isometric plantar flexion task. The results indicated that the symptomatic leg was weaker (P < 0.05) than the asymptomatic leg at baseline, but improved (P < 0.001) with eccentric rehabilitation. Additionally, the rehabilitation resulted in greater GU in both soleus (P < 0.01) and lateral gastrocnemius (P < 0.001) in the symptomatic leg, while the asymptomatic leg displayed higher uptake for medial gastrocnemius and flexor hallucis longus (P < 0.05). While both patient legs had higher tendon GU than the controls (P < 0.05), there was no rehabilitation effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative activity in the symptomatic leg compared with both the asymptomatic and control legs (P < 0.05), probably reflecting an effort to compensate for the decreased force potential. The rehabilitation resulted in greater SEMG activity in the lateral gastrocnemius (P < 0.01) of the symptomatic leg with no other within- or between-group differences. Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle. Copyright © 2014 the American Physiological Society.

Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

PubMed

Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

2015-01-01

Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

Clinical utility of the AlphaFIM® instrument in stroke rehabilitation.

PubMed

Lo, Alexander; Tahair, Nicola; Sharp, Shelley; Bayley, Mark T

2012-02-01

The AlphaFIM instrument is an assessment tool designed to facilitate discharge planning of stroke patients from acute care, by extrapolating overall functional status from performance in six key Functional Independence Measure (FIM) instrument items. To determine whether acute care AlphaFIM rating is correlated to stroke rehabilitation outcomes. In this prospective observational study, data were analyzed from 891 patients referred for inpatient stroke rehabilitation through an Internet-based referral system. Simple linear and stepwise regression models determined correlations between rehabilitation-ready AlphaFIM rating and rehabilitation outcomes (admission and discharge FIM ratings, FIM gain, FIM efficiency, and length of stay). Covariates including demographic data, stroke characteristics, medical history, cognitive deficits, and activity tolerance were included in the stepwise regressions. The AlphaFIM instrument was significant in predicting admission and discharge FIM ratings at rehabilitation (adjusted R² 0.40 and 0.28, respectively; P < 0.0001) and was weakly correlated with FIM gain and length of stay (adjusted R² 0.04 and 0.09, respectively; P < 0.0001), but not FIM efficiency. AlphaFIM rating was inversely related to FIM gain. Age, bowel incontinence, left hemiparesis, and previous infarcts were negative predictors of discharge FIM rating on stepwise regression. Intact executive function and physical activity tolerance of 30 to 60 mins were predictors of FIM gain. The AlphaFIM instrument is a valuable tool for triaging stroke patients from acute care to rehabilitation and predicts functional status at discharge from rehabilitation. Patients with low AlphaFIM ratings have the potential to make significant functional gains and should not be denied admission to inpatient rehabilitation programs.

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Bridges self-management program for people with stroke in the community: A feasibility randomized controlled trial.

PubMed

McKenna, Suzanne; Jones, Fiona; Glenfield, Pauline; Lennon, Sheila

2015-07-01

Enabling self-management behaviors is considered important in order to develop coping strategies and confidence for managing life with a long-term condition. However, there is limited research into stroke-specific self-management interventions. The aim of this randomized controlled trial was to evaluate the feasibility of delivering the Bridges stroke self-management program in addition to usual stroke rehabilitation compared with usual rehabilitation only. Participants recruited from the referrals to a community stroke team were randomly allocated to the Bridges stroke self-management program, receiving either one session of up to one-hour per week over a six-week period in addition to usual stroke rehabilitation, or usual rehabilitation only. Feasibility was measured using a range of methods to determine recruitment and retention; adherence to the program; suitability and variability of outcome measures used; application and fidelity of the program; and acceptability of the program to patients, carers and professionals. Twenty-five people were recruited to the study over a 13-month period. Eight out of the 12 participants in the Bridges stroke self-management program received all six sessions; there was one withdrawal from the study. There were changes in outcomes between the two groups. Participants who received the Bridges stroke self-management program appeared to have a greater change in self-efficacy, functional activity, social integration and quality of life over the six-week intervention period and showed less decline in mood and quality of life at the three-month follow-up. Professionals found the program acceptable to use in practice, and feedback from participants was broadly positive. The findings from this study appear promising, but questions remain regarding the feasibility of delivering the Bridges stroke self-management program in addition to usual rehabilitation. The dose response of receiving the program cannot be ruled out, and the next stage of research should explore the feasibility of an integrated program. Exploration of the reasons behind relatively low recruitment and of the sensitivity of outcome measures to detect a change are also required. Additional investigation of intervention fidelity is required to monitor if the program is being delivered as intended. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Anterior Knee Pain (Chondromalacia Patellae).

ERIC Educational Resources Information Center

Garrick, James G.

1989-01-01

This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

The impact of Kinesio taping technique on children with cerebral palsy

PubMed Central

Shamsoddini, Alireza; Rasti, Zabihallah; Kalantari, Minoo; Hollisaz, Mohammad Taghi; Sobhani, Vahid; Dalvand, Hamid; Bakhshandeh-Bali, Mohammad Kazem

2016-01-01

Cerebral palsy (CP) is the most common movement disorder in children that is associated with life-long disability and multiple impairments. The clinical manifestations of CP vary among children. CP is accompanied by a wide range of problems and has a broad spectrum. Children with CP demonstrate poor fine and dross motor function due to psychomotor disturbances. Early rehabilitation programs are essential for children with CP and should be appropriate for the age and functional condition of the patients. Kinesio taping (KT) technique is a relatively new technique applied in rehabilitation programs of CP. This article reviews the effects of KT techniques on improving motor skills in children with CP. In this study, we used keywords "cerebral palsy, Kinesio Tape, KT and Taping" in the national and international electronic databases between 1999 and 2016. Out of the 43 articles obtained, 21 studies met the inclusion criteria. There are several different applications about KT technique in children with CP. Review of the literature demonstrated that the impact of this technique on gross and fine motor function and dynamic activities is more effective than postural and static activities. Also this technique has more effectiveness in the child at higher developmental and motor stages. The majority of consistent findings showed that KT technique as part of a multimodal therapy program can be effective in the rehabilitation of children with CP to improve motor function and dynamic activities especially in higher developmental and motor stages. PMID:28435631

34 CFR 303.3 - Activities that may be supported under this part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... activities: (a) To maintain and implement a statewide system of early intervention services for children eligible under this part and their families. (b) For direct services for eligible children and their... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR...

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

PubMed Central

Calleo, Jessica; Burrows, Cristina; Levin, Harvey; Marsh, Laura; Lai, Eugene; York, Michele K.

2012-01-01

Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits. PMID:22135762

Technologic advances in aural rehabilitation: applications and innovative methods of service delivery.

PubMed

Sweetow, Robert W; Sabes, Jennifer Henderson

2007-06-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

Technologic Advances in Aural Rehabilitation: Applications and Innovative Methods of Service Delivery

PubMed Central

Sweetow, Robert W.; Sabes, Jennifer Henderson

2007-01-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described. PMID:17494876

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

PubMed

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

2013-01-01

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

Changes in task-based effective connectivity in language networks following rehabilitation in post-stroke patients with aphasia

PubMed Central

Kiran, Swathi; Meier, Erin L.; Kapse, Kushal J.; Glynn, Peter A.

2015-01-01

In this study, we examined regions in the left and right hemisphere language network that were altered in terms of the underlying neural activation and effective connectivity subsequent to language rehabilitation. Eight persons with chronic post-stroke aphasia and eight normal controls participated in the current study. Patients received a 10 week semantic feature-based rehabilitation program to improve their skills. Therapy was provided on atypical examples of one trained category while two control categories were monitored; the categories were counterbalanced across patients. In each fMRI session, two experimental tasks were conducted: (a) picture naming and (b) semantic feature verification of trained and untrained categories. Analysis of treatment effect sizes revealed that all patients showed greater improvements on the trained category relative to untrained categories. Results from this study show remarkable patterns of consistency despite the inherent variability in lesion size and activation patterns across patients. Across patients, activation that emerged as a function of rehabilitation on the trained category included bilateral IFG, bilateral SFG, LMFG, and LPCG for picture naming; and bilateral IFG, bilateral MFG, LSFG, and bilateral MTG for semantic feature verification. Analysis of effective connectivity using Dynamic Causal Modeling (DCM) indicated that LIFG was the consistently significantly modulated region after rehabilitation across participants. These results indicate that language networks in patients with aphasia resemble normal language control networks and that this similarity is accentuated by rehabilitation. PMID:26106314

A systematic review of physical activity policy recommendations and interventions for people with mental health problems in Sub-Saharan African countries

PubMed Central

Vancampfort, Davy; Stubbs, Brendon; De Hert, Marc; du Plessis, Christy; Gbiri, Caleb Ademola Omuwa; Kibet, Jepkemoi; Wanyonyi, Nancy; Mugisha, James

2017-01-01

Introduction There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. Methods We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Results Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Conclusion Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA. PMID:28491235

A systematic review of physical activity policy recommendations and interventions for people with mental health problems in Sub-Saharan African countries.

PubMed

Vancampfort, Davy; Stubbs, Brendon; De Hert, Marc; du Plessis, Christy; Gbiri, Caleb Ademola Omuwa; Kibet, Jepkemoi; Wanyonyi, Nancy; Mugisha, James

2017-01-01

There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA.

CORE Knowledge Domain C.4 Employment and Career Development: Application for Rehabilitation Counselor Educators

ERIC Educational Resources Information Center

McGuire-Kuletz, Maureen; Hergenrather, Kenneth C.

2008-01-01

The Council on Rehabilitation Education (CORE) CORE revised the standards for rehabilitation counseling master's degree program accreditation in 2004. These standards seek to promote effective rehabilitation services to persons with disabilities in both private and public programs (CORE, 2008). This article focuses on the new CORE standard…

38 CFR 21.266 - Payment of subsistence allowance under special conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and... rehabilitation program under Chapter 31 while hospitalized in a VA medical center or in any other hospital at VA... provided under § 21.264 that may be paid to a veteran pursuing a rehabilitation program for any month for...

34 CFR 371.10 - What types of projects are authorized under this program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What types of projects are authorized under this... REHABILITATION SERVICE PROJECTS FOR AMERICAN INDIANS WITH DISABILITIES What Kinds of Activities Does the Department of Education Assist Under This Program? § 371.10 What types of projects are authorized under this...

The impact of rehabilitation and counseling services on the labor market activity of Social Security Disability Insurance (SSDI) beneficiaries.

PubMed

Weathers, Robert R; Bailey, Michelle Stegman

2014-01-01

We use data from a social experiment to estimate the impact of a rehabilitation and counseling program on the labor market activity of newly entitled Social Security Disability Insurance (SSDI) beneficiaries. Our results indicate that the program led to a 4.6 percentage point increase in the receipt of employment services within the first year following random assignment and a 5.1 percentage point increase in participation in the Social Security Administration's Ticket to Work program within the first three years following random assignment. The program led to a 5.3 percentage point increase, or almost 50 percent increase, in employment, and an $831 increase in annual earnings in the second calendar year after the calendar year of random assignment. The employment and earnings impacts are smaller and not statistically significant in the third calendar year following random assignment, and we describe SSDI rules that are consistent with this finding. Our findings indicate that disability reform proposals focusing on restoring the work capacity of people with disabilities can increase the disability employment rate.

Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment.

PubMed

Szturm, Tony; Reimer, Karen M; Hochman, Jordan

2015-06-01

Disease or damage of the vestibular sense organs cause a range of distressing symptoms and functional problems that could include loss of balance, gaze instability, disorientation, and dizziness. A novel computer-based rehabilitation system with therapeutic gaming application has been developed. This method allows different gaze and head movement exercises to be coupled to a wide range of inexpensive, commercial computer games. It can be used in standing, and thus graded balance demands using a sponge pad can be incorporated into the program. A case series pre- and postintervention study was conducted of nine adults diagnosed with peripheral vestibular dysfunction who received a 12-week home rehabilitation program. The feasibility and usability of the home computer-based therapeutic program were established. Study findings revealed that using head rotation to interact with computer games, when coupled to demanding balance conditions, resulted in significant improvements in standing balance, dynamic visual acuity, gaze control, and walking performance. Perception of dizziness as measured by the Dizziness Handicap Inventory also decreased significantly. These preliminary findings provide support that a low-cost home game-based exercise program is well suited to train standing balance and gaze control (with active and passive head motion).

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

PubMed

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

2014-01-01

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

Goal Management Training for rehabilitation of executive functions: a systematic review of effectiveness in patients with acquired brain injury.

PubMed

Krasny-Pacini, Agata; Chevignard, Mathilde; Evans, Jonathan

2014-01-01

To determine if Goal Management Training (GMT) is effective for the rehabilitation of executive functions following brain injury when administered alone or in combination with other interventions. Systematic review, with quality appraisal specific to executive functions research and calculation of effect sizes. Twelve studies were included. Four studies were "Proof-of-principle" studies, testing the potential effectiveness of GMT and eight were rehabilitation studies. Effectiveness was greater when GMT was combined with other interventions. The most effective interventions appeared to be those combing GMT with: Problem Solving Therapy; personal goal setting; external cueing or prompting apply GMT to the current task; personal homework to increase patients' commitment and training intensity; ecological and daily life training activities rather than paper-and-pencil, office-type tasks. Level of support for GMT was higher for studies measuring outcome in terms of increases in participation in everyday activities rather than on measures of executive impairment. Comprehensive rehabilitation programs incorporating GMT, but integrating other approaches, are effective in executive function rehabilitation following brain injury in adults. There is insufficient evidence to support use of GMT as a stand-alone intervention.

A New Framework and Practice Center for Adapting, Translating, and Scaling Evidence-Based Health/Wellness Programs for People With Disabilities.

PubMed

Rimmer, James H; Vanderbom, Kerri A; Graham, Ian D

2016-04-01

Supporting the transition of people with newly acquired and existing disability from rehabilitation into community-based health/wellness programs, services, and venues requires rehabilitation professionals to build evidence by capturing successful strategies at the local level, finding innovative ways to translate successful practices to other communities, and ultimately to upgrade and maintain their applicability and currency for future scale-up. This article describes a knowledge-to-practice framework housed in a national resource and practice center that will support therapists and other rehabilitation professionals in building and maintaining a database of successful health/wellness guidelines, recommendations, and adaptations to promote community health inclusion for people with disabilities. A framework was developed in the National Center on Health, Physical Activity and Disability (NCHPAD) to systematically build and advance the evidence base of health/wellness programs, practices, and services applicable to people with disabilities. N-KATS (NCHPAD Knowledge Adaptation, Translation, and Scale-up) has 4 sequencing strategies: strategy 1-new evidence- and practice-based knowledge is collected and adapted for the local context (ie, community); strategy 2-customized resources are effectively disseminated to key stakeholders including rehabilitation professionals with appropriate training tools; strategy 3-NCHPAD staff serve as facilitators assisting key stakeholders in implementing recommendations; strategy 4-successful elements of practice (eg, guideline, recommendation, adaptation) are archived and scaled to other rehabilitation providers. The N-KATS framework supports the role of rehabilitation professionals as knowledge brokers, facilitators, and users in a collaborative, dynamic structure that will grow and be sustained over time through the NCHPAD.Video abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A130).

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

PubMed

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

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

Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial.

PubMed

Kairy, Dahlia; Veras, Mirella; Archambault, Philippe; Hernandez, Alejandro; Higgins, Johanne; Levin, Mindy F; Poissant, Lise; Raz, Amir; Kaizer, Franceen

2016-03-01

Telerehabilitation (TR), or the provision of rehabilitation services from a distance using telecommunication tools such as the Internet, can contribute to ensure that patients receive the best care at the right time. This study aims to assess the effect of an interactive virtual reality (VR) system that allows ongoing rehabilitation of the upper extremity (UE) following a stroke, while the person is in their own home, with offline monitoring and feedback from a therapist at a distance. A single-blind (evaluator is blind to group assignment) two-arm randomized controlled trial is proposed, with participants who have had a stroke and are no longer receiving rehabilitation services randomly allocated to: (1) 4-week written home exercise program, i.e. usual care discharge home program or (2) a 4-week home-based TR exercise program using VR in addition to usual care i.e. treatment group. Motor recovery of the UE will be assessed using the Fugl-Meyer Assessment-UE and the Box and Block tests. To determine the efficacy of the system in terms of functional recovery, the Motor Activity Log, a self-reported measure of UE use will be used. Impact on quality of life will be determined using the Stroke Impact Scale-16. Lastly, a preliminary cost-effectiveness analysis will be conducted using costs and outcomes for all groups. Findings will contribute to evidence regarding the use of TR and VR to provide stroke rehabilitation services from a distance. This approach can enhance continuity of care once patients are discharged from rehabilitation, in order to maximize their recovery beyond the current available services. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Inpatient rehabilitation outcomes for patients receiving left ventricular assist device.

PubMed

Alsara, Osama; Reeves, Ronald K; Pyfferoen, Mary D; Trenary, Tamra L; Engen, Deborah J; Vitse, Merri L; Kessler, Stacy M; Kushwaha, Sudhir S; Clavell, Alfredo L; Thomas, Randal J; Lopez-Jimenez, Francisco; Park, Soon J; Perez-Terzic, Carmen M

2014-10-01

The aim of this study was to evaluate outcomes of patients participating in inpatient rehabilitation program after left ventricular assist device (LVAD) implantation. Medical records of 94 patients who received LVADs between January 1, 2008, and June 30, 2010, at the Mayo Clinic in Rochester, MN, were retrospectively reviewed for demographic data, and inpatient rehabilitation functional outcomes were measured by the Functional Independence Measure scale. After successful implantation of LVAD, the patients were either discharged directly home from acute care (44%) or admitted to inpatient rehabilitation (56%). The patients admitted to inpatient rehabilitation were older than those discharged home. They were also more medically complex and more likely to have the LVAD placed as destination therapy. At discharge, significant improvement occurred in 17 of the 18 activities evaluated by the Functional Independence Measure scale. The mean total Functional Independence Measure scale score at admission was 77.1 compared with a score of 95.2 at discharge (P < 0.0001). Approximately half of the patients who received LVAD therapy were admitted in the inpatient rehabilitation. After the implantation of LVAD and inpatient rehabilitation, significant functional improvements were observed. Further studies addressing the role of inpatient rehabilitation for LVAD patients are warranted.

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

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke

PubMed Central

Lee, Myung Mo; Lee, Kyeong Jin

2018-01-01

Background Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. Material/Methods Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. Results At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). Conclusions Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs. PMID:29702630

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.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

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

Rehabilitation at the County Jail Level: A Model Program.

ERIC Educational Resources Information Center

Stearns, James D.

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

76 FR 17428 - Notice of Submission of Proposed Information Collection to OMB Rehabilitation Mortgage Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... Proposed Information Collection to OMB Rehabilitation Mortgage Insurance Underwriting Program Section 203(K... processes for participants in HUD-FHA's 203(K) Rehabilitation Mortgage Insurance Program. DATES: Comments... Program Section 203(K). OMB Approval Number: 2502-0527. Form Numbers: HUD-92700, HUD-92700-A, HUD-9746-A...

Attitudes of Disabled Individuals Enrolled in a Workstation Center and a Community College Program

ERIC Educational Resources Information Center

Wada, Michael A.; Brodwin, Martin

1975-01-01

Measured attitudes of disabled individuals toward the staff who gave them rehabilitation services. Attitudes of two groups at a rehabilitation hospital were evaluated: (a) clients from a vocational rehabilitation workshop and (b) clients from a community college satellite program. Found clients in the community college program perceived staff as…

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

ERIC Educational Resources Information Center

Halperin, Ronnie; Kessler, Suzanne; Braunschweiger, Dana

2012-01-01

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

77 FR 69812 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... DEPARTMENT OF EDUCATION [Docket No. ED-2012-ICCD-0054] Agency Information Collection Activities... Independent Living (SPIL) for the State Independent Living Services and Center for Independent Living Programs AGENCY: Department of Education (ED), Office of Special Education and Rehabilitative Services (OSERS...

78 FR 30900 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Education (TACE) Centers, Service Programs, Centers for Independent Living, the Helen Keller National Center... DEPARTMENT OF EDUCATION [Docket No. ED-2013-ICCD-0068] Agency Information Collection Activities... Education (ED), Office of Special Education and Rehabilitative Services (OSERS). ACTION: Notice. SUMMARY: In...

20 CFR 672.310 - What eligible activities may be funded under the YouthBuild program?

Code of Federal Regulations, 2012 CFR

2012-04-01

... shadowing; and (4) Job search assistance. (c) Other eligible activities include: (1) Supervision and... for homeless individuals and families or low-income families, or transitional housing for homeless individuals and families; (2) Supervision and training for participants in the rehabilitation or construction...

20 CFR 672.310 - What eligible activities may be funded under the YouthBuild program?

Code of Federal Regulations, 2014 CFR

2014-04-01

... shadowing; and (4) Job search assistance. (c) Other eligible activities include: (1) Supervision and... for homeless individuals and families or low-income families, or transitional housing for homeless individuals and families; (2) Supervision and training for participants in the rehabilitation or construction...

20 CFR 672.310 - What eligible activities may be funded under the YouthBuild program?

Code of Federal Regulations, 2013 CFR

2013-04-01

... shadowing; and (4) Job search assistance. (c) Other eligible activities include: (1) Supervision and... for homeless individuals and families or low-income families, or transitional housing for homeless individuals and families; (2) Supervision and training for participants in the rehabilitation or construction...

78 FR 22253 - Agency Information Collection Activities; Comment Request; Study of the Delivery of Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... DEPARTMENT OF EDUCATION [Docket No.: ED-2013-ICCD-0049] Agency Information Collection Activities... Program AGENCY: Office of Special Education and Rehabilitative Services (OSERS), Department of Education.... Department of Education, 400 Maryland Avenue SW., LBJ, Room 2E105, Washington, DC 20202-4537. FOR FURTHER...

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

Treatment and postrelease rehabilitative programs for juvenile offenders.

PubMed

Underwood, Lee A; Knight, Pamela

2006-04-01

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

78 FR 73851 - Privacy Act of 1974; Notice of a Computer Matching Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... system for the match: Compensation, Pension, Education, and Vocational Rehabilitation and Employment... spent time on active duty while a member of the Reserve Forces. F. Inclusive Dates of the Matching...

Impact of Long-Term Forest Enrichment Planting on the Biological Status of Soil in a Deforested Dipterocarp Forest in Perak, Malaysia

PubMed Central

Karam, D. S.; Arifin, A.; Radziah, O.; Shamshuddin, J.; Majid, N. M.; Hazandy, A. H.; Zahari, I.; Nor Halizah, A. H.; Rui, T. X.

2012-01-01

Deforestation leads to the deterioration of soil fertility which occurs rapidly under tropical climates. Forest rehabilitation is one of the approaches to restore soil fertility and increase the productivity of degraded areas. The objective of this study was to evaluate and compare soil biological properties under enrichment planting and secondary forests at Tapah Hill Forest Reserve, Perak after 42 years of planting. Both areas were excessively logged in the 1950s and left idle without any appropriate forest management until 1968 when rehabilitation program was initiated. Six subplots (20 m × 20 m) were established within each enrichment planting (F1) and secondary forest (F2) plots, after which soil was sampled at depths of 0–15 cm (topsoil) and 15–30 cm (subsoil). Results showed that total mean microbial enzymatic activity, as well as biomass C and N content, was significantly higher in F1 compared to F2. The results, despite sample variability, suggest that the rehabilitation program improves the soil biological activities where high rate of soil organic matter, organic C, N, suitable soil acidity range, and abundance of forest litter is believed to be the predisposing factor promoting higher population of microbial in F1 as compared to F2. In conclusion total microbial enzymatic activity, biomass C and biomass N evaluation were higher in enrichment planting plot compared to secondary forest. After 42 years of planting, rehabilitation or enrichment planting helps to restore the productivity of planted forest in terms of biological parameters. PMID:22606055

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Implementation of Interdisciplinary Cancer Rehabilitation

ERIC Educational Resources Information Center

Cromes, G. Fred, Jr.

1978-01-01

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

Disease Profiling for Computerized Peer Support of Ménière's Disease.

PubMed

Rasku, Jyrki; Pyykkö, Ilmari; Levo, Hilla; Kentala, Erna; Manchaiah, Vinaya

2015-09-03

Peer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière's disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. The aim of this study was to design a computerized data collection system for the peer support of Menière's disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. The expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière's Federation and utilized in the construction and evaluation of the program. The program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person's attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. This computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person's complaints for hearing loss, tinnitus, and vertigo. ©Jyrki Rasku, Ilmari Pyykkö, Hilla Levo, Erna Kentala, Vinaya Manchaiah. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 03.09.2015.

The Rehabilitation Project in Data Processing: A Prototype Demonstration Project of University, State Government and Industrial Cooperation.

ERIC Educational Resources Information Center

White, Robert C.; Cormier, Robert J., Eds.

1986-01-01

In cooperation with the Maine Bureau of Rehabilitation, the University of Maine established the Rehabilitation Project in Data Processing in 1978 to train physically handicapped individuals to become business application computer programmers. Discusses various aspects of the program, considered one of the most successful rehabilitation programs in…

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

ERIC Educational Resources Information Center

Aumann, Jon; And Others

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

Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

PubMed

Parry, Selina M; Knight, Laura D; Connolly, Bronwen; Baldwin, Claire; Puthucheary, Zudin; Morris, Peter; Mortimore, Jessica; Hart, Nicholas; Denehy, Linda; Granger, Catherine L

2017-04-01

To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454. Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment. The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

Validity of a Questionnaire to Assess the Physical Activity Level in Coronary Artery Disease Patients

ERIC Educational Resources Information Center

Guiraud, Thibaut; Granger, Richard; Bousquet, Marc; Gremeaux, Vincent

2012-01-01

The aim of the study is to compare, in coronary artery disease patients, physical activity (PA) assessed with the Dijon Physical Activity Questionnaire (DPAQ) and the true PA objectively measured using an accelerometer. Seventy patients wore an accelerometer (MyWellness Key actimeter) throughout 1 week after a cardiac rehabilitation program that…

Vestibular rehabilitation outcomes in chronic vertiginous patients through computerized dynamic visual acuity and Gaze stabilization test.

PubMed

Badaracco, Carlo; Labini, Francesca Sylos; Meli, Annalisa; De Angelis, Ezio; Tufarelli, Davide

2007-09-01

To evaluate the efficiency of the rehabilitative protocols in patients with labyrinthine hypofunction, focusing on computerized dynamic visual acuity test (DVAt) and Gaze stabilization test (GST) specifically evaluating the vestibulo-oculomotor reflex (VOR) changes due to vestibular rehabilitation. Consecutive sample study. Day hospital in Ears, Nose, and Throat Rehabilitation Unit. Thirty-two patients with chronic dizziness with a mean age of 60.74 years. Patients performed one cycle of 12 daily rehabilitation sessions (2 h each) consisting of exercises aimed at improving VOR gain. The rehabilitation program included substitutional and/or habitudinal exercises, exercises on a stability platform, and exercises on a moving footpath with rehabilitative software. Dizziness Handicap Inventory and Activities-specific Balance Confidence Scale. Computerized dynamic posturography, computerized DVAt, and GST. The patients significantly improved in all the tests. Vestibular rehabilitation improved the quality of life by reducing the handicap index and improving the ability in everyday tasks. The recovery of the vestibular-ocular reflex and vestibular-spinal reflex efficiency was objectively proven by instrumental testing. The DVAt and the GST allow to objectively quantify the fixation ability at higher frequencies and speeds (main VOR function). Moreover, these new parameters permit to completely evaluate vestibular rehabilitation outcomes, adding new information to the generally used tests that only assess vestibulospinal reflex.

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.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

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

Association of total serum cholesterol with functional outcome following home care rehabilitation in Italian patients with stroke.

PubMed

Cataldo, Maria Concetta; Calcara, Maria Luisa; Caputo, Giuseppe; Mammina, Caterina

2012-04-01

Stroke is a disabling disease. In elderly populations, stroke is the third leading cause of death and the primary cause of reduction in or loss of functional ability and personal autonomy. Possible associations between levels of total serum cholesterol (TC) and both incidence of stroke and functional outcomes after rehabilitation are still under study. To detect positive and negative prognostic factors associated with functional outcomes in first-time stroke patients admitted to an integrated home care rehabilitative program. This study enrolled 141 patients with a first-time stroke who were admitted to a home care rehabilitation program. Primary outcome measures were the Barthel activities of daily living (ADL) and mobility indices at the beginning and end of the rehabilitative treatment. The impact of TC and other demographic and clinical variables was analyzed using bivariate and multivariate logistic regression analyses. Age and Short Portable Mental Status Questionnaire (SPMSQ) score were negatively associated with functional outcome. In contrast, elevated TC was positively associated with a better home rehabilitative treatment outcome. Barthel index score at admission was negatively associated with outcomes assessed by the Barthel ADL index and age with outcomes assessed by the Barthel mobility index. In a multivariate logistic regression analysis, SPMSQ score and elevated TC were significantly associated with outcome. Specifically, higher SPMSQ scores were negatively associated with better rehabilitative treatment outcomes, whereas elevated TC was positively associated. Elevated TC seems to be associated with better functional outcomes in patients with first-time stroke. Copyright © 2012 Elsevier Inc. All rights reserved.

77 FR 60116 - Notice of Proposed Information Collection Requests; State Plan for Vocational Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... Rehabilitation Services Administration a State Plan for the Vocational Rehabilitation (VR) Services program and... approved VR State Plan and SE supplement form the basis upon which a state participates in programs under...

Community Reintegration Problems Among Veterans and Active Duty Service Members With Traumatic Brain Injury.

PubMed

McGarity, Suzanne; Barnett, Scott D; Lamberty, Greg; Kretzmer, Tracy; Powell-Cope, Gail; Patel, Nitin; Nakase-Richardson, Risa

To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties. VA Polytrauma Rehabilitation Centers. Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.6%; moderate/severe = 71.4%) and 1-year postinjury outcome data. Prospective, longitudinal cohort. Community reintegration outcomes included independent driving, employability, and general community participation. Additional measures assessed depression, posttraumatic stress, and cognitive and motor functioning. In the mild TBI (mTBI) group, posttraumatic stress disorder and depressive symptoms were associated with lower levels of various community reintegration outcomes. In the moderate/severe TBI group, cognition and motor skills were significantly associated with lower levels of community participation, independent driving, and employability. Community reintegration is problematic for Veterans and active duty service members with a history of TBI. Unique comorbidities across injury severity groups inhibit full reintegration into the community. These findings highlight the ongoing rehabilitation needs of persons with TBI, specifically evidence-based mental healthcare, in comprehensive rehabilitation programs consistent with a chronic disease management model.

Supervised rehabilitation versus home exercise in the treatment of acute ankle sprains: a systematic review.

PubMed

Feger, Mark A; Herb, C Collin; Fraser, John J; Glaviano, Neal; Hertel, Jay

2015-04-01

In competitive sports medicine, supervised rehabilitation is the standard of care; in the general population, unsupervised home exercise is more common. We systematically reviewed randomized, controlled trials comparing outcomes for supervised rehabilitation versus home exercise programs. Supervised rehabilitation programs resulted in (1) less pain and subjective instability, (2) greater gains in ankle strength and joint position sense, and (3) inconclusive results regarding prevention of recurrent ankle sprains. We recommend supervised rehabilitation over home exercise programs owing to the improved short-term patient-recorded evidence with a strength-of-recommendation taxonomy level of evidence of 2B. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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.

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.

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.

Examining a participation-focused stroke self-management intervention in a day rehabilitation setting: a quasi-experimental pilot study.

PubMed

Lee, Danbi; Fischer, Heidi; Zera, Sarah; Robertson, Rosetta; Hammel, Joy

2017-12-01

Background People with stroke often find discharge from rehabilitation distressing because they do not feel prepared to participate in life roles as they want. A self-management approach can facilitate improvement in confidence and ability to manage post-stroke community living and participation after transitioning into the community. Objective To evaluate the feasibility and effectiveness of the Improving Participation After Stroke Self-management program - Rehab version (IPASS-R) in a day rehabilitation setting. Methods We used a mixed-method non-randomized quasi-experimental design. The IPASS-R program is a six-session group-based intervention led by a trained occupational therapist and lay person with stroke. The program uses an efficacy building approach to support aging adults to maintain active participation in home and community activities post-stroke. Primary outcome measures were the Reintegration to Normal Living Index (RNLI), Stroke Impact Scale (SIS), and Participation Strategies Self-Efficacy Scale. Qualitative feedback was collected post-treatment. Results Seventeen participants with stroke (intervention n = 9; control n = 8) were enrolled across two sites. Non-parametric effect sizes calculated using the Wilcoxon Signed-Rank test revealed larger effects on RNLI and SIS outcomes in the intervention group. The Mann-Whitney U test showed significant differences between the two groups' changes in scores on perceived recovery and strength. Conclusions The result shows that IPASS-R has the potential to be integrated into a day rehabilitation setting with a positive impact on community integration and perceived recovery outcomes. Future study is needed to investigate the IPASS-R with a larger sample size and more rigorous study design.

Health-related quality of life in end-stage renal disease patients: the effects of renal rehabilitation.

PubMed

Kouidi, E

2004-05-01

Health-related quality of life (HRQoL) consists of a number of components like functional status, psychological and social functioning, cognition and disease and treatment-related symptoms. End-stage renal disease (ESRD) patients display emotional disturbances, as well as non-adherence to treatment and fluid and food intake, depression, anxiety, social withdrawal and cardiovascular and other co-existing disease morbidity. They have very low functional capacity and physical limitations in their daily activities that affect their mortality and morbidity. Exercise training in ESRD patients is effective in increasing work related activities and important components of their daily life and improving physical functioning. A physical rehabilitation program also leads to a reduction in depression and improvement in family and social interactions. Therefore, renal rehabilitation should be considered as an important therapeutic method for improving physical fitness, social function, well-being and thus health-adjusted quality of life in ESRD patients.

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

PubMed

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

2012-05-01

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

24 CFR 882.803 - Project eligibility and other requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Section 8 Moderate... section, housing suitable for moderate rehabilitation is eligible for inclusion under this program...

Motivational factors of adherence to cardiac rehabilitation.

PubMed

Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

2012-05-01

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

75 FR 13111 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... Information; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Advanced Rehabilitation Research Training (ARRT) Projects... and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

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

34 CFR 350.15 - What must a grantee do in carrying out a demonstration activity?

Code of Federal Regulations, 2011 CFR

2011-07-01

... REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does the Secretary Assist? § 350.15 What must... under this program, a grantee shall apply results derived from previous research, testing, or practice to determine the effectiveness of a new strategy or approach. (Authority: Sec. 202; 29 U.S.C. 761a) ...

45 CFR 2540.210 - What provisions exist to ensure that Corporation-supported programs do not discriminate in the...

Code of Federal Regulations, 2010 CFR

2010-10-01

... the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), section 504 of the Rehabilitation Act of... Federal financial assistance to an education program or activity for purposes of the Education Amendments... project that receives Corporation assistance may not discriminate on the basis of religion against a...

34 CFR 350.15 - What must a grantee do in carrying out a demonstration activity?

Code of Federal Regulations, 2010 CFR

2010-07-01

... REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does the Secretary Assist? § 350.15 What must... under this program, a grantee shall apply results derived from previous research, testing, or practice to determine the effectiveness of a new strategy or approach. (Authority: Sec. 202; 29 U.S.C. 761a) ...

Rehabilitation of syndesmotic (high) ankle sprains.

PubMed

Williams, Glenn N; Allen, Eric J

2010-11-01

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

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

PubMed

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

2013-11-14

During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness. Clinical Trials.gov: file. NCT01772849 and NCT01772862.

"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.

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

PubMed

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

2008-12-01

To determine the relative efficacy of 2 different acute traumatic brain injury (TBI) rehabilitation approaches: cognitive didactic versus functional-experiential, and secondarily to determine relative efficacy for different patient subpopulations. Randomized, controlled, intent-to-treat trial comparing 2 alternative TBI treatment approaches. Four Veterans Administration acute inpatient TBI rehabilitation programs. Adult veterans or active duty military service members (N=360) with moderate to severe TBI. One and a half to 2.5 hours of protocol-specific cognitive-didactic versus functional-experiential rehabilitation therapy integrated into interdisciplinary acute Commission for Accreditation of Rehabilitation Facilities-accredited inpatient TBI rehabilitation programs with another 2 to 2.5 hours daily of occupational and physical therapy. Duration of protocol treatment varied from 20 to 60 days depending on the clinical needs and progress of each participant. The 2 primary outcome measures were functional independence in living and return to work and/or school assessed by independent evaluators at 1-year follow-up. Secondary outcome measures consisted of the FIM, Disability Rating Scale score, and items from the Present State Exam, Apathy Evaluation Scale, and Neurobehavioral Rating Scale. The cognitive-didactic and functional-experiential treatments did not result in overall group differences in the broad 1-year primary outcomes. However, analysis of secondary outcomes found differentially better immediate posttreatment cognitive function (mean+/-SD cognitive FIM) in participants randomized to cognitive-didactic treatment (27.3+/-6.2) than to functional treatment (25.6+/-6.0, t332=2.56, P=.01). Exploratory subgroup analyses found that younger participants in the cognitive arm had a higher rate of returning to work or school than younger patients in the functional arm, whereas participants older than 30 years and those with more years of education in the functional arm had higher rates of independent living status at 1 year posttreatment than similar patients in the cognitive arm. Results from this large multicenter randomized controlled trial comparing cognitive-didactic and functional-experiential approaches to brain injury rehabilitation indicated improved but similar long-term global functional outcome. Participants in the cognitive treatment arm achieved better short-term functional cognitive performance than patients in the functional treatment arm. The current increase in war-related brain injuries provides added urgency for rigorous study of rehabilitation treatments. (http://ClinicalTrials.gov ID# NCT00540020.).

Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms

PubMed Central

Tosin, Michelle Hyczy de Siqueira; Campos, Débora Moraes; de Andrade, Leonardo Tadeu; de Oliveira, Beatriz Guitton Renaud Baptista; Santana, Rosimere Ferreira

2016-01-01

ABSTRACT Objective: to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease. Method: a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification. Results: a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention. Conclusion: the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification. PMID:27508903

76 FR 33730 - Applications for New Awards; National Institute on Disability and Rehabilitation Research (NIDRR...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... Rehabilitation Research (NIDRR)--Disability Rehabilitation Research Project (DRRP)--Disability in the Family.... Overview Information National Institute on Disability and Rehabilitation Research (NIDRR)-- Disability and Rehabilitation Research Projects and Centers Program-- Disability Rehabilitation Research Project (DRRP...

78 FR 26509 - Final Priority; National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects... Rehabilitative Services announces a priority under the Disability Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

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

24 CFR 882.410 - Rent adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Special Procedures for Moderate Rehabilitation-Basic... Annual Adjustment Factor by the base rents. However, if the amounts borrowed to finance the rehabilitation costs or to finance purchase of the property are subject to a variable rate or are otherwise...

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…

Patient preferences for cardiac rehabilitation and desired program elements.

PubMed

Filip, J; McGillen, C; Mosca, L

1999-01-01

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

[The investigation into dynamics of depression level and the quality of life in the patients after myocardial infarction under the influence of the program of physical rehabilitation].

PubMed

Belikova, N A; Indyka, S Ya

2016-01-01

The evaluation of the psychological condition of the patients who survived myocardial infarction and its correction taking into consideration the peculiar features of the individual reaction to the disease are the indispensable components of physical rehabilitation. The present article was designed to report the results of the study on the influence of the authors' physical rehabilitation program on the prevalence of depression and the life quality characteristics of the patients treated after myocardial infarction during the follow-up period. The patients of the main group (n=30) were enrolled in the original physical rehabilitation program. Those comprising the group of comparison (n=30) were given a course of rehabilitation in accordance with the scheme that had been recommended by the leading scientists and generally accepted in the Ukraine for the patients recovering after myocardial infarction under conditions of the out-patient clinics, spa and health resort facilities or convalescent centers. The study has demonstrated that the patients of both groups exhibited positive dynamics of their clinical condition (e.g. the decrease in the number of depressed subjects); however, this tendency was more pronounced in the main group where the number of the patients experiencing depression decreased by 61% at the end of the observation period (р<0,05). The analysis of the causes of anxiety associated with this pathology in the individual patients has demonstrated that the main factors responsible for the deterioration of the quality of life were the necessity of treatment, the limitations on the everyday physical activity, and the feeling of emotional tension. Moreover, the positive dynamics of the characteristics being evaluated was documented in the patients of the main group which gives reason to conclude that the program of physical rehabilitation proposed by the authors for the treatment of the patients after myocardial infarction is highly efficient during the follow-up period. Suffice it to say that 23 (76,7%) patients of the main group did not consider their lives as of poor quality by the end of the study period (р<0,01). There were only 18 such patients in the control group (р<0,05). The results of the present study provide a basis for recommending the proposed authors' program of physical rehabilitation for the patients treated after myocardial infarction with the emphasis on the necessity to do special dynamic exercises for the cervical and thoraco-cervical spine segments to be supplemented by the relevant educational program.

Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders.

PubMed

Klobas, Luciano; Axelsson, Susanna; Tegelberg, Ake

2006-11-01

The aim of this study was to investigate the effect of a specific therapeutic jaw exercise on the temporomandibular disorders of patients with chronic whiplash-associated disorders. Ninety-four consecutive patients with whiplash-related conditions were referred to and accepted for a treatment period at a center for functional evaluation and rehabilitation during 2001-2002. The patients followed a program of physical therapy, occupational therapy, and pain management. At the start of their stay, they were examined by a physician specialized in rehabilitation medicine and also by a dentist who performed a functional examination of the stomatognathic system. Of the 93 patients who accepted participation in the study, 55 were diagnosed with temporomandibular disorders and chronic whiplash-associated disorders in accordance with the inclusion criteria. They were randomized into a jaw exercise group (n = 25), who performed specific therapeutic jaw exercises, and a control group (n = 30). Both groups undertook the whiplash rehabilitation program at the center. There were no inter- or intra-group differences in symptoms and signs of temporomandibular disorders at baseline, nor at the 3-week and 6-month follow-ups, except for an increase of maximum active mouth-opening capacity in the control group. In conclusion, the therapeutic jaw exercises, in addition to the regular whiplash rehabilitation program, did not reduce symptoms and signs of temporomandibular disorders in patients with chronic whiplash-associated disorders.

Clinicians' and Patients' Assessment of Activity Overuse and Underuse and Its Relation to Physical Capacity

ERIC Educational Resources Information Center

de Jong, Annemieke Bonny; Preuper, Henrica R. Schiphorst; Reneman, Michiel F.

2012-01-01

To explore clinicians' and patients' (self)-assessment of activity overuse and underuse, and its relationship with physical capacity in patients with chronic musculoskeletal pain (CMP). Study design was cross-sectional. Participants included patients with CMP, admitted to a multidisciplinary outpatient pain rehabilitation program. The main…

34 CFR 377.3 - What types of activities may the Secretary fund?

Code of Federal Regulations, 2010 CFR

2010-07-01

... CLIENT CHOICE PROGRAM General § 377.3 What types of activities may the Secretary fund? The Secretary... eligible clients in the rehabilitation process as follows: (a) At a minimum, all projects must demonstrate effective ways to increase the choices available to clients in selecting goals, services, and providers of...

An Update: The Cardiac Wellness Training Project.

ERIC Educational Resources Information Center

Zinn, Lorraine; Long, Patrick

1983-01-01

This article reports on the scope of activities and the effectiveness of a Colorado program that trained community park and recreation personnel to carry out local cardiac wellness services. Participants were trained to provide rehabilitation and fitness activities for those recovering from heart attacks or surgery and for other high-risk persons.…

34 CFR 370.4 - What kinds of activities may the Secretary fund?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What kinds of activities may the Secretary fund? 370.4 Section 370.4 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CLIENT ASSISTANCE PROGRAM General...

Simulated Activity But Real Trauma: A Systematic Review on Nintendo Wii Injuries Based on a Case Report of an Acute Anterior Cruciate Ligament Rupture

PubMed Central

Müller, Sebastian A.; Vavken, Patrick; Pagenstert, Geert

2015-01-01

Abstract Video gaming injuries are classically regarded as eccentric accidents and novelty diagnoses. A case of an anterior cruciate ligament (ACL) tear sustained during Wii boxing spurned us to review the literature for other Wii-related injuries and Wii-based posttraumatic rehabilitation. The English literature listed in PubMed was systematically reviewed by searching for “Wii (trauma or injury or fracture).” Full-text articles were included after duplicate, blinded review. The type and treatment of injury as well as the Wii-based rehabilitation programs found were analyzed. Additionally, a new case of an acute ACL tear-sustained playing, Wii boxing, is additionally presented. After exclusion of irrelevant articles, 13 articles describing Wii-related injuries were included reporting on 3 fractures, 6 nonosseous, 2 overuse injuries, and 2 rehabilitation programs using Wii for posttraumatic rehabilitation. Among the presented Wii-related injuries, only 12.5% were treated conservatively, whereas 87.5% underwent either surgical or interventional treatment. Because of the reported case, the literature search was limited to Wii-related injuries excluding other video games. Another limitation of this article lies in the fact that mainly case reports but no controlled trials exist on the topic. Assumingly, primarily the more severe injuries are reported in the literature with an unknown number of possibly minor injuries. Motion-controlled video games, such as Wii, are becoming increasingly popular as a recreational entertainment. Because of their wide acceptance and entertaining nature, they are also increasingly recognized as a tool in rehabilitation. However, although the activity is simulated, injuries are real. Our systematic review shows that Wii gaming can lead to severe injuries, sometimes with lasting limitations. PMID:25816033

Vocational rehabilitation for adults with psychotic disorders in a Scandinavian welfare society.

PubMed

Falkum, Erik; Klungsøyr, Ole; Lystad, June Ullevoldsæter; Bull, Helen Christine; Evensen, Stig; Martinsen, Egil W; Friis, Svein; Ueland, Torill

2017-01-17

This study examined the outcomes of a vocational rehabilitation program (The Job Management Program, JUMP) for persons with psychotic disorders based on close collaboration between health and welfare services. Participants (N = 148) with broad schizophrenia spectrum disorders (age 18-65) were recruited from six counties in Norway. Three counties were randomized to vocational rehabilitation augmented with cognitive behaviour therapy (CBT), while the remaining three counties were randomized to vocational rehabilitation augmented with cognitive remediation (CR). This paper compares the vocational activity of the total group of JUMP participants with a treatment as usual group (N = 341), and further examines differences between the two JUMP interventions. Employment status (working/not working) was registered at the time of inclusion and at the end of the intervention period. The total number of JUMP participants in any kind of vocational activity increased from 17 to 77% during the intervention. Of these, 8% had competitive employment, 36% had work placements in ordinary workplaces with social security benefits as their income, and 33% had sheltered work. The total number of working participants in the TAU group increased from 15.5 to 18.2%. The JUMP group showed significant improvements of positive (t = -2.33, p = 0.02) and general (t = -2.75, p = 0.007) symptoms of psychosis. Significant differences between the CBT and CR interventions were not demonstrated. The study supports existing evidence that the majority of persons with broad schizophrenia spectrum disorders can cope with some kind of work, given that internal and external barriers are reduced. Those who wish to work should be offered vocational rehabilitation. ClinicalTrials.gov Identifier: NCT01139502 . Registered on 6 February 2010.

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

PubMed

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

2014-12-05

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

[The effectiveness of comprehensive rehabilitation after a first episode of ischemic stroke].

PubMed

Starosta, Michał; Niwald, Marta; Miller, Elżbieta

2015-05-01

Ischemic stroke is the most common cause of hospitalization in the Department of Neurological Rehabilitation. Comprehensive rehabilitation is essential for regaining lost functional efficiency. The aim of study was to evaluate the effectiveness of specific disorder rehabilitation program in 57 patients with first-ever ischemic stroke. The study included 57 patients (27 women, 30 men) aged from 47 to 89. Patients were admitted for comprehensive rehabilitation, lasted an average of 25 days. The treatment program consisted of exercises aimed at reeducation of posture and gait. In addition, physical treatments were used. Evaluation of the effectiveness of rehabilitation was measured using the Activity Daily Living scale, Modified Rankin Scale, Rivermead Measure Assessment (RMA1-global movements, RMA2-lower limb and trunk, RMA3-upper limb) and the psychological tests - Geriatric Depression Scale (GDS) and Beck Depression Inventory (BDI). As a result of comprehensive rehabilitation treatment, functional status and mental health improvement was observed in relation to the ADL scale by 32% (woman 36%, man 30%), Rankin scale by 22% (woman 22%, man 21%). In the RMA, improvement was observed with the statistical significance of p=0.001 in all of the subscales. The highest rate of improvement affected upper limb function: RMA/3 (41%). In other subscales women have achieved statistically more significant improvement than men (RMA/1-43% versus 25%; RMA/2-41% versus 30%). The results related to the psychological assessment showed statistically significant GDS improvement p<0.001 (<60 years old) and BDI (> 60 years old) in test men (p=0.038). Spearman correlation coefficient showed no relation between mental state and functional improvement (GDS versus ADL; BDI versus ADL). The 25 days comprehensive rehabilitation program during the subacute stroke phase affects mainly the improvement of upper limb function. Women have achieved better functional improvement in all of the parameters. In addition, it was observed that symptoms of depression were presented in all study group, and the improvement of mental focused primarily on patients after 60 years old. © 2015 MEDPRESS.

[The Role of Physician In Enhancement of Rehabilitation of Disabled Children].

PubMed

Nizova, L M; Kislisyna, I G

2017-09-01

The national and international experience of rehabilitation of disabled children was investigated. On the basis of monitoring data problem of increasing of number of children with diagnosis of infantile cerebral paralysis, including necessity of development of new methods of their rehabilitation was established. The comparative dynamics of nosology of disabled children permitted to detect diseases of nervous system and congenital abnormalities (malformations), deformations and chromosomal disorders, psychological disorders and behavioral disorders mostly specific for urban and rural area. The model of institutional environment of rehabilitation of disabled children was developed including system of formal (state, legislative acts, health institutions, organizations of social support of population)and non-formal (public, non-commercial and social psychological organizations) institutions impacted by economic, social,legal and demographic factors. The role of physician is substantiated concerning increasing of quality of rehabilitation services: diagnostic of disordered functions, detection of optimal volume of medical, psychological and pedagogue activities in patients with severe speech disorders, motoric and and neuro-censorial disorders developed as a result of early organic damage of brain, neuro-infections, strokes, and other affection of brain. The adequate curative rehabilitative complex programs were developed of social everyday and social labor rehabilitation.

Nursing Roles and Functions in the Acute and Subacute Rehabilitation of Patients With Stroke: Going All In for the Patient.

PubMed

Dreyer, Pia; Angel, Sanne; Langhorn, Leanne; Pedersen, Birgitte Blicher; Aadal, Lena

2016-04-01

The description of nursing roles and functions in rehabilitation of patients with stroke remains sparse. The aim of this study was to describe the experienced roles and functions of nurses during in-hospital rehabilitation of patients with stroke. Within a phenomenological hermeneutic approach, 19 nurses working with in-hospital rehabilitation of patients with stroke participated in three focus group interviews during 2013. The nurses' experiences were described in two themes: (a) the nurse's role and function in relation to the patient's needs 24/7 and (b) the nurse's role and function in the interdisciplinary team. Getting to know the patient as a person was essential to the nurses to care for the patient's basic needs; these must come first working with rehabilitation and always include the relatives. Recognition of the team members' individual skills with focus on the patient's needs must be the center of attention. An interdisciplinary rehabilitation program actively needs to include the patient by integrating the patient's perspective in the goals as well as in daily rehabilitation. In the team, nurses had the role of coordinator and the patient's voice.

Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

PubMed

Stiers, William; Barisa, Mark; Stucky, Kirk; Pawlowski, Carey; Van Tubbergen, Marie; Turner, Aaron P; Hibbard, Mary; Caplan, Bruce

2015-05-01

This study describes the results of a multidisciplinary conference (the Baltimore Conference) that met to develop consensus guidelines for competency specification and measurement in postdoctoral training in rehabilitation psychology. Forty-six conference participants were chosen to include representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, persons involved in medical education practice and research, and consumers of training programs (students). Consensus education and training guidelines were developed that specify the key competencies in rehabilitation psychology postdoctoral training, and structured observation checklists were developed for their measurement. This study continues the development of more than 50 years of thinking about education and training in rehabilitation psychology and builds on the existing work to further advance the development of guidelines in this area. The conference developed aspirational guidelines for competency specification and measurement in rehabilitation psychology postdoctoral training (i.e., for studying the outcomes of these training programs). Structured observation of trainee competencies allows examination of actual training outcomes in relation to intended outcomes and provides a methodology for studying how program outcomes are related to program structures and processes so that program improvement can occur. Best practices in applying program evaluation research methods to the study of professional training programs are discussed. (c) 2015 APA, all rights reserved).

34 CFR 350.13 - What must a grantee do in carrying out a research activity?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What must a grantee do in carrying out a research... REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does the Secretary Assist? § 350.13 What must a grantee do in carrying out a research activity? In carrying out a research activity under this...

34 CFR 350.13 - What must a grantee do in carrying out a research activity?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true What must a grantee do in carrying out a research... REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does the Secretary Assist? § 350.13 What must a grantee do in carrying out a research activity? In carrying out a research activity under this...

Evaluation of an occupational rehabilitation program.

PubMed

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

2005-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

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

"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD.

PubMed

Desveaux, Laura; Harrison, Samantha; Lee, Annemarie; Mathur, Sunita; Goldstein, Roger; Brooks, Dina

Despite well-established improvements following rehabilitation, functional gains often diminish following discharge. To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance. Semi-structured interviews were conducted with 11 individuals with HF or COPD. Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) "We are all there for the same purpose" - participant support for integrated exercise, including the benefit of multiple perspectives and sustainability. A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD. Copyright © 2017 Elsevier Inc. All rights reserved.

34 CFR 361.62 - Maintenance of effort requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provides for the construction of a facility for community rehabilitation program purposes, the amount of... for the construction of a facility for community rehabilitation program purposes or the establishment of a facility for community rehabilitation purposes, must be at least equal to the expenditures for...

34 CFR 361.62 - Maintenance of effort requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... provides for the construction of a facility for community rehabilitation program purposes, the amount of... for the construction of a facility for community rehabilitation program purposes or the establishment of a facility for community rehabilitation purposes, must be at least equal to the expenditures for...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

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

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

ERIC Educational Resources Information Center

Phelps, William R.

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

Responsiveness and minimal clinically important changes for the Tampa Scale of Kinesiophobia after lumbar fusion during cognitive behavioral rehabilitation.

PubMed

Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

2017-06-01

The Tampa Scale of Kinesiophobia (TSK) is a commonly-used measure for the assessment of fear of movement beliefs in chronic complaints, but its responsiveness in subjects after lumbar fusion has been never reported. Evaluating the responsiveness and minimal clinically important differences (MCIDs) for the TSK and its subscales after lumbar fusion. Population-based cohort study. Secondary care rehabilitation hospital. In-patients undergoing rehabilitation after lumbar fusion. At the beginning and end of a four-week motor and cognitive-behavioral rehabilitation program, 180 patients completed the TSK. After the intervention, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the TSK and its subscales were calculated by distribution (effect size [ES], standardized response mean [SRM]) and anchor-based methods (receiver operating characteristics (ROC) curves; correlations between change scores of the TSK and its subscales and GPE). ROC curves were also used to compute MCID values. The ES ranged from 1.63 to 1.77 and the SRM from 1.25 to 1.39 for TSK and its subscales. The ROC analyses revealed a value of area under the curve (0.999 [95% CI: 0.978; 1.000], 0.998 [95% CI: 0.975; 1.000], 0.990 [95% CI: 0.962; 0.999] for the TSK, Harm and Activity Avoidance subscales, respectively). MCID values greater than 6 (95% CI: >5; >6), 4 (95% CI: >3; >5), and 2 (95% CI: >2; >2) were achieved for the TSK, Harm and Activity Avoidance subscales, respectively. Correlations between change scores of the TSK and its subscales and GPE were high (0.786-0.830). The TSK and its subscales were sensitive in detecting clinical changes in subjects undergoing rehabilitation after lumbar fusion. The obtained MCID values will help in the design of future randomized controlled trials and in the interpretation of the clinical impact of a rehabilitation program after lumbar fusion.

Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years

PubMed Central

Toffola, Elena Dalla; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

2014-01-01

Summary Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XII-VII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable. PMID:25473738

"Here we're all in the same boat"--a qualitative study of group based rehabilitation for sick-listed citizens with chronic pain.

PubMed

Andersen, Lotte Nygaard; Kohberg, Maria; Herborg, Lene Gram; Søgaard, Karen; Roessler, Kirsten Kaya

2014-08-01

Musculoskeletal pain impacts upon everyday life. A degree of chronicity may pose an increased risk of sickness absence. One of two rehabilitative interventions, "Tailored Physical Activity" or "Chronic Pain Self-Management Program", was offered to sick-listed citizens who experienced pain. The objectives of this paper were to: (1) Assess what factors are experienced as problematic for sick-listed citizens in everyday life with chronic pain, and (2) Evaluate the significance of two distinct rehabilitative interventions on the future everyday lives of sick-listed citizens. Seven semi-structured interviews with sick-listed citizens were analyzed using a phenomenological-hermeneutical approach. Results were discussed by applying the theoretical framework of Antonovsky's salutogenetic model and Yaloms principles for group psychology. The potential for development of citizen's coping is evaluated based on Roessler's notion of progression. The analysis revealed four main themes: (1) Living with pain and unemployment; (2) "Putting my foot down" and "asking for help"; (3) Significance of the group, including instructors, and; (4) Aspects significant to progression. Unemployment is a major life event that promotes stress and can be accompanied by problems related to depressed mood, acceptance of the life situation, feelings of not being useful, feelings of losing control and identity conflicts. Group characteristics that gave a significant basis for progression in the self-management program are both emotional and instrumental, while the physical training program offers a "here-and-now"-experience and motivation to participate. This study indicates that the self-management program could potentially improve coping while the physical activity program revealed one example of a means of progression. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

The evaluation of a strength and balance exercise program for falls prevention in community primary care.

PubMed

Hawley-Hague, Helen; Roden, Amy; Abbott, Jo

2017-08-01

We aimed to evaluate a strength and balance program delivered in the community. There is little evidence of implementation of evidence-based exercise in practice. The program was a step-down model, designed to encourage long-term exercise in community classes. The program consisted of a fully funded referral only evidence-based 12-week strength and balance (Community Otago) class, followed by an evidence-based continuous open-access community strength and balance class (Active Always). The program was offered to patients: 1) after formal falls rehabilitation (falls and fracture service); 2) after falls rehabilitation in intermediate care; and 3) referred by a GP who were not eligible for rehabilitation (preventative measure). Outcome evaluation used descriptive statistics to report changes in function, confidence in balance, hospital attendance/admission for falls/fractures and transition to community classes. Focus groups established participant experience/satisfaction. Seventy-nine participants were included, aged 56-96, and 53 (67%) were women. About 63.3% of patients transitioned to Active Always classes, demonstrating improvement in maintenance. Follow-up scores from baseline attendance at falls and fracture service to 12-weeks follow-up (24 weeks) in Community Otago showed the majority of patients improved their function (Timed up and Go), confidence (ConfBal) and lowered their falls risk (Tinetti). Follow-up of participants from Community Otago baseline to the end of 12-weeks showed improvement in function and confidence, but only a third of participants lowered their falls risk. Focus groups data suggest that continuity of delivery, the role of the instructor, health professional, and social and physical outcomes were essential for maintenance. A supportive environment can be created which encourages older adults' continued participation in group-based strength and balance, helping the delivery of evidence-based practice.

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

PubMed

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

2015-01-01

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

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.

COPD online-rehabilitation versus conventional COPD rehabilitation - rationale and design for a multicenter randomized controlled trial study protocol (CORe trial).

PubMed

Hansen, Henrik; Bieler, Theresa; Beyer, Nina; Godtfredsen, Nina; Kallemose, Thomas; Frølich, Anne

2017-11-16

Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program and 30-50% drop-out before completion. The main reasons are severe symptoms, inflexible accessibility and necessity for transportation. Currently there are no well-established and evident rehabilitation alternatives. Supervised online screen rehabilitation could be a useful approach to increase accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). This study is a randomized assessor- and statistician blinded superiority multicenter trial with two parallel groups, employing 1:1 allocation to the intervention and the comparison group.On the basis of a sample size calculation, 134 patients with severe or very severe COPD and eligible to conventional hospital based outpatient COPD rehabilitation will be included and randomized from eight different hospitals. The CORe intervention group receives group supervised resistance- and endurance training and patient education, 60 min, three times/week for 10 weeks at home via online-screen. The CCRe comparison group receives group based supervised resistance- and endurance training and patient education, 90 min, two times/week for 10 weeks (two hospitals) or 12 weeks (six hospitals) in groups at the local hospital. The primary outcome is change in the 6-min walking distance after 10/12 weeks; the secondary outcomes are changes in 30 s sit-to-stand chair test, physical activity level, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline assessments. The study will likely contribute to knowledge regarding COPD tele-rehabilitation and to which extent it is more feasible and thereby more efficient than conventional COPD rehabilitation in patients with severe and very severe COPD. Clinicaltrials.gov Identifier: NCT02667171 . Registration data: January 28th 2016.

[Effects of exercise training on ergocycle during hemodialysis in patients with end stage renal disease: relevance of the anaerobic threshold intensity].

PubMed

Besnier, Florent; Laruelle, Eric; Genestier, Sandrine; Gié, Sophie; Vigneau, Cécile; Carré, François

2012-07-01

Chronic kidney failure (CRF) in addition to cardiovascular comorbidities and aging decrease physical activity capacity. An adapted rehabilitation program might be strongly recommended in this population. The aim of the study is to evaluate a 3 months exercise training program with ergocycle at the anaerobic threshold (AT) during dialysis sessions on effort tolerance, quality of life, blood pressure and lipidic disorders. Six patients meanly aged 72 were evaluated before (t(0)) and after (t(3)) the rehabilitation program by: maximal cardiorespiratory ergotest, a 6-Minute Walk Test (6MWT) and 2 quality of life tests: Medical Outcome Survey Short Form 36-items and the Kidney Disease Quality of Life (SF 36, KDQol). Physical activity during dialysis is well tolerated. There was no undesirable event during rehabilitation sessions. The dyspnea and muscular weariness threshold linked to the AT increased meanly by 39% (8.83 ± 0.87 vs. 12.25 ± 1.23 mL/min per kg). Distances walked during 6 MWT increased for all patients (351.83 ± 72.17 vs. 412.80 ± 82 meters) Moreover, physical component scale improved (+4.7), mean systolic blood pressure (-7 mmHg) and mean triglycerides concentration (-19%) decreased. An exercise training program during dialysis sessions with ergocycle and working intensity based on AT seems safe and an effective alternative to improve the effort functional capacity by hemodialysis patients. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

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. Vocational rehabilitation case managers should raise the referral rate and cooperation with job coaches as this directly affects the quality of services and clients' employment rate.

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

DOT National Transportation Integrated Search

1976-09-01

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

The Family's Role in Rehabilitation: "Early Warning System."

ERIC Educational Resources Information Center

Westin, Marijo Thomas; Reiss, David

1979-01-01

Describes methods used in a project at George Washington University's Rehabilitation Research and Training Center to predict and classify a family's involvement in a patient's rehabilitation program. As family attitudes can enhance or damage a program's effectiveness, early identification of uncooperative families is necessary so that intervention…

Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

PubMed Central

Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

2012-01-01

The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed. PMID:25945193

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

PubMed

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

2012-09-01

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

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

PubMed

Johari Moghadam, Adel; Azizinejad, Saied

2016-12-01

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

Application of a contextual instructional framework in a continuing professional development training program for physiotherapists in Rwanda.

PubMed

Dunleavy, Kim; Chevan, Julia; Sander, Antoinette P; Gasherebuka, Jean Damascene; Mann, Monika

2018-06-01

Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation. Contextual facilitating factors and needs informed choices in each phase. The model resulted in delivery of continuing professional development to the majority of physiotherapists in Rwanda (n = 168, 0.48 rural/0.52 urban) with participants reporting improvement in skills and perceived benefit for their patients. Environmental and healthcare system factors resulted in offering the courses in rural and urban areas. Content was developed and delivered in partnership with Rwandan coinstructors. Based on the domestic needs identified in early courses, the program included advocacy and leadership activities, in addition to practical and clinical instruction. The contextual factors (environment, healthcare service organization, need for rehabilitation and status and history of the physiotherapy profession) were essential for project and instructional choices. Facilitating factors included the established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects. The processes and contextual considerations may be useful in countries with established professional-level education but without established postentry-level training. Implications for Rehabilitation Organizations planning continuing professional development programs may benefit from considering the context surrounding training when planning, designing and developing instruction. The surrounding context including the environment, the organization of healthcare services, the population defined need for rehabilitation, and the domestic status and history of the physiotherapy profession, is important for physiotherapy projects in countries with lower resources. Facilitating factors in low resource countries such as an established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects impact the success of projects. Methods that may be useful for relevance, dissemination and consistency include involvement of in-country leaders and instructors and attendance in multiple courses with consistent themes. Rehabilitation professionals in low resource countries may benefit from continuing professional development courses that emphasize practical skills, and clinical reasoning, accompanied by clinical mentoring and directed coaching that encourages knowledge transfer to the clinical setting. Active learning approaches and multiple progressive courses provide opportunities to develop peer support through professional communities of practice.

Current trends in rehabilitation engineering in Japan.

PubMed

Ohnabe, Hisaichi

2006-01-01

In 2005, the elderly generation comprised 20% of the Japanese population. This percentage will grow to approximately 30% in 2030, meaning that nearly one in three people in Japan will be 65 years of age or older. Japan is the first nation in the world to face this situation. This article uses the context of Japanese society to give an overview of the elderly and people with disabilities; the International Classification of Functioning, Disability, and Health model; rehabilitation engineering-related policy; and education. In addition, we examine how governmental programs and Japanese law regarding technical aids may evolve by 2030. Partner robots, intelligent powered wheelchairs, nursing robots, and other technologies are introduced as examples of rehabilitation engineering and assistive technology. We also discuss the volunteer activities of the Rehabilitation Engineering Society of Japan (RESJA) in response to the Asian tsunami disaster and the achievements of a group of students from a Japanese senior high school of industry.

[Organization and methodology of early rehabilitation of the patients with cardioembolic stroke complicated by cardiac insufficiency].

PubMed

Isaeva, T V

2013-01-01

The present work was focused on the safety and effectiveness of the combined rehabilitative treatment in the case of pre-acute and acute cardioembolic stroke in 45 patients with varying degree of cardiac decompensation. The study showed that the use of "passive" remediation, such as the postural treatment, breathing exercises, selective massage, neuromuscular electrical stimulation, is safe and can be recommended to the patients with stroke and cardiac decompensation of different severity (II and III FC of chronic cardiac insufficiency). The introduction of such active measures as verticalization into the program of comprehensive rehabilitation may cause decompensation of cardiac insufficiency. The rehabilitation strategy used in the present study improved performance and exercise tolerance in the majority of the patients. Moreover, it resulted in the significant reduction of the severity of stroke, improved the motor function, and increased functional independence of the patients.

Neuropsychiatric rehabilitation for persistent mental illness.

PubMed

Jaeger, J; Douglas, E

1992-01-01

The benefits of new knowledge on the psychobiology and neuropsychology of serious mental illnesses have been slow to impact on psychiatric rehabilitation technology. A literature review reveals that, at least in the case of schizophrenia, enough is known about neurobiological deficits and their impact on neurocognitive functioning to justify a more informed approach to psychiatric rehabilitation. Essential elements for a program of research are presented and preliminary data are reported examining the prevalence of executive deficits, correlations between neuropsychological deficits and social adjustment, and the nature of socially stigmatizing neuromotor deficits and their reliable assessment. In addition, early experience with the remediation of executive deficits is described and suggestions are made for future developments in this area. The authors conclude that barriers to the integration of knowledge from biological psychiatry and psychiatric rehabilitation have been largely related to academic "cultural" isolation, and that active cross fertilization of ideas is clearly justified by the present state of knowledge.

Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.

PubMed

Pellegrini, Christine A; Ledford, Gwendolyn; Chang, Rowland W; Cameron, Kenzie A

2017-05-05

We sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. Twenty patients with knee osteoarthritis aged 40-79 years who had knee arthroplasty surgery scheduled or completed within 3 months were interviewed. Interview topics included perceived barriers and facilitators to healthy eating and activity before or after surgery. Interviews were coded and analyzed using constant comparative analysis. Interviews were completed with 11 pre-operative (67.1 ± 7.6 years, 45.5% female, BMI 31.2 ± 6.3) and nine post-operative patients (61.7 ± 11.7 years, 44.4% female, BMI 30.2 ± 4.7 kg/m 2 ). The most commonly identified personal barriers to healthy eating identified were desire for high-fat/high-calorie foods, managing overconsumption and mood. Factors related to planning, portion control and motivation to improve health were identified as healthy eating facilitators. Identified personal barriers for activity included pain, physical limitations and lack of motivation, whereas facilitators included having motivation to improve knee symptoms/outcomes, personal commitment to activity and monitoring activity levels. Identifying specific eating and activity barriers and facilitators, such as mood and motivation to improve outcomes, provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients. Implications for rehabilitation This study provides insight into the identified barriers and facilitators to healthy eating and physical activity in knee arthroplasty patients, both before and after surgery. Intrapersonal barriers that may hinder engagement in physical activity and rehabilitation include pain, physical limitations and lack of motivation; factors that may help to improve activity and the rehabilitation process include being motivated to improve knee outcomes, having a personal commitment to activity and tracking activity levels. Barriers that may interfere with healthy eating behaviors and knee arthroplasty rehabilitation include the desire for high-fat/high-calorie foods, overeating and mood; whereas planning and portion control may help to facilitate healthy eating. Understanding barriers and facilitators to healthy eating and physical activity can help guide rehabilitation professionals with their discussions on weight management with patients who had or are contemplating knee arthroplasty.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

[Role of controlled physical activity as a method of therapy in patients with heart failure after invasive treatment of angina pectoris].

PubMed

Irzmański, Robert; Kapusta, Joanna; Kowalski, Jan

2014-08-01

Due to the aging of the population is an increase in the incidence of heart failure. According to the current guidelines for conduct in the treatment of cardiovascular diseases, rehabilitation is introduced in the first treatment period. Individually matched to the severity of illness of each patient, increases the quality of life of patients and reduces mortality in this group of patients. The aim of the study was to evaluate the effect of controlled exercise on left ventricular systolic function of heart and change the level of concentration of natriuretic peptide NT-pro-BNP in patients with heart failure after invasive treatment of angina pectoris. The study group consisted of 87 patients, men and women aged 35 to 85 years (mean age 65.6 +/- 10.4) with a diagnosis of heart failure. Patients were divided into 3 groups. I group numbering 19 patients (67.3 +/- 7.8) were subjected to two-week cardiac rehabilitation program, representing 46. Group II patients (59.4 +/- 10.9) was qualified for the 4-week program. The basis for rehabilitation of patients accounted for interval training was performed using a bicycle ergometer. Group III--control, representing 22 patients (68.1 +/- 9.2) were excluded from the training groups because of the high risk. Used with them individually tailored program of cardiac rehabilitation. All patients were performed: submaximal exercise test, echocardiography and examined the concentration of NT-pro-BNP (N-terminal pro-B-type natriuretic peptide). After a period of 6 months from the end of the second phase of cardiac rehabilitation in 32 patients who agreed repeated the scope of clinical trials. In groups where physical training was conducted controlled noticed an improvement in EF and reduction of NT pro-BNP. It was also a significant, negative correlation between the degree of damage to the left ventricle (EF), and the level of NT pro-BNP. After a period of 6 months from the end of the second stage of rehabilitation, the analysis showed a statistically significant further and improve. It was observed that the best results were obtained in the group with the longest period of rehabilitation. Rehabilitation, part of cardiac rehabilitation is an important component of therapy in patients with heart failure. By influencing the improvement actions cardiovascular favorable effect on the clinical course of the disease.

Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences.

PubMed

Flick, C L

1999-05-01

This self-directed learning module highlights recent research in assessment of stroke outcomes and management of the psychosocial consequences of stroke. It is a part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses predictive factors for mortality and functional recovery; proposed case mix adjustment and prospective payment systems for stroke rehabilitation; continuum of care and utilization of acute, nursing home, outpatient and home health rehabilitation programs; reintegration and socialization after stroke; vocational rehabilitation of stroke patients; and management of the psychosocial effects of stroke on patients and families.

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

PubMed

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

2017-01-01

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

A treatment program for individuals with deficient evaluative processing and consequent impaired social and risk judgement.

PubMed

Park, Norman W; Conrod, Brian; Hussain, Zahra; Murphy, Kelly J; Rewilak, Dmytro; Black, Sandra E

2003-01-01

The current study evaluated the effectiveness of a rehabilitation program developed to assist individuals such as AM who have impaired social and risk judgement. AM's difficulties developed after a severe traumatic brain injury that resulted in bilateral frontal and temporal lobe damage including damage to the amygdala. Previous work (Park et al., 2001) established that AM had impaired automatic processing of negative, but not positive evaluative information, and relatively spared processing of both types of evaluative information when using controlled or strategic processing. In the Strategic Evaluation of Alternatives (SEA) treatment program, AM was trained to compensate for his impairments by explicitly retrieving positive and negative attributes associated with potential actions prior to performing them. The SEA treatment focused specifically on improving AM's ability to obtain financial compensation for his work-related activities. Results showed improved performance on work-related activities and evidence of generalization. Analyses suggested that the process underlying improved performance was compensatory rather than restorative in nature. We discuss the implications of these results for the development of rehabilitation treatment for patients with impaired social and risk judgement.

75 FR 39431 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

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... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Disability Rehabilitation Research Project (DRRP)-- International Exchange of Knowledge and Experts in Disability and Rehabilitation Research...

Rehabilitation in Justice: The Prisoner's Perspective.

ERIC Educational Resources Information Center

Erez, Edna

1987-01-01

Surveyed 348 prison inmates about their needs or interests in rehabilitation programs, reasons for their needs, whether they deserved treatment, and why. Results suggest that prisoners view rehabilitation and reform as the major purpose of punishment or prison sentence. Need was endorsed most often as fairest criterion for program participation.…

34 CFR 356.2 - Who is eligible for assistance under this program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... scientific research related to the solution of rehabilitation problems of individuals with disabilities. (c... REHABILITATION RESEARCH: RESEARCH FELLOWSHIPS General § 356.2 Who is eligible for assistance under this program... research experience in subject areas, methods, or techniques relevant to rehabilitation research and must...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... rehabilitation treatment, and psychosocial evaluation of the individual's response to and rate of progress under... coronary artery bypass surgery; (iii) Current stable angina pectoris; (iv) Heart valve repair or replacement; (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or...

24 CFR 572.215 - Implementation grants-eligible activities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES HOPE FOR HOMEOWNERSHIP OF SINGLE FAMILY HOMES PROGRAM... homebuyers. Provision of assistance to families to make acquisition and rehabilitation of eligible properties...

28 CFR 91.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Comprehensive correctional plan means a plan which represents an integrated approach to the management and... manslaughter, forcible rape, robbery, and aggravated assault as reported to the Federal Bureau of Investigation... offenders, prisoner rehabilitation and treatment programs, prisoner work activities (including to the extent...

38 CFR 21.7305 - Conflicting interests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Conflicting interests. 21...) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Administrative § 21.7305 Conflicting interests. In administering benefits payable...

38 CFR 21.7170 - Course measurement.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Course Assessment § 21.7170 Course measurement. In administering benefits payable...) and (a)(3) and those portions of paragraph (c) and footnotes dealing with farm cooperative training...

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

PubMed Central

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

2012-01-01

Background In the coming years, the number of survivors of critical illness is expected to increase. These survivors frequently develop newly acquired physical and cognitive impairments. Long-term cognitive impairment is common following critical illness and has dramatic effects on patients' abilities to function autonomously. Neuromuscular weakness affects similar proportions of patients and leads to equally profound life alterations. As knowledge of these short-term and long-term consequences of critical illness has come to light, interventions to prevent and rehabilitate these devastating consequences have been sought. Physical rehabilitation has been shown to improve functional outcomes in people who are critically ill, but subsequent studies of physical rehabilitation after hospital discharge have not. Post-hospital discharge cognitive rehabilitation is feasible in survivors of critical illness and is commonly used in people with other forms of acquired brain injury. The feasibility of early cognitive therapy in people who are critically ill remains unknown. Objective The purpose of this novel protocol trial will be to determine the feasibility of early and sustained cognitive rehabilitation paired with physical rehabilitation in patients who are critically ill from medical and surgical intensive care units. Design This is a randomized controlled trial. Setting The setting for this trial will be medical and surgical intensive care units of a large tertiary care referral center. Patients The participants will be patients who are critically ill with respiratory failure or shock. Intervention Patients will be randomized to groups receiving usual care, physical rehabilitation, or cognitive rehabilitation plus physical rehabilitation. Twice-daily cognitive rehabilitation sessions will be performed with patients who are noncomatose and will consist of orientation, memory, and attention exercises (eg, forward and reverse digit spans, matrix puzzles, letter-number sequences, pattern recognition). Daily physical rehabilitation sessions will advance patients from passive range of motion exercises through ambulation. Patients with cognitive or physical impairment at discharge will undergo a 12-week, in-home cognitive rehabilitation program. Measurements A battery of neurocognitive and functional outcomes will be measured 3 and 12 months after hospital discharge. Conclusions If feasible, these interventions will lay the groundwork for a larger, multicenter trial to determine their efficacy. PMID:22577067

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

PubMed

Bidargaddi, N P; Sarela, A

2008-01-01

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

Cognitive rehabilitation for patients with schizophrenia in Korea.

PubMed

Lee, Won Hye; Lee, Woo Kyeong

2017-02-01

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

Medically related activities of application team program

NASA Technical Reports Server (NTRS)

1971-01-01

Application team methodology identifies and specifies problems in technology transfer programs to biomedical areas through direct contact with users of aerospace technology. The availability of reengineering sources increases impact of the program on the medical community and results in broad scale application of some bioinstrumentation systems. Examples are given that include devices adapted to the rehabilitation of neuromuscular disorders, power sources for artificial organs, and automated monitoring and detection equipment in clinical medicine.

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

PubMed

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

2018-05-01

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

Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians.

PubMed

Demers, Marika; Chan Chun Kong, Daniel; Levin, Mindy F

2018-03-11

To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation.    • Input from end-users (therapists and individuals with stroke) is critical for the development and implementation of a virtual reality intervention.

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

PubMed

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

2010-01-01

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

Shock Incarceration: Rehabilitation or Retribution?

ERIC Educational Resources Information Center

MacKenzie, Doris Layton; And Others

1989-01-01

Reviews Louisiana's shock incarceration program used as alternative to standard prison incarceration. Program involves short period of imprisonment in a "boot camp" type atmosphere followed by three phases of intensive parole supervision. Examines the program in regard to its rehabilitative potential and compares program elements to…

Business Enterprise Program | Division of Vocational Rehabilitation

Science.gov Websites

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

75 FR 22767 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... vocational rehabilitation (VR) programs, or other programs serving transition-age youth with disabilities. (b...) Enhancement of the knowledge base of policy makers, State VR personnel, and personnel of other programs...

Educating Chinese Nurses About Rehabilitation Nursing: Findings From a Single Cohort Quantitative Pilot Project.

PubMed

Mauk, Kristen L; Li, Pei Ying; Jin, Huilu; Rogers, Julie; Scalzitti, Kristina

The purpose of this study was to present results of a pilot program to educate nurses in China about rehabilitation nursing. A single cohort, pre- and posttest design with an educational intervention. A 3-day basic rehabilitation nursing education program was conducted in Shanghai and Hangzhou by a certified rehabilitation nurse specialist from the United States. The effect of the educational intervention was measured using pre- and posttests for six topic areas. Data were analyzed using descriptive statistics, correlations, and paired samples t tests. Paired samples t tests showed a significant improvement (p < .01) as a result of the educational intervention on all three tests covering the six basic topics. The knowledge of the nurses on topics of basic rehabilitation nursing significantly increased as a result of the educational program. Rehabilitation nurses interested in international travel and developing professional relationships with nurses in China can provide education to promote our specialty practice overseas.

Does Somatosensory Discrimination Activate Different Brain Areas in Children with Unilateral Cerebral Palsy Compared to Typically Developing Children? An fMRI Study

ERIC Educational Resources Information Center

Van de Winckel, Ann; Verheyden, Geert; Wenderoth, Nici; Peeters, Ron; Sunaert, Stefan; Van Hecke, Wim; De Cock, Paul; Desloovere, Kaat; Eyssen, Maria; Feys, Hilde

2013-01-01

Aside from motor impairment, many children with unilateral cerebral palsy (CP) experience altered tactile, proprioceptive, and kinesthetic awareness. Sensory deficits are addressed in rehabilitation programs, which include somatosensory discrimination exercises. In contrast to adult stroke patients, data on brain activation, occurring during…

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Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis.

PubMed

Fuentes, María Antonia; Borrego, Adrián; Latorre, Jorge; Colomer, Carolina; Alcañiz, Mariano; Sánchez-Ledesma, María José; Noé, Enrique; Llorens, Roberto

2018-04-02

Impairments of the upper limb function are a major cause of disability and rehabilitation. Most of the available therapeutic options are based on active exercises and on motor and attentional inclusion of the affected arm in task oriented movements. However, active movements may not be possible after severe impairment of the upper limbs. Different techniques, such as mirror therapy, motor imagery, and non-invasive brain stimulation have been shown to elicit cortical activity in absence of movements, which could be used to preserve the available neural circuits and promote motor learning. We present a virtual reality-based paradigm for upper limb rehabilitation that allows for interaction of individuals with restricted movements from active responses triggered when they attempt to perform a movement. The experimental system also provides multisensory stimulation in the visual, auditory, and tactile channels, and transcranial direct current stimulation coherent to the observed movements. A feasibility study with a chronic stroke survivor with severe hemiparesis who seemed to reach a rehabilitation plateau after two years of its inclusion in a physical therapy program showed clinically meaningful improvement of the upper limb function after the experimental intervention and maintenance of gains in both the body function and activity. The experimental intervention also was reported to be usable and motivating. Although very preliminary, these results could highlight the potential of this intervention to promote functional recovery in severe impairments of the upper limb.

Musculoskeletal injury review in the U.S. space program.

PubMed

Jennings, R T; Bagian, J P

1996-08-01

Astronauts in NASA's space program are expected to remain fit to complete their on-orbit tasks and to function effectively in the event of contingency operations. Due to the generally self-directed exercise program and reliance on competitive sports and running for conditioning, plus limited emphasis on training techniques and rehabilitation, there have been a surprising number of orthopedic injuries and surgeries in this small adult population. This article examines the orthopedic injury history of U.S. astronauts during the period from 1987-95. The type of injury, activity involved, and subsequent surgical interventions are cataloged. There were a total of 26 fractures, 36 serious ligament, cartilage, or soft tissue injuries, and 28 orthopedic surgical procedures in this adult group with a mean astronaut corps size of only 94. Women accounted for 16% of the study population but accounted for only 1 of 28 surgical procedures. Knee injuries required surgical intervention 19 times. Running, skiing, and basketball were most frequently associated with injuries. The descriptive data regarding frequency of adverse events and activity associated with injuries is presented. These injury patterns are analyzed and suggestions made for future improvement, including decreased reliance on running and competitive athletics for conditioning, improved personal fitness training preflight, and coordinated rehabilitation postflight. Also recommended is the use of a lap pool for preflight total body fitness training, since swimming provides conditioning to those muscle groups used during spaceflight, and for variably weighted gravity rehabilitation postflight.

Commentary on Stiers and colleagues' guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

PubMed

Hatcher, Robert L

2015-05-01

Comments on the article, "Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training," by Stiers et al. (see record 2014-55195-001). Stiers and colleagues have provided a thorough and well-conceived set of guidelines that lay out the competencies expected for graduates of postdoctoral residencies in rehabilitation psychology, accompanied by a set of more specific, observable indicators of the residents' competence level. This work is an important aspect of the broader project of the Rehabilitation Psychology Specialty Council (APA Division 22, the American Board of Rehabilitation Psychology, the Foundation for Rehabilitation Psychology, the Academy of Rehabilitation Psychology, and the Council of Rehabilitation Psychology Postdocotral Training Programs) to develop overall guidelines for programs providing postdoctoral training in this field (Stiers et al., 2012). (c) 2015 APA, all rights reserved).

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.

[The substantiation of the use of high-frequency intrapulmonary ventilation in the patients presenting with chronic obstructive pulmonary disease at the spa and health resort stage of rehabilitation].

PubMed

Zaripova, T N; Zhilyakova, L V; Bulanova, Z P

The importance of the development of the new methods for the rehabilitation of the patients presenting with chronic obstructive pulmonary disease under conditions of the spa and health resort-based treatment arises from the high prevalence and the progressive character of this disease, poor quality of the patients' life, great economic losses due to the reduction of the working capacity of the patients, and the high cost of COPD treatment. The objective of the present study was to substantiate the advisability of inclusion of high-frequency intrapulmonary ventilation in the program of the therapeutic and rehabilitative treatment of the patients with COPD based at a spa and health resort facility. The analysis of the results of examination and rehabilitative treatment included 49 patients treated at the «Belokurikha» health resort (14 women and 35 men presenting with stage 1 and 2 COPD). The patients were divided into two groups. The main one included 23 patients while the group of comparison consisted of 26 patients. Those of the main group were given the treatment that included the mineral water baths, inhalations, exercise therapy for the training of skeletal muscles, manual massage, high-frequency intrapulmonary ventilation, intake of extract maral root (Rhaponticum carthamoides) and the «Yantar antiox» (amber antiox) preparation. The patients of the comparison group received the same rehabilitative treatment but without high-frequency intrapulmonary ventilation. The effectiveness of the rehabilitative measures was comprehensively estimated from the dynamics of the clinical data, indices of the inflammatory activity, the results of spirography and 6 minute walking test. It has been shown that the introduction of high-frequency intrapulmonary ventilation into the spa and health resort-based rehabilitative program facilitates the elimination of clinical manifestation of the disease, promotes recovery of the external respiration function due to sputum recruiting and stimulation of mucociliary clearance that in turn decreases the activity of the inflammatory processes. Simultaneously, the thoracic mobility and physical efficiency of the patients increased. The overall result of the treatment was the enhanced quality of rehabilitation of the patients suffering COPD within 14-16 days of their stay at the health resort with excellent tolerability of the proposed therapeutic modality.

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

PubMed

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

1978-02-18

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

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

PubMed Central

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

1978-01-01

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

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

PubMed

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

2018-04-01

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

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

PubMed

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

2017-12-02

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

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.

Predicting Employment Outcomes of Consumers of State-Operated Comprehensive Rehabilitation Centers

ERIC Educational Resources Information Center

Beach, David Thomas

2009-01-01

This study used records from a state-operated comprehensive rehabilitation center to investigate possible predictive factors related to completing comprehensive rehabilitation center programs and successful vocational rehabilitation (VR) case closure. An analysis of demographic data of randomly selected comprehensive rehabilitation center…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

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

78 FR 29234 - Final Priority; National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and... 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...