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...

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Improved functions and reduced length of stay after inpatient rehabilitation programs in older adults with stroke: A systematic review and meta-analysis of randomized controlled trials.

PubMed

Bindawas, Saad M; Vennu, Vishal; Moftah, Emad

2017-01-01

to examine the effects of inpatient rehabilitation programs on function and length of stay in older adults with strokeMETHODS: A total of five electronic databases were searched for relevant randomized controlled trials that examined the effects of inpatient rehabilitation programs on functional recovery, as measured by the functional independence measure and length of stay, which was measured in days. We included full-text articles written in English, and no time limit. The methodological quality and risk of bias were assessed using the Physiotherapy Evidence Database Scale and the Cochrane collaboration tools respectively. The effect sizes and confidence intervals were estimated using fixed-effect modelsRESULTS: Eight randomized controlled trials involving 1,910 patients with stroke were included in the meta-analysis showed that patients who participated in the inpatient rehabilitation programs had significantly (p less than 0.05) higher functional independence measure scores (effect size = 0.10; 95 percent confidence interval = 0.01, 0.22) and shorter length of stay (effect size = 0.14; 95 percent confidence interval = 0.03, 0.22). This systematic review provided evidence that inpatient rehabilitation programs have beneficial effects, improving functionality and reducing length of stay for older adults with stroke.

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…

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

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

PubMed

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

2014-02-01

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

Study Protocol for a Randomized Controlled Trial Evaluating the Efficacy of an Evidence-Based iPad-App for Cognitive Rehabilitation in Patients with Primary Brain Tumors.

PubMed

van der Linden, Sophie Dorothee; Sitskoorn, Margriet Maria; Rutten, Geert-Jan Maria; Gehring, Karin

2018-06-16

Many patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive rehabilitation program. After successful completion of a feasibility study, a randomized controlled trial has been started. To evaluate the immediate and long-term effects of the iPad-based program on cognitive performance and patient-reported outcome measures (PROMs) in patients with primary brain tumors in an early stage of the disease. Prior to surgery, patients with presumed low-grade glioma and meningioma are included. Before surgery and 3 mo after surgery, neuropsychological assessments are conducted. After the second neuropsychological assessment, patients are assigned to the intervention group or waiting-list control group. The intervention consists of psychoeducation, compensation training, and retraining. Patients are advised to spend 3 h per week on the program for 10 wk. Immediately after completion of the program and a half-year thereafter, postintervention assessments take place. Patients in the control group are offered the opportunity to follow the program after all study assessments. We expect that early cognitive rehabilitation has beneficial effects on cognitive performance and PROMs in brain tumor patients. The iPad-based program allows brain tumor patients to follow a cognitive rehabilitation program from their homes. Forthcoming results may contribute to further improvement of supportive care for brain tumor patients.

Long-Term Pavement Performance Program: Pavement Performance Measures and Forecasting and the Effects of Maintenance and Rehabilitation Strategy on Treatment Effectiveness [Tech Brief

DOT National Transportation Integrated Search

2016-08-01

This document is a technical summary of the Federal Highway Administration Long-Term Pavement Performance Program report, Pavement Performance Measures and Forecasting and the Effects of Maintenance and Rehabilitation Strategy on Treatment Effectiven...

[Optimal rehabilitation of patients with coronary heart disease in outpatient setting].

PubMed

Korzhenkov, N P; Kuzichkina, S F; Shcherbakova, N A; Kukhaleishvili, N R; Iarlykov, I I

2012-01-01

The problem of invalid rehabilitation in Russia is an important state task and dictates necessity of design of an effective state program of primary prevention of cardiovascular diseases. Common global practice of medico-social model is based on complex detailed medico-social aid. Rehabilitation of postmyocardial infarction patients consists of three phases (stages): hospital posthospital (readaptation) and postreconvalescent (supportive). The program includes physical, psychological and pharmacological rehabilitation. Departments of readaptation and medico-social rehabilitation provide effective conduction of all kinds of rehabilitation. The Moscow North-East Regional Administration has a rich experience in organization of departments of readaptation and medico-social rehabilitation. The departments practice an individual approach to the patients and work in a close contact with bureaus of medico-social commission of experts. Management of patients by cardiologist, rehabilitation specialist and outpatient clinic's physicians provides uninterrupted staged rehabilitation, timely correction of pharmacotherapy, early patient referral to invasive investigations and treatment of coronary heart disease. A course of rehabilitative measures lasts 2 months. Setting up departments of medico-social rehabilitation in outpatient clinics provides more effective use of money assigned by the state for social support of invalids.

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

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.

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

PubMed

Odinets, Tatiana; Briskin, Yuriy; Pityn, Maryan

2018-02-26

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

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.

Successful rehabilitation program rests on service utilization.

PubMed

Lane, L

1993-07-01

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

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

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

PubMed

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

2016-09-01

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

Neural Coding for Effective Rehabilitation

PubMed Central

2014-01-01

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

Medical Rehabilitation in Natural Disasters: A Review.

PubMed

Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M

2015-09-01

To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A bio-psycho-social exercise program (RÜCKGEWINN) for chronic low back pain in rehabilitation aftercare--study protocol for a randomised controlled trial.

PubMed

Hentschke, Christian; Hofmann, Jana; Pfeifer, Klaus

2010-11-17

There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent. This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN) in comparison to the current usual aftercare (IRENA) and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation. Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured contents, media and material for organisation assistance as well as training manuals for therapists in the aftercare.

Humanistic psychology and rehabilitation programs in mental hospitals.

PubMed

Steele, R L

1976-07-01

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

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.

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.

Study on an advanced early rehabilitation training system for postural control using a tilting bed

NASA Astrophysics Data System (ADS)

Yu, Chang-Ho; Kim, Kyong; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

2005-12-01

It proposed a new early rehabilitation training system for postural control using a tilting bed, a visual display and a force plate. The conventional rehabilitation systems for postural control can't be applied to the patients lying in bed because the rehabilitation training using those systems is only possible when the patient can stand up by himself or herself. Moreover, there did not exist any device that could provide the sense of balance or the sensation of walking to the patients in bed. The software for the system consists of the training program and the analysis program. The training program was designed to improve the ability of postural control of the subjects by repeated training of moving the center of pressure (COP) applied to the forceplate. The training program consists of the COP maintaining training and the COP movement training in horizontal, vertical, 45° and -45° directions. The analysis program consists of the COP moving time analysis modules, the COP maintaining time analysis module. Through the experiments with real people, it verified the effectiveness of the new early rehabilitation training system. The results showe that this system is an effective system for early rehabilitation training and that our system might be useful as clinical equipment.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... Security Disability Insurance (SSDI) Served by State Vocational Rehabilitation (VR) Agencies AGENCY: Office... vocational rehabilitation (VR) agencies. The Assistant Secretary may use this priority for competitions in... beneficiaries receiving services from State VR agencies. DATES: Effective Date: This priority is effective...

Hearing on the Rehabilitation, Education, and Training Programs Administered by the Veteran's Administration--Nashville, Tenn. Hearing before the Subcommittee on Education, Training, and Employment of the Committee on Veterans' Affairs. House of Representatives. Ninety-Sixty Congress, Second Session (September 26, 1980).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

These Congressional hearings contain testimony given in Nashville, Tennessee, concerning the administration, execution, and effectiveness of four rehabilitation, education, and training programs relating to veterans and their dependents that are administered by the Veteran's Administration. Programs reviewed are Vocational Rehabilitation; the G.I.…

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

PubMed

Kwon, Hye Kyung; Lee, Sook Ja

2017-06-01

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

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.

Evaluating the "Reasoning and Rehabilitation" Program for Young Offenders

ERIC Educational Resources Information Center

Mitchell, Jonathan; Palmer, Emma J.

2004-01-01

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

[Work-Related Medical Rehabilitation in Cancer Rehabilitation - Short-Term Results from a Cluster-Randomized Multicenter-Trial].

PubMed

Wienert, Julian; Bethge, Matthias

2018-05-25

Rehabilitation programs that support return to work become increasingly relevant for cancer survivors. In Germany, such programs were established as work-related medical rehabilitation (WMR). The study investigated whether WMR leads to better results compared to medical rehabilitation (MR). We report effects on secondary outcomes when the rehabilitation program was completed. Clusters of participants were randomly assigned to WMR or MR. Patients of working age and an elevated risk of not returning to work were included. The grade of implementation was assessed by dose delivered and dose received. Study outcomes were assessed using scales measuring functioning and symptoms, coping with illness as well as self-reported work ability. Treatment effects were estimated using mixed linear models. From 232 planned randomized intervention groups, 165 (71%) were realized. In total, 476 patients were included. Mean age of participants was 50.7 years (SD=7.3). Most frequent primary diagnoses were malignant neoplasms of the breast. Participants in the WMR program reported significantly better outcomes regarding quality of life (SMD=0.17-0.25), fatigue (SMD=0.18-0.27), coping with illness (SMD=0.17-0.22), and self-reported work-ability (SMD=0.16) compared to participants in MR program (all p<0.05). The results indicate a positive effect in favor of WMR for cancer patients with an elevated risk of not returning to work at the end of their treatment. © Georg Thieme Verlag KG Stuttgart · New York.

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.

Cardiac rehabilitation after myocardial infarction.

PubMed

Contractor, Aashish S

2011-12-01

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

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

PubMed

Lee, Chang Kwan

2007-04-01

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

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.

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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

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.

Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a  study protocol.

PubMed

Rise, Marit B; Skagseth, Martin; Klevanger, Nina E; Aasdahl, Lene; Borchgrevink, Petter; Jensen, Chris; Tenggren, Hanne; Halsteinli, Vidar; Jacobsen, Trym N; Løland, Svein B; Johnsen, Roar; Fimland, Marius S

2018-02-05

Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed persons', rehabilitation therapists' and employers' perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation. Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapists' experiences with working towards return to work within an ACT-approach and stakeholders' experiences with the workplace intervention. A mixed methods study will combine quantitative and qualitative findings on the participants' expectations and motivation for return to work. The outline of this comprehensive study could represent an important addition to the standard designs of return to work evaluation. The mixed methods design, with qualitative approaches as well as a rigorous randomized controlled trial, might prove useful to shed light on contextual factors. ClinicalTrials.gov : NCT02541890 . September 4, 2015.

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.

LC-REHAB: randomised trial assessing the effect of a new patient education method--learning and coping strategies--in cardiac rehabilitation.

PubMed

Lynggaard, Vibeke; May, Ole; Beauchamp, Alison; Nielsen, Claus Vinther; Wittrup, Inge

2014-12-13

Due to improved treatments and ageing population, many countries now report increasing prevalence in rates of ischemic heart disease and heart failure. Cardiac rehabilitation has potential to reduce morbidity and mortality, but not all patients complete. In light of favourable effects of cardiac rehabilitation it is important to develop patient education methods which can enhance adherence to this effective program. The LC-REHAB study aims to compare the effect of a new patient education strategy in cardiac rehabilitation called 'learning and coping' to that of standard care. Further, this paper aims to describe the theoretical basis and details of this intervention. Open parallel randomised controlled trial conducted in three hospital units in Denmark among patients recently discharged with ischemic heart disease or heart failure. Patients are allocated to either the intervention group with learning and coping strategies incorporated into standard care in cardiac rehabilitation or the control group who receive the usual cardiac rehabilitation program. Learning and coping consists of two individual clarifying interviews, participation of experienced patients as educators together with health professionals and theory based, situated and inductive teaching. Usual care in cardiac rehabilitation is characterised by a structured deductive teaching style with use of identical pre-written slides in all hospital units. In both groups, cardiac rehabilitation consists of training three times a week and education once a week over eight weeks. The primary outcomes are adherence to cardiac rehabilitation, morbidity and mortality, while secondary outcomes are quality of life (SF-12, Health education impact questionnaire and Major Depression Inventory) and lifestyle and risk factors (Body Mass Index, waist circumference, blood pressure, exercise work capacity, lipid profile and DXA-scan). Data collection occurs four times; at baseline, at immediate completion of cardiac rehabilitation, and at three months and three years after the finished program. It is expected that learning and coping incorporated in cardiac rehabilitation will improve adherence in cardiac rehabilitation and may decrease morbidity and mortality. By describing learning and coping strategies the study aims to provide knowledge that can contribute to an increased transparency in patient education in cardiac rehabilitation. Identifier NCT01668394.

Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease.

PubMed

Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum

2013-05-01

Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

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...

Program Evaluation Grant. Final Report.

ERIC Educational Resources Information Center

Quadco Rehabilitation Center, Inc., Stryker, OH.

The purpose of the project was to increase the effectiveness and efficiency of those rehabilitation facilities which were utilized by the Ohio Rehabilitation Services Commission (RSC) through the development, installation, and utilization of a program evaluation system and a management information system. The two systems were developed and…

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

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

ERIC Educational Resources Information Center

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

2011-01-01

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

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.

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.

Employer Service Strategies in Rehabilitation: New Approaches to Placement. Institute on Rehabilitation Issues. Report from the Study Group (18th, Memphis, Tennessee, October 1991).

ERIC Educational Resources Information Center

Arkansas Univ., Fayetteville. Research and Training Center in Vocational Rehabilitation.

This resource/training document addresses innovative employment strategies for individuals with disabilities and their implications for rehabilitation, and provides information on model programs to assist state rehabilitation agencies, employers, and potential employers to identify effective strategies and networks to develop cooperative programs…

Integrated cognitive remediation and standard rehabilitation therapy in patients of schizophrenia: persistence after 5years.

PubMed

Buonocore, Mariachiara; Spangaro, Marco; Bechi, Margherita; Baraldi, Maria Alice; Cocchi, Federica; Guglielmino, Carmelo; Bianchi, Laura; Mastromatteo, Antonella; Bosia, Marta; Cavallaro, Roberto

2018-02-01

Cognitive remediation, often used in combination with standard rehabilitation programs, represents the best available tool to treat cognitive impairments in patients with schizophrenia. However, there are still open questions about durability of effects and generalization of cognitive improvements to functional outcome. This study aims to investigate the persistence of both cognitive and functional effects of combined cognitive remediation plus standard rehabilitation interventions, 5years after completion of the intervention, also comparing different durations of the standard rehabilitation. Sixty patients diagnosed with schizophrenia and previously treated with a 6months intervention, consisting of standard rehabilitation plus 3-months of cognitive remediation, either followed by another year of standard rehabilitation or routine psychiatric treatment, were reassessed with neuropsychological and functional measures 5years after the intervention. Results show that cognitive abilities remained stable after 5years in both groups, while functional performance significantly decreased in patients treated with the 6months intervention only. Data thus suggest that cognitive effects persist even after 5years, while a longer standard rehabilitation following the cognitive remediation program may be needed to achieve a stable functional gain. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2012-01-01

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

Early intensive rehabilitation after oral cancer treatment.

PubMed

Bschorer, Maximilian; Schneider, Daniel; Hennig, Matthias; Frank, Bernd; Schön, Gerhard; Heiland, Max; Bschorer, Reinhard

2018-06-01

The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain.

PubMed

Ju, Sung-Bum; Park, Gi Duck

2017-02-01

[Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain

PubMed Central

Ju, Sung-Bum; Park, Gi Duck

2017-01-01

[Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function. PMID:28265157

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

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.

Spitting in the Ocean: Realistic Expectations of the Impact of Driver Alcohol Education and Rehabilitation Programs on the Problem of Drunk Driving.

ERIC Educational Resources Information Center

Waller, Patricia F.

Alcohol education and rehabilitation programs are widely accepted as an integral part of the enforcement of drunk driving laws; however, careful evaluations of these programs generally fail to show subsequent beneficial effects on traffic crashes. This fact is due in part to the many barriers to conducting sound program evaluations and in part to…

[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".

Training in Rational-Behavior Problem Solving and Employability Enhancement of Rehabilitation Clients.

ERIC Educational Resources Information Center

Farley, Roy C.

1984-01-01

Examined the effects of a psychoeducational program on employability enhancement of 23 rehabilitation clients. The program had a significant, positive impact on clients' thinking, feeling, acting, and vocational outcome and reduced task-interfering beliefs, thoughts, emotions, and problem behavior. Participants had a lower vocational training…

Recruiting for Rehabilitation Counselor Education Programs: Twenty Years Later

ERIC Educational Resources Information Center

Paul, Heidi; Brodwin, Martin G.

2017-01-01

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

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.

Best Practice Models of Effective Vocational Rehabilitation Service Delivery in the Public Rehabilitation Program: A Review and Synthesis of the Empirical Literature

ERIC Educational Resources Information Center

Fleming, Allison R.; Del Valle, Roy; Kim, Muwoong; Leahy, Michael J.

2013-01-01

Rehabilitation counselors and practitioners are under increased pressure to adopt and pursue evidenced-based practices, and the rehabilitation counseling literature has been criticized for a lack of empirical work providing support for individual-level interventions. The purpose of this literature review was to examine the last 25 years of…

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.

Outpatient rehabilitation as an intervention to improve employees' physical capacity.

PubMed

Ojala, Birgitta; Nygård, Clas-Håkan; Nikkari, Seppo T

2016-01-01

The aging of the workforce poses new challenges for maintaining work ability. Because of limited information on the effectiveness of vocational rehabilitation performed in traditional inpatient programs, extended interest in outpatient rehabilitation has risen in the past few years. We examined the effects of a new outpatient rehabilitation program where every participant defined their own goals to improve work ability by the aid of a goal-oriented multi-professional team. This report will focus on the employees' physical capacity during a nine-month program. A total of 605 municipal employees from different production areas of the City of Tampere took part in the outpatient rehabilitation program, implemented by the occupational health unit. Groups of 12 employees participated in eight one-day sessions at intervals of two to three weeks; the final follow-up was 9 months from the beginning. Submaximal aerobic capacity was tested by a calibrated cycle ergometer with a commercial program (Aino Fitware pro, Helsinki, Finland). Musculoskeletal tests assessed muscle strength, balance and mobility. During the 9-month follow-up of the rehabilitation program, the employees' physical capacity was improved. The follow-up test scores from a total of 329 employees were significantly higher in the submaximal aerobic capacity test (p < 0.001). Other tests were also improved, such as standing on one foot (p = 0.001), back side bending flexibility test (p < 0.001), dynamic sit up (p = 0.001), upper extremity right (p < 0.001), and knee bending (p = 0.029). About 40% of the participants did not have an adequate health situation to take part in physical capacity tests; however they took part in the intervention. The new outpatient rehabilitation program organized by the occupational health unit had a positive influence on employees' physical capacity during a nine-month follow up.

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...

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.

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)…

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

PubMed

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

2017-06-06

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

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.

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...

Simulation-Based Estimates of the Effectiveness and Cost-Effectiveness of Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease in France.

PubMed

Atsou, Kokuvi; Crequit, Perrine; Chouaid, Christos; Hejblum, Gilles

2016-01-01

The medico-economic impact of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) is poorly documented. To estimate the effectiveness and cost-effectiveness of pulmonary rehabilitation in a hypothetical cohort of COPD patients. We used a multi-state Markov model, adopting society's perspective. Simulated cohorts of French GOLD stage 2 to 4 COPD patients with and without pulmonary rehabilitation were compared in terms of life expectancy, quality-adjusted life years (QALY), disease-related costs, and the incremental cost-effectiveness ratio (ICER). Sensitivity analyses included variations of key model parameters. At the horizon of a COPD patient's remaining lifetime, pulmonary rehabilitation would result in mean gain of 0.8 QALY, with an over disease-related costs of 14 102 € per patient. The ICER was 17 583 €/QALY. Sensitivity analysis showed that pulmonary rehabilitation was cost-effective in every scenario (ICER <50 000 €/QALY). These results should provide a useful basis for COPD pulmonary rehabilitation programs.

78 FR 16447 - Rehabilitation Continuing Education Program (RCEP) for the Technical Assistance and Continuing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... vocational rehabilitation (VR) agencies and agency partners that cooperate with State VR agencies in providing VR and other rehabilitation services (e.g., Centers for Independent Living (CILs), Client... following outcomes: Improved quality of VR services, increased effectiveness and efficiency of State VR...

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

PubMed

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

2018-05-01

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

75 FR 21610 - Overview Information: State Vocational Rehabilitation Unit In-Service Training; Notice Inviting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... rehabilitation (VR) unit personnel in program areas essential to the effective management of the unit's program of VR services and in skill areas that will enable personnel to improve their ability to provide VR services leading to employment outcomes for individuals with disabilities. The State VR Unit In- Service...

Pulmonary Rehabilitation for Patients With Chronic Pulmonary Disease (COPD)

PubMed Central

2012-01-01

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this evidence-based review was to determine the effectiveness and cost-effectiveness of pulmonary rehabilitation in the management of chronic obstructive pulmonary disease (COPD). Technology Pulmonary rehabilitation refers to a multidisciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. Exercise training is the cornerstone of pulmonary rehabilitation programs, though they may also include components such as patient education and psychological support. Pulmonary rehabilitation is recommended as the standard of care in the treatment and rehabilitation of patients with COPD who remain symptomatic despite treatment with bronchodilators. For the purpose of this review, the Medical Advisory Secretariat focused on pulmonary rehabilitation programs as defined by the Cochrane Collaboration—that is, any inpatient, outpatient, or home-based rehabilitation program lasting at least 4 weeks that includes exercise therapy with or without any form of education and/or psychological support delivered to patients with exercise limitations attributable to COPD. Research Questions What is the effectiveness and cost-effectiveness of pulmonary rehabilitation compared with usual care (UC) for patients with stable COPD? Does early pulmonary rehabilitation (within 1 month of hospital discharge) in patients who had an acute exacerbation of COPD improve outcomes compared with UC (or no rehabilitation)? Do maintenance or postrehabilitation programs for patients with COPD who have completed a pulmonary rehabilitation program improve outcomes compared with UC? Research Methods Literature Search Search Strategy For Research Questions 1and 2, a literature search was performed on August 10, 2010 for studies published from January 1, 2004 to July 31, 2010. For Research Question 3, a literature search was performed on February 3, 2011 for studies published from January 1, 2000 to February 3, 2011. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists and health technology assessment websites were also examined for any additional relevant studies not identified through the systematic search. Inclusion Criteria Research questions 1 and 2: published between January 1, 2004 and July 31, 2010 randomized controlled trials, systematic reviews, and meta-analyses COPD study population studies comparing pulmonary rehabilitation with UC (no pulmonary rehabilitation) duration of pulmonary rehabilitation program ≥ 6 weeks pulmonary rehabilitation program had to include at minimum exercise training Research question 3: published between January 1, 2000 and February 3, 2011 randomized controlled trials, systematic reviews, and meta-analyses COPD study population studies comparing a maintenance or postrehabilitation program with UC (standard follow-up) duration of pulmonary rehabilitation program ≥ 6 weeks initial pulmonary rehabilitation program had to include at minimum exercise training Exclusion Criteria Research questions 1, 2, and 3: grey literature duplicate publications non-English language publications study population ≤ 18 years of age studies conducted in a palliative population studies that did not report primary outcome of interest Additional exclusion criteria for research question 3: studies with ≤ 2 sessions/visits per month Outcomes of Interest The primary outcomes of interest for the stable COPD population were exercise capacity and health-related quality of life (HRQOL). For the COPD population following an exacerbation, the primary outcomes of interest were hospital readmissions and HRQOL. The primary outcomes of interest for the COPD population undertaking maintenance programs were functional exercise capacity and HRQOL. Quality of Evidence The quality of each included study was assessed taking into consideration allocation concealment, randomization, blinding, power/sample size, withdrawals/dropouts, and intention-to-treat analyses. The quality of the body of evidence was assessed as high, moderate, low, or very low according to the GRADE Working Group criteria. The following definitions of quality were used in grading the quality of the evidence: High Further research is very unlikely to change confidence in the estimate of effect. Moderate Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate. Very Low Any estimate of effect is very uncertain. Summary of Findings Research Question 1: Effect of Pulmonary Rehabilitation on Outcomes in Stable COPD Seventeen randomized controlled trials met the inclusion criteria and were included in this review. The following conclusions are based on moderate quality of evidence. Pulmonary rehabilitation including at least 4 weeks of exercise training leads to clinically and statistically significant improvements in HRQOL in patients with COPD.1 Pulmonary rehabilitation also leads to a clinically and statistically significant improvement in functional exercise capacity2 (weighted mean difference, 54.83 m; 95% confidence interval, 35.63–74.03; P < 0.001). Research Question 2: Effect of Pulmonary Rehabilitation on Outcomes Following an Acute Exacerbation of COPD Five randomized controlled trials met the inclusion criteria and are included in this review. The following conclusion is based on moderate quality of evidence. Pulmonary rehabilitation (within 1 month of hospital discharge) after acute exacerbation significantly reduces hospital readmissions (relative risk, 0.50; 95% confidence interval, 0.33–0.77; P = 0.001) and leads to a statistically and clinically significant improvement in HRQOL.3 Research Question 3: Effect of Pulmonary Rehabilitation Maintenance Programs on COPD Outcomes Three randomized controlled trials met the inclusion criteria and are included in this review. The conclusions are based on a low quality of evidence and must therefore be considered with caution. Maintenance programs have a nonsignificant effect on HRQOL and hospitalizations. Maintenance programs have a statistically but not clinically significant effect on exercise capacity (P = 0.01). When subgrouped by intensity and quality of study, maintenance programs have a statistically and marginally clinically significant effect on exercise capacity. PMID:23074434

Effects of disability compensation on participation in and outcomes of vocational rehabilitation.

PubMed

Drew, D; Drebing, C E; Van Ormer, A; Losardo, M; Krebs, C; Penk, W; Rosenheck, R A

2001-11-01

The authors sought to determine the relationship between receipt of disability compensation and participants' success in a vocational rehabilitation program. Administrative data for 22,515 individuals who participated in the Veterans Health Administration compensated work therapy program between 1993 and 1998 were analyzed. Six dependent variables were compared between participants who were receiving disability compensation and those who were not: duration of participation in compensated work therapy, number of hours worked per week, mean hourly earnings, total income from compensated work therapy, dropout rate, and competitive employment status at discharge. Regression equations were determined for each dependent variable to assess associations with the degree of disability, the amount of disability compensation, and the type of compensation program. Participants who were receiving disability benefits worked fewer hours in compensated work therapy each week, earned less income, had a higher dropout rate, and were less likely to be competitively employed at discharge. The amount of compensation and the type of program were modestly but significantly associated with participation in compensated work therapy and with outcome. Unintended effects of disability compensation programs discourage full participation in vocational rehabilitation and result in poorer rehabilitation outcomes.

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.

Lasting effect of an oral hygiene care program for patients with stroke during in-hospital rehabilitation: a randomized single-center clinical trial.

PubMed

Kim, Eun-Kyong; Park, Eun Young; Sa Gong, Jung-Whan; Jang, Sung-Ho; Choi, Youn-Hee; Lee, Hee-Kyung

2017-11-01

Because the oral hygiene is poorly prioritized in the immediate post-stroke period, we implemented an oral hygiene care program (OHCP) for stroke in-patients and evaluated its persistence after discharge. In all, 62 patients with stroke who were admitted to the rehabilitation ward were randomly assigned to two groups: 33 patients to the intervention group and 29 to the control group. The OHCP, including tooth brushing education and professional tooth cleaning, was administered to the intervention group twice a week six times during in-hospital rehabilitation. Oral health status was examined both at baseline and three months after discharge from the hospital. Oral hygiene status was examined at three- to four-day intervals five times during the hospitalization period. After OHCP, oral hygiene status including the plaque index, calculus index, and O'Leary plaque index improved significantly in the intervention group, compared to the control group (p < 0.05). In the intervention group, after administration of the OHCP for the fourth time, the O'Leary index improved significantly, and remained high when checked three months after discharge (p < 0.001). An OHCP conducted during in-hospital rehabilitation was effective in improving oral health and plaque control performance among patients with stroke, with effects still seen three months after discharge from the hospital. Implications for Rehabilitation Initial oral hygiene status and plaque control performance were poor in stroke patients who were in rehabilitation center. An oral hygiene care program during in-hospital rehabilitation was effective in improving oral hygiene status and plaque control performance among stroke patients at three months after discharge. Repeated tooth brushing education and professional tooth cleaning were necessary to improve plaque control performance of stroke patients.

Driving and Low Vision: An Evidence-Based Review of Rehabilitation

ERIC Educational Resources Information Center

Strong, J. Graham; Jutai, Jeffrey W.; Russell-Minda, Elizabeth; Evans, Mal

2008-01-01

This systematic review of the effectiveness of driver rehabilitation interventions found that driver training programs enhance driving skills and awareness, but further research is needed to determine their effectiveness in improving driving performance of drivers with low vision. More research is also needed to determine the effectiveness of low…

Improving vocational rehabilitation services for injured workers in Washington State.

PubMed

Sears, Jeanne M; Wickizer, Thomas M; Schulman, Beryl A

2014-06-01

Workers who incur permanent impairments or have ongoing medical restrictions due to injuries or illnesses sustained at work may require support from vocational rehabilitation programs in order to return to work. Vocational rehabilitation programs implemented within workers' compensation settings are costly, and effective service delivery has proven challenging. The Vocational Improvement Project, a 5.5-year pilot program beginning in 2008, introduced major changes to the Washington State workers' compensation-based vocational rehabilitation program. In the evaluation of this pilot program, set within a large complex system characterized by competing stakeholder interests, we assessed effects on system efficiency and employment outcomes for injured workers. While descriptive in nature, this evaluation provided evidence that several of the intended outcomes were attained, including: (1) fewer repeat referrals, (2) fewer delays, (3) increased choice for workers, and (4) establishment of statewide partnerships to improve worker outcomes. There remains substantial room for further improvement. Retraining plan completion rates remain under 60% and only half of workers earned any wages within two years of completing their retraining plan. Ongoing communication with stakeholders was critical to the successful conduct and policy impact of this evaluation, which culminated in a 3-year extension of the pilot program through June 2016. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adding a vocational focus to mental health rehabilitation.

PubMed

Blankertz, L; Robinson, S

1996-11-01

The study examined the effect of adding two employment specialists to the staff of a community mental health center; their sole responsibility was to develop the skills and positive work attitudes that clients with severe mental illness need to enter the state vocational rehabilitation system or to seek employment. A total of 122 clients were randomly assigned to a program with an employment specialist or to a control group with no specialized vocational services. Clients in the program were taught work skills and attitudes in group and individual sessions and through a trial work experience. A schedule of rewards reinforced positive changes. Outcomes measured were skill gains, changes in work attitudes, attainment of employment, and entry into the state vocational rehabilitation system. At nine months, 34 of the 61 clients in the program achieved positive changes in vocational status that included competitive employment, participation in training and evaluation programs operated by the state vocational system, and formal referral to the system. Only one client in the control group was linked to the state system. Skill gains and positive changes in work attitudes were found for all program clients. Logistical regression suggested that program participation, rather than client characteristics, was an important predictor of a positive outcome. Over a relatively short time period, targeted vocational programs can help clients with severe mental illness develop the skills and attitudes necessary to attain employment or entry into the vocational rehabilitation system. Vocational rehabilitation can be an integral part of the rehabilitation process for all mental health clients.

77 FR 41391 - Final Priority; Rehabilitation Research and Training Center on Vocational Rehabilitation and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and Developing Strategies to Meet... Projects and Centers Program administered by NIDRR. Specifically, this priority is for an RRTC on VR and... effective VR practices that take into account economic conditions, labor market trends, and employer needs...

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.

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...

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.

A randomized controlled trial of a supported employment program for persons with long-term mental illness in Hong Kong.

PubMed

Kin Wong, Kenny; Chiu, Rose; Tang, Betty; Mak, Donald; Liu, Joanne; Chiu, Siu Ning

2008-01-01

Supported employment is an evidence-based practice that has proved to be consistently more effective than conventional vocational rehabilitation in helping people with severe mental illness find and sustain competitive employment. Most research on the effectiveness of supported employment comes from the United States. This study examined the effectiveness and applicability of a supported employment program based on the individual placement and support model in a Hong Kong setting. Ninety-two unemployed individuals with long-term mental illness who desired competitive employment were randomly assigned to either a supported employment program or a conventional vocational rehabilitation program and followed up for 18 months. Both vocational and nonvocational outcomes were measured. Over the 18-month study period, compared with participants in the conventional vocational rehabilitation program, those in the supported employment group were more likely to work competitively (70% versus 29%; odds ratio=5.63, 95% confidence interval=2.28-13.84), held a greater number of competitive jobs, earned more income, worked more days, and sustained longer job tenures. Repeated-measures analysis of variance found no substantive differences between participants in the two groups and no significant change from baseline over time for psychiatric symptoms and self-perceived quality of life. Consistent with previous research findings in the United States, the supported employment program was more effective than the conventional vocational rehabilitation program in helping individuals with long-term mental illness find and sustain competitive employment in a Hong Kong setting. The supported employment program based on the individual placement and support model can thus be recommended for wider use in local mental health practice.

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.

Cognitive rehabilitation in schizophrenia: a quantitative analysis of controlled studies.

PubMed

Krabbendam, Lydia; Aleman, André

2003-09-01

Cognitive rehabilitation is now recognized as an important tool in the treatment of schizophrenia, and findings in this area are emerging rapidly. There is a need for a systematic review of the effects of the different training programs. To review quantitatively the controlled studies on cognitive rehabilitation in schizophrenia for the effect of training on performance on tasks other than those practiced in the training procedure. A meta-analysis was conducted on 12 controlled studies of cognitive rehabilitation in schizophrenia taking into account the effects of type of rehabilitation approach (rehearsal or strategy learning) and duration of training. The mean weighted effect size was 0.45, with a 95% confidence interval from 0.26 to 0.64. Effect sizes differed slightly, depending on rehabilitation approach, in favor of strategy learning, but this difference did not reach statistical significance. Duration of training did not influence effect size. Cognitive rehabilitation can improve task performance in patients with schizophrenia and this effect is apparent on tasks outside those practiced during the training procedure. Future studies should include more real-world outcomes and perform longitudinal evaluations.

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...

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

PubMed Central

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

2013-01-01

Many clinical studies have investigated the use of mental practice (MP) through motor imagery (MI) to enhance functional recovery of patients with diverse physical disabilities. Although beneficial effects have been generally reported for training motor functions in persons with chronic stroke (e.g., reaching, writing, walking), attempts to integrate MP within rehabilitation programs have been met with mitigated results. These findings have stirred further questioning about the value of MP in neurological rehabilitation. In fact, despite abundant systematic reviews, which customarily focused on the methodological merits of selected studies, several questions about factors underlying observed effects remain to be addressed. This review discusses these issues in an attempt to identify factors likely to hamper the integration of MP within rehabilitation programs. First, the rationale underlying the use of MP for training motor function is briefly reviewed. Second, three modes of MI delivery are proposed based on the analysis of the research protocols from 27 studies in persons with stroke and Parkinson's disease. Third, for each mode of MI delivery, a general description of MI training is provided. Fourth, the review discusses factors influencing MI training outcomes such as: the adherence to MI training, the amount of training and the interaction between physical and mental rehearsal; the use of relaxation, the selection of reliable, valid and sensitive outcome measures, the heterogeneity of the patient groups, the selection of patients and the mental rehearsal procedures. To conclude, the review proposes a framework for integrating MP in rehabilitation programs and suggests research targets for steering the implementation of MP in the early stages of the rehabilitation process. The challenge has now shifted towards the demonstration that MI training can enhance the effects of regular therapy in persons with subacute stroke during the period of spontaneous recovery. PMID:24065903

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.

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.

[Cardiac rehabilitation. Recent advances].

PubMed

Lellamo, Ferdinando; Volterrani, Maurizio

2010-03-01

Evidence derived from studies which support the relevance of exercise as a core component of cardiac rehabilitation programs are presented, along with the beneficial effects of exercise training in counteracting the mechanisms sustaining the atherosclerotic process and cardiovascular risk factors in the context of secundary, as well as primary, cardiovascular prevention. Practical guides to plan exercise training programs are also provided with suggestions for specific pathological conditions and advanced age. Recent advances on the benefits of exercise training in patients with heart failure are reported along with the potential of telemedicine for home rehabilitation aiming to a widespread diffusion of exercise as a cardiovascular therapy. Finally, the possible risks of exercise and practical open questions in cardiac rehabilitation are discussed.

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

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.

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...

A Delphi Study to Understand Relational Bonds in Supervision and Their Effect on Rehabilitation Counselor Disclosure in the Public Rehabilitation Program

ERIC Educational Resources Information Center

Magnuson, Lori Anne

2012-01-01

The scholarly literature surrounding counselor supervision suggests that relational bonds built on liking, trusting, and caring between supervisors and counselors positively impact counselor willingness to disclose practice errors and ethical issues in supervision. This Delphi study explored the opinions of expert public rehabilitation supervisors…

Penile rehabilitation following prostate cancer treatment: review of current literature

PubMed Central

Clavell-Hernandez, Jonathan; Wang, Run

2015-01-01

Radical prostatectomy (RP) and radiotherapy (RT) are highly effective in improving prostate cancer survival. However, both have a detrimental effect on erectile function (EF). Penile rehabilitation consists of understanding the mechanisms that cause erectile dysfunction (ED) and utilizing pharmacologic agents, devices or interventions to promote male sexual function. For the past decade, many researchers have pursued to define effective treatment modalities to improve ED after prostate cancer treatment. Despite the understanding of the mechanisms and well-established rationale for postprostate treatment penile rehabilitation, there is still no consensus regarding effective rehabilitation programs. This article reviews a contemporary series of trials that assess penile rehabilitation and explore treatment modalities that might play a role in the future. Published data and trials related to penile rehabilitation after RP and RT were reviewed and presented. Although recent trials have shown that most therapies are well-tolerated and aid in some degree on EF recovery, we currently do not have tangible evidence to recommend an irrefutable penile rehabilitation algorithm. However, advancements in research and technology will ultimately create and refine management options for penile rehabilitation. PMID:25851656

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,…

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

ERIC Educational Resources Information Center

Dillon, Laura; Colling, Kyle

2010-01-01

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

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.

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.

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...

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

PubMed Central

Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

2017-01-01

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

PubMed

Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

2017-10-27

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

Community-based training and employment: an effective program for persons with traumatic brain injury.

PubMed

Wall, J R; Niemczura, J G; Rosenthal, M

1998-01-01

Occupational entry is an important issue for persons with disabilities, as many become or remain unemployed after their injury. After traumatic brain injury (TBI), individuals exhibit high unemployment rates, especially those persons with injuries of greater severity, a limited premorbid work history and/or persons from economically disadvantaged backgrounds. Vocational rehabilitation programs have been developed to improve employability. Traditional vocational rehabilitation approaches, based on integrating work skills with cognitive rehabilitation models have proven only minimally effective with TBI. The supported employment model has been demonstrated to be much more effective with this group, as has an approach that combines vocational and psychosocial skills training along with job support. Even with these generally successful approaches, the literature on vocational rehabilitation in clients from economically disadvantaged environments who are diagnosed with TBI is limited. An approach for the economically disadvantaged, which combines work skills training in a real work community along with supported employment is presented.

An Ex Post Facto Analysis of Juvenile Recidivism and the Effectiveness of Rehabilitation and Incarceration

ERIC Educational Resources Information Center

Mbangowah, Ngowah Hans

2017-01-01

Up to the close of the 21st century, criminal justice experts and probation officers in Minnesota expressed frustration with lack of resources and program effectiveness to address the delinquency and recidivism problems in the juvenile justice system. The purpose of this quantitative study was to examine the effectiveness of rehabilitative and…

"The Whole Is Greater Than the Sum of the Parts": Prison Staff Perceptions of Domestic Violence Rehabilitation Programs.

PubMed

Shoham, Efrat; Zelig, Anat; Hasisi, Badi; Weisburd, David; Haviv, Noam

2017-11-01

This qualitative study is part of a mixed methods research project that examined the effectiveness of the primary rehabilitation program for domestic violence offenders in the Israeli Prison Services-the "House of Hope." The quantitative part of the study showed that the "House of Hope" program was effective in reducing recidivism among participating inmates. The purpose of this qualitative study was to describe the rehabilitation program according to the perspectives of the program staff. For this purpose, semistructured interviews were conducted with the department staff during the study as well as with past directors. The qualitative findings suggested that the success of the program probably stemmed from a synergistic combination of several components, for example, identifying the characteristics of domestic violence offenders and adjusting treatment programs to their needs, along with exposure to psychological treatment in varied therapies (cognitive behavioral therapy, psychoeducational, and psychodynamic) and formats (group therapy and individual therapy) during a 1-year stay in a hierarchical therapeutic community. Other components mentioned are staff professionalism, stability, and the program's location in a therapeutic-oriented prison that is architecturally designed and built to create a less stressful environment for the inmates and the staff.

Getting Back to Living: Further Evidence for the Efficacy of an Interdisciplinary Pediatric Pain Treatment Program.

PubMed

Bruce, Barbara K; Ale, Chelsea M; Harrison, Tracy E; Bee, Susan; Luedtke, Connie; Geske, Jennifer; Weiss, Karen E

2017-06-01

This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at 3-month follow-up. Participants included 171 adolescents (12 to 18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up. Similar to other interdisciplinary pediatric pain rehabilitation program outcome studies, significant improvements were observed at the end of the program. These improvements appeared to be maintained or further improved at 3-month follow-up. Nearly 14% of the patients were taking daily opioid medication at admission to the program. All adolescents were completely tapered off of these medications at the end of the 3-week program and remained abstinent at 3-month follow-up. This study adds to the available data supporting interdisciplinary pediatric pain rehabilitation as effective in improving functioning and psychological distress even when discontinuing opioids. Implications for future research and limitations of the study are discussed.

Outcomes of an enhancement study with additional psychoeducational sessions for healthy siblings of a child with cancer during inpatient family-oriented rehabilitation.

PubMed

Niemitz, Mandy; Goldbeck, Lutz

2018-03-01

Chronic illness of a child puts healthy children of the family at risk of distress. Previous studies have demonstrated that healthy children's psychological symptoms can be reduced when the child knows more about the disease. So far, there is limited evidence of the effectiveness of psychoeducational interventions for healthy children. To compare the effectiveness of an inpatient family-oriented rehabilitation program with vs without additional psychoeducational sessions for healthy children of families with children with cancer. We performed a controlled study in 4 German family-oriented rehabilitation clinics. The outcomes of n = 73 healthy children (mean age: M = 9.55; SD = 3.14; range: 4-18), who participated in 5 additional psychoeducational sessions, were compared with the outcomes of n = 111 healthy children (mean age: M = 8.85; SD = 3.28; range: 4-17), who underwent the usual inpatient rehabilitation program. Primary outcomes were the healthy children's cancer-specific knowledge and their emotional symptoms. Secondary outcomes were family satisfaction and quality of life. Intention-to-treat analyses showed that both groups improved significantly from preintervention to postintervention. Improvements comprised knowledge about cancer (F(1,174) = 11.03, p < 0.001), self-reported emotional symptoms (F(1,135) = 31.68, p < 0.001), and parent-proxy-reported emotional symptoms (F(1,179) = 37.07, p < 0.001). The additional psycho-educational program did not significantly enhance the outcomes. The same pattern of significant improvement in both conditions emerged for all secondary outcomes. The immediate effects of the intervention persisted until 2 months after discharge from the rehabilitation program. Inpatient family-oriented rehabilitation is effective in improving multiple psychosocial outcomes of healthy children in families which have a child with cancer. Additional psycho-educational sessions did not show any substantial additional improvement. Copyright © 2017 John Wiley & Sons, Ltd.

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

PubMed Central

2014-01-01

Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and decrease the disabling effects of musculoskeletal diseases within two low-income Mexican communities. PMID:25474820

Effectiveness of a family-oriented rehabilitation program on the quality of life of parents of chronically ill children.

PubMed

West, C A; Besier, T; Borth-Bruhns, T; Goldbeck, L

2009-01-01

Parents of chronically ill children face numerous burdens in daily life, which can impair their quality of life (QoL) significantly. Therefore in family-oriented rehabilitation, not only the children themselves, but also their parents receive interventions. These aim at stabilizing parents both mentally and physically to enable them to support their children in the best possible way. This study investigates the effects of an inpatient family-oriented rehabilitation program on the QoL of parents of chronically ill children. A consecutive sample of 231 mothers and 155 fathers of children suffering from cancer, cardiac diseases or cystic fibrosis participated in the study. In a prospective longitudinal study, parental QoL was repeatedly assessed using the Ulm Quality of Life Inventory for Parents (ULQIE) at three different time points: admission to the rehabilitation clinic, discharge after four weeks of inpatient treatment, and at a six-month follow-up. Parental QoL increased markedly during rehabilitation treatment (mothers eta (2)=.326, fathers eta (2)=.249). Moreover, six months after the intervention, parental quality of life was still markedly improved compared to baseline assessment (mothers eta (2)=.259, fathers eta (2)=.069). The child's diagnosis had no effect on the level and course of parental QoL. Taking part in family-oriented rehabilitation can improve the QoL of parents of children suffering from cancer, cardiac diseases or cystic fibrosis. Such programs could be expected to affect the way chronically ill children cope with their condition and this should be examined in future studies.

Back home after an acquired brain injury: building a "low-cost" team to provide theory-driven cognitive rehabilitation after routine interventions.

PubMed

Pierini, Davide; Hoerold, Doreen

2014-01-01

Individuals with Acquired Brain Injury (ABI) could benefit from further cognitive rehabilitation, after they have returned home. However, a lack of specialist services to provide such rehabilitation often prevents this. This leads to reduced reintegration of patients, increased social disadvantages and ultimately, higher economic costs. 10 months post-stroke, a 69 year-old woman was discharged from an inpatient rehabilitation program and returned home with severe cognitive impairments. We describe a pilot project which provided an individualised, low cost rehabilitation program, supervised and trained by a neuropsychologist. Progress was monitored every 3 months in order to decide on continuation of the program, based on the achieved results and predicted costs. Post intervention, despite severe initial impairment, cognitive and most notably daily functioning had improved. Although the financial investment was moderately high for the family, the intervention was still considered cost-effective when compared with the required costs of care in a local non-specialist care home. Moreover, the pilot experience was used to build a "local expert team" available for other individuals requiring rehabilitation. These results encourage the development of similar local "low cost" teams in the community, to provide scientifically-grounded cognitive rehabilitation for ABI patients returning home.

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

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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...

Burned area emergency watershed rehabilitation: Program goals, techniques, effectiveness, and future directions in the 21st Century

Treesearch

Daniel G. Neary; Peter R. Robichaud; Jan L. Beyers

2000-01-01

Following wildfires, burned areas are assessed by special teams to determine if emergency watershed rehabilitation measures are required to restore watershed function and minimize damage to soil resources. The objective of burned area emergency rehabilitation (BAER) treatments is to restore watershed condition and reduce erosional losses on hillslopes, in channels, and...

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.

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

PubMed

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

2006-05-01

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

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

PubMed

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

2005-04-01

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

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

Pulmonary rehabilitation. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).

PubMed

Güell Rous, María Rosa; Díaz Lobato, Salvador; Rodríguez Trigo, Gema; Morante Vélez, Fátima; San Miguel, Marta; Cejudo, Pilar; Ortega Ruiz, Francisco; Muñoz, Alejandro; Galdiz Iturri, Juan Bautista; García, Almudena; Servera, Emilio

2014-08-01

Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy: a qualitative focus group interview study.

PubMed

Rise, Marit B; Gismervik, Sigmund Ø; Johnsen, Roar; Fimland, Marius S

2015-11-27

Occupational medicine has shifted emphasis from disease treatment to disability rehabilitation and management. Hence, newly developed occupational rehabilitation programs are often generic and multicomponent, aiming to influence the sick-listed persons' perception on return to work, and thereby support the return to work process. The aim of this study was to explore sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy. Twenty-nine adults on sickness benefit or work assessment allowance due to musculoskeletal and/or common mental health disorders participated in this study. They were interviewed in focus groups at the beginning and at the end of a 3.5 week inpatient group-based occupational rehabilitation program in Central Norway. Key elements in the program were Acceptance and Commitment Therapy (ACT), physical exercise and creating a work-participation plan. The program was mainly group-based including participants with different diagnoses. Data was analyzed according to a phenomenological approach. At the start of the program most participants expressed frustration regarding being sick-listed, external anticipations as well as hindrances towards returning to work, and described hope that the program would provide them with the skills and techniques necessary to cope with health problems and being able to return to work. At the end of the program the participants described that they had embarked upon a long process of increased awareness. This process encompassed four areas; an increased awareness of what was important in life, realizing the strain from external expectations and demands, a need to balance different aspects of life, and return to work as part of a long and complex process. The occupational rehabilitation program induced a perceived meaningful reorientation encompassing several aspects of life. However, the return to work process was described as diffuse and uncertain for most participants. The providers of occupational rehabilitation program should balance this reorientation with specific steps towards return to work. Effect studies and long-term qualitative studies evaluating how this affects long-term work- and health outcomes are underway.

Evaluation of Short-Term Training for Rehabilitation Counselors: Effectiveness of an Institute on Epilepsy

ERIC Educational Resources Information Center

Stude, E. W.

1973-01-01

The effectiveness of a short-term training Institute for Rehabilitation Counselors on Epilipsy was determined by evaluating information gained, change in attitudes and change in job behavior. No significant difference in attitudes or job behavior toward epiliptic individuals was found after the training program had been administered. Suggestions…

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...

Early 4-week cardiac rehabilitation exercise training in elderly patients after heart surgery.

PubMed

Eder, Barbara; Hofmann, Peter; von Duvillard, Serge P; Brandt, Dieter; Schmid, Jean-Paul; Pokan, Rochus; Wonisch, Manfred

2010-01-01

The aim of this study was to assess the effects on exercise performance of supplementing a standard cardiac rehabilitation program with additional exercise programming compared to the standard cardiac rehabilitation program alone in elderly patients after heart surgery. In this prospective, randomized controlled trial, 60 patients (32 men and 28 women, mean age 73.1 +/- 4.7 years) completed cardiac rehabilitation (initiated 12.2 +/- 4.9 days postsurgery). Subjects were assigned to either a control group (CG, standard cardiac rehabilitation program [n = 19]), or an intervention group (IG, additional walking [n = 19], or cycle ergometry training [n = 22]). A symptom limited cardiopulmonary exercise test and 6-minute walk test (6MWT) were performed before and after 4 weeks of cardiac rehabilitation. The MacNew questionnaire was used to assess quality of life (QOL). At baseline, no significant differences for peak oxygen uptake ((.)VO2), maximal power output, or the 6MWT were detected between IG and CG. Global QOL was significantly higher in IG. After 4 weeks of cardiac rehabilitation, patients significantly improved in absolute values of the cardiopulmonary exercise test, 6MWT, and QOL scores. Significant differences between groups were found for peak (.)VO2 (IG: 18.2 +/- 3.1 mL x kg x min vs. CG: 16.5 +/- 2.2 mL x kg x min, P < .05); maximal power output (IG: 72.2 +/- 16 W vs. CG: 60.7 +/- 15 W, P < .05); 6MWT (IG: 454.8 +/- 76.3 m vs. CG: 400.5 +/- 75.5 m, P < .05); and QOL global (IG: 6.5 +/- 0.5 vs. CG: 6.3 +/- 0.6, P < .05). The supplementation of additional walking or cycle exercise training to standard cardiac rehabilitation programming compared to standard cardiac rehabilitation alone in elderly patients after heart surgery leads to significantly better exercise tolerance.

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...

[Implementation and evaluation of an ambulatory exercise therapy based rehabilitation program for breast cancer patients].

PubMed

Schulz, K H; Szlovák, C; Schulz, H; Gold, S; Brechtel, L; Braumann, M; Koch, U

1998-01-01

Physical exercise does not only have positive effects on physical fitness but also on mental health. However, there has been little empirical study on effects of rehabilitation programmes based on physical exercise in cancer patients. We conducted a study to examine the interrelation between the participation of breast cancer patients in an exercise rehabilitation training and aspects of quality of life and physical fitness. 28 patients with not metastasized mamma carcinoma participated in a structured exercise rehabilitation program twice a week for ten weeks. Before and after the intervention the patients were asked to fill in questionnaires to assess their quality of life. At the same instants they underwent physical examination and a bicycle ergometry as well as a blood drawing. The training was aimed at changes at the social, emotional, as well as the motor physical level. Pre-post comparisons demonstrated an improvement in quality of life, such as decreased levels of depression and anxiety. Furthermore the women proved to show an obvious increase in physical fitness. Present results support an implementation of an exercise rehabilitation training for breast cancer outpatients.

An evaluation of the strategic approach to the rehabilitation of traumatic brain injury (TBI) patients

PubMed Central

Tomaszewski, Wiesław; Mańko, Grzegorz

2011-01-01

Summary Background The objective of our study was to evaluate a goal-driven strategic plan for the step-by-step rehabilitation of traumatic brain injury (TBI) patients, with effectiveness measured in terms of quality of life, as compared to patients treated according to a standard, progressive rehabilitation program. Material/Methods We studied 40 patients after TBI awakened from a long-term coma. The patients were divided into two equal groups: a control group (n=20) involving patients treated before the introduction of the strategic approach, and an experimental group (n=20) involving patients rehabilitated under the strategic approach. In evaluating the effectiveness of rehabilitation we used a structured interview with clinical observation and a scale for assessing the quality of life of patients after TBI. Results The deterioration in the quality of life of TBI patients is mainly related to difficulties in satisfying physiological needs, self-care, reduced mobility and disorders of cognitive, regulatory, and social functions. In both groups, the feature most susceptible to rehabilitation related change was movement, while the least susceptible functions were associated with the use of different means of transport. This change is significantly greater in persons in the experimental group, as compared to controls. Conclusions We found that a rehabilitation program controlled by a strategic plan, with the cooperation of the patient, is more effective in improving the quality of life, as the patient is more self-motivated to individually designed objectives. PMID:21873948

Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.

PubMed

Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M

2016-01-01

Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.

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

PubMed Central

Hardison, Mark E.

2017-01-01

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

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...

Training-induced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: an extra benefit of water-based exercises?

PubMed

Laurent, Mourot; Daline, Teffaha; Malika, Bouhaddi; Fawzi, Ounissi; Philippe, Vernochet; Benoit, Dugue; Catherine, Monpère; Jacques, Regnard

2009-04-01

Rehabilitation programs involving immersed exercises are more and more frequently used, with severe cardiac patients as well. This study investigated whether a rehabilitation program including water-based exercises has additional effects on the cardiovascular system compared with a traditional land-based training in heart disease patients. Twenty-four male stable chronic heart failure patients and 24 male coronary artery disease patients with preserved left ventricular function participated in the study. Patients took part in the rehabilitation program performing cycle endurance exercises on land. They also performed gymnastic exercises either on land (first half of the participants) or in water (second half). Resting plasma concentration of nitric oxide metabolites (nitrate and nitrite) and catecholamine were evaluated, and a symptom-limited exercise test on a cycle ergometer was performed before and after the rehabilitation program. In the groups performing water-based exercises, the plasma concentration of nitrates was significantly increased (P = 0.035 for chronic heart failure and P = 0.042 for coronary artery disease), whereas it did not significantly change in the groups performing gymnastic exercise on land. No changes in plasma catecholamine concentration occurred. In every group, the cardiorespiratory capacity of patients was significantly increased after rehabilitation. The water-based exercises seemed to effectively increase the basal level of plasma nitrates. Such changes may be related to an enhancement of endothelial function and may be of importance for the health of the patients.

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

PubMed

Bradford, DanaKai; Hansen, David; Karunanithi, Mohan

2015-01-01

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

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

PubMed

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

2011-12-01

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

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.

Does the addition of hip strengthening exercises improve outcomes following total knee arthroplasty? A study protocol for a randomized trial.

PubMed

Schache, Margaret B; McClelland, Jodie A; Webster, Kate E

2016-06-13

Total knee arthroplasty (TKA) is effective in reducing pain and improving function for end-stage knee osteoarthritis. However, muscle weakness and functional limitations persist despite assistance from post-operative rehabilitation programs that traditionally focus on quadriceps strengthening and range of movement exercises. Hip abductor muscle weakness is evident in knee osteoarthritis and hip muscle strengthening reduces knee pain in this group. Following TKA, people with weak hip abductor strength perform more poorly on measures of physical function. However, very little is known of the effectiveness of including hip abductor strengthening exercises in post-operative rehabilitation. The aim of this trial is to compare the effects of targeted hip abductor strengthening to those of traditional care in a TKA rehabilitation program on muscle strength, patient reported outcomes and functional performance measures. This protocol describes a single-blinded randomized controlled trial, where 104 participants referred for inpatient rehabilitation following TKA will be recruited. Participants will be randomized using computer-generated numbers to one of two groups: usual care or usual care with additional hip strengthening exercises. Participants will attend physiotherapy daily during their inpatient length of stay, and will then attend between six and eight physiotherapy sessions as an outpatient. Primary outcomes are isometric hip abductor strength and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes are stair climb test, 6 min walk test, timed up and go, 40 m fast-paced walk test, 30 second chair stand test, isometric quadriceps strength, Lower Extremity Functional Scale (LEFS) and SF-12. Outcome measures will be recorded at baseline (admission to inpatient rehabilitation), and then 3 weeks, 6 weeks and 6 months post admission to rehabilitation. The findings of this study will determine whether the addition of targeted hip strengthening to usual care rehabilitation improves physical performance and patient reported outcomes following TKA when compared to usual care rehabilitation. This will then determine whether targeted hip strengthening exercises should be included in traditional rehabilitation programs to improve the outcomes following total knee arthroplasty. The trial protocol was registered with the Australian Clinical Trial Registry ( ACTRN12615000863538 ) on 18 August 2015.

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

A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

PubMed

Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

2015-03-04

People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical rehabilitation program on ambulation in people with multiple sclerosis presenting with different neurological impairment levels.

Usefulness of rehabilitation in patients with rotator cuff calcific tendinopathy after ultrasound-guided percutaneous treatment.

PubMed

Abate, Michele; Schiavone, Cosima; Salini, Vincenzo

2015-01-01

To evaluate the efficacy of a specific rehabilitation program for patients in whom ultrasound-guided percutaneous treatment (UGPT) was performed for rotator cuff calcific tendinopathy (RCCT). In this prospective observational study, 86 patients (22 males and 64 females) with shoulder calcific tendinopathy treated with UGPT were enrolled. At the end of the procedure, a corticosteroid injection into the subacromial-subdeltoid bursa was performed. The patients were then asked to follow a specific rehabilitation protocol (2 times/week for 5 weeks) that focused on mobility, strength and function. At baseline and after 6 weeks, clinical parameters, visual analog scale (VAS) and Constant-Murley scale (CMS) scores and ultrasound (US) features were collected. The mean age of the patients was 48.9 ± 8.4 years and their mean BMI was 22.7 ± 2.1. Considering the whole cohort, the treatment was effective, with a significant decrease in the VAS score and an improvement in the CMS score. Thereafter, on the basis of the compliance to the rehabilitation program (by self-report), 53 and 33 patients were included in the rehabilitation group (Rehab group; performed exercises ≥2 times/week) and the No Rehab group (performed exercises <2 times/week), respectively. The comparison between the groups showed that the subjects who performed the exercises regularly had better results in terms of pain and functional recovery, and less associated diseases (e.g. adhesive bursitis and tenosynovitis of the long head of the biceps) than those who were less compliant with the program. UGPT, followed by a specific postprocedure rehabilitation program, was an effective treatment for RCCT. © 2014 S. Karger AG, Basel.

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...

Psychometric Properties and Rater Effects of the Computer Adaptive Test of Functional Cognition for Traumatic Brain Injury

ERIC Educational Resources Information Center

Wen, Pey-Shan

2009-01-01

Individuals with moderate to severe TBI often need extensive rehabilitation. To verify the effectiveness of intervention and design rehabilitation programs that meet individual's needs, precise and efficient outcome measures are crucial. Current assessments for TBI either focus on measuring impairments, such as neuropsychological tests or lack of…

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...

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.

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

ERIC Educational Resources Information Center

Rehabilitation Services Administration (DHEW), Washington, DC.

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

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

ERIC Educational Resources Information Center

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

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

On-site programmatic attendance to cardiac rehabilitation and the healthy-adherer effect.

PubMed

Alter, David A; Zagorski, Brandon; Marzolini, Susan; Forhan, Mary; Oh, Paul I

2015-10-01

On-site attendance to prescheduled cardiac rehabilitation visits has been shown to be associated with improved outcomes following cardiac rehabilitation. The extent to which on-site programmatic attendance represents a healthy-adherer effect remains unknown. This retrospective cohort study consisted of 17,000 consecutively referred patients to a cardiac rehabilitation program in Ontario, Canada. On-site attendance at prescheduled visits was our primary exposure variable. The primary outcome was all-cause death or hospitalization at two years following the expected program completion date, irrespective of drop-out. Secondary outcomes included adherence to statins, health-seeking preventative health visits, and changes in clinical risk-profiles. Cox proportional hazards adjusted for baseline sociodemographic, clinical and comorbid characteristics. Among the 12,440 patients who attended at least one prescheduled on-site visit, on-site attendance was inversely correlated with baseline smoking rates and body mass index at program entry. After adjustment for baseline factors, the risk of death or hospitalization progressively fell with incremental increases in on-site attendance (adjusted hazard ratio for each 10% increase in on-site attendance: 0.96; 95% confidence interval: 0.93-0.99, p = 0.007). Such associations were driven predominantly by differences in non-cardiovascular hospitalizations. Incremental increases in on-site attendance were associated with improvements in cardiopulmonary fitness and body mass index (both p < 0.001), better attendance of preventative care physician visits (p < 0.001) and higher medication adherence to statins (p = 0.007). Associations between on-site attendance at cardiac rehabilitation and outcomes may represent a healthy-adherer effect. Future research must evaluate the clinical utility of on-site attendance as a behavioral health-adherence metric for cardiac rehabilitation monitoring and surveillance. © The European Society of Cardiology 2014.

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.

The effects of pulmonary rehabilitation in the national emphysema treatment trial.

PubMed

Ries, Andrew L; Make, Barry J; Lee, Shing M; Krasna, Mark J; Bartels, Matthew; Crouch, Rebecca; Fishman, Alfred P

2005-12-01

Pulmonary rehabilitation is an established treatment in patients with chronic lung disease but is not widely utilized. Most trials have been conducted in single centers. The National Emphysema Treatment Trial (NETT) provided an opportunity to evaluate pulmonary rehabilitation in a large cohort of patients who were treated in centers throughout the United States. Prospective observational study of cohort prior to randomization in a multicenter clinical trial. University-based clinical centers and community-based satellite pulmonary rehabilitation programs. A total of 1,218 patients with severe emphysema underwent pulmonary rehabilitation before and after randomization to lung volume reduction surgery (LVRS) or continued medical management. Rehabilitation was conducted at 17 NETT centers supplemented by 539 satellite centers. Lung function, exercise tolerance, dyspnea, and quality of life were evaluated at regular intervals. Significant (p < 0.001) improvements were observed consistently in exercise (cycle ergometry, 3.1 W; 6-min walk test distance, 76 feet), dyspnea (University of California, San Diego Shortness of Breath Questionnaire score, -3.2; Borg breathlessness score: breathing cycle, -0.8; 6-min walk, -0.5) and quality of life (St. George Respiratory Questionnaire score, -3.5; Quality of Well-Being Scale score, +0.035; Medical Outcomes Study 36-item short form score: physical health summary, +1.3; mental health summary, + 2.0). Patients who had not undergone prior rehabilitation improved more than those who had. In multivariate models, only prior rehabilitation status predicted changes after rehabilitation. In 20% of patients, exercise level changed sufficiently after rehabilitation to alter the NETT subgroup predictive of outcome. Overall, changes after rehabilitation did not predict differential mortality or improvement in exercise (primary outcomes) by treatment group. The NETT experience demonstrates the effectiveness of pulmonary rehabilitation in patients with severe emphysema who were treated in a national cross-section of programs. Pulmonary rehabilitation plays an important role in preparing and selecting patients for surgical interventions such as LVRS.

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

PubMed Central

2014-01-01

Background Long-term sick leave has considerably negative impact on the individual and society. Hence, the need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous evaluation has been performed. The described randomized controlled trial aims primarily to compare two structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual care reference group. Methods/design The study is designed as a randomized controlled trial with parallel groups. The Social Security Office performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sick leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter “untouched” control group will be monitored for future sick leave in the National Social Security Register, and 2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental training, physical training and work-related problem solving. The primary outcome is number of sick leave days. Secondary outcomes include time until full sustainable return to work, health related quality of life, health related behavior, functional status, somatic and mental health, and perceptions of work. In addition, health economic evaluation will be performed, and the implementation of the interventions, expectations and experiences of users and service providers will be investigated with different qualitative methods. Trial registration ClinicalTrials.gov: NCT01926574. PMID:24735616

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…

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...

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.

Cognitive Behavioral Therapy for Management of Dyspnea: A Pilot Study.

PubMed

Williams, Marie T; Cafarella, Paul; Paquet, Catherine; Frith, Peter

2015-09-01

In patients with COPD, psychological interventions usually target generalized anxiety and depression rather than the sensation of breathlessness. The objectives of this pilot study were to develop and implement a cognitive behavioral therapy (CBT) program specific to the perceptual experience of breathlessness, identify practical issues in the study protocol, and estimate beneficial effects of combining the CBT program with comprehensive pulmonary rehabilitation. The CBT program for the sensation of breathlessness (Breathing: Recognize sensations, Explore thoughts and beliefs, Validate thoughts as useful or harmful, Evolve and change behavior [BREVE]) was developed as a sequential series of 8 modules enabling it to be embedded within an 8-week comprehensive pulmonary rehabilitation program. When appropriate, outcomes from the pilot group (comprehensive pulmonary rehabilitation program + BREVE) were compared with those from a retrospective control group (comprehensive pulmonary rehabilitation program only). Outcomes included feedback provided by pilot study subjects, sensation of breathlessness (volunteered and endorsed descriptors of breathlessness), 6-min walk distance (6MWD), and St George Respiratory Questionnaire (SGRQ) total score. Within-group analyses were undertaken for descriptors of breathlessness (the McNemar test), whereas between-group analyses (repeated-measures analysis of variance, effect-size comparison) were conducted for the 6MWD and SGRQ total score. Pilot (n = 11) and control (n = 58) groups were not significantly different at baseline. Feedback indicated that the program structure and content were positively received. No significant changes were evident for the sensation of breathlessness or the SGRQ score (< 4 points). The 6MWD improved significantly in both groups, with the pilot group demonstrating greater gains compared with the control group (mean change of 57 m and effect size of 0.73 vs mean change of 27 m and effect size of 0.23; between groups, P = .03, effect size of 0.69). The CBT program for the perceptual experience of breathlessness was feasible and well accepted by subjects, although the protocol raised a number of methodological limitations warranting modification. A larger randomized controlled trial is needed to determine the effectiveness and longer-term outcomes. Copyright © 2015 by Daedalus Enterprises.

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.

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...

Challenges and Concerns Faced by Doctoral Candidates Seeking Academic Positions.

ERIC Educational Resources Information Center

Porter, Dion; Donnell, Chandra; Buck, Tina; Edwards, Yolanda

A panel discussion offered suggestions and recommendations for faculty and institutions of rehabilitation counseling education on more effective recruitment methods. Strategies were also considered for potential faculty members. Candidates seeking academic positions in rehabilitation counseling education face many challenges. Location of program;…

[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.

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.

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

PubMed

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

2018-02-01

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

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.

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

PubMed

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

2017-07-01

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

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.

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

PubMed

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

2015-10-01

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

Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

PubMed

Farrell, Elizabeth; Naber, Erin; Geigle, Paula

2010-01-01

This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

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.

Current trends in cardiac rehabilitation

PubMed Central

Dafoe, W; Huston, P

1997-01-01

Cardiac rehabilitation can reduce mortality and morbidity for patients with many types of cardiac disease cost-effectively, yet is generally underutilized. Rehabilitation is helpful not only for patients who have had a myocardial infarction but also for those with stable angina or congestive heart failure or those who have undergone myocardial revascularization procedures, a heart transplant or heart valve surgery. The beneficial effects of rehabilitation include a reduction in the rate of death from cardiovascular disease, improved exercise tolerance, fewer cardiac symptoms, improved lipid levels, decreased cigarette smoking, improvement in psychosocial well-being and increased likelihood of return to work. Rehabilitation involves a multidisciplinary team that focuses on education, individually tailored exercise, risk-factor modification and the optimization of functional status and mental health. Current research trends in this area include the evaluation of new secondary-prevention modalities and alternative program options, such as home-based rehabilitation. PMID:9054823

The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient

PubMed Central

Hassan, Mahdi; Bugnariu, Nicoleta

2016-01-01

Fatigue is common in older adults and has a significant effect on quality of life. Despite the high prevalence of fatigue in older individuals, several aspects are poorly understood. It is important to differentiate subjective fatigue complaints from fatigability of motor performance because the two are independent constructs with potentially distinct consequences on mobility. Performance fatigability is the magnitude of change in a performance criterion over a given time of task performance. Performance fatigability is a compulsory element of any strength training program, yet strength training is an important component of rehabilitation programs for older adults. The consequences of fatigability for older adults suggest that acute exercise of various types may result in acute impairments in postural control. The effects of performance fatigability on postural control in older adults are evaluated here to aid the rehabilitation clinician in making recommendations for evaluation of fall risks and exercise prescription. PMID:28154794

The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient.

PubMed

Papa, Evan V; Hassan, Mahdi; Bugnariu, Nicoleta

2016-09-01

Fatigue is common in older adults and has a significant effect on quality of life. Despite the high prevalence of fatigue in older individuals, several aspects are poorly understood. It is important to differentiate subjective fatigue complaints from fatigability of motor performance because the two are independent constructs with potentially distinct consequences on mobility. Performance fatigability is the magnitude of change in a performance criterion over a given time of task performance. Performance fatigability is a compulsory element of any strength training program, yet strength training is an important component of rehabilitation programs for older adults. The consequences of fatigability for older adults suggest that acute exercise of various types may result in acute impairments in postural control. The effects of performance fatigability on postural control in older adults are evaluated here to aid the rehabilitation clinician in making recommendations for evaluation of fall risks and exercise prescription.

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...

Inpatient or Outpatient Rehabilitation after Herniated Disc Surgery? – Setting-Specific Preferences, Participation and Outcome of Rehabilitation

PubMed Central

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

2014-01-01

Objective To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. Methods The longitudinal observational study referred to 534 consecutive disc surgery patients (18–55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. Results The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). Conclusion The results suggest a “pre-selection” of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return to work. PMID:24598904

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

PubMed

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

2014-01-01

To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return to work.

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

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

PubMed Central

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

2016-01-01

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

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…

Effect of Intense Lifestyle Modification and Cardiac Rehabilitation on Psychosocial Cardiovascular Disease Risk Factors and Quality of Life

ERIC Educational Resources Information Center

Aldana, Steven G.; Whitmer, William R.; Greenlaw, Roger; Avins, Andrew L.; Thomas, Dean; Salberg, Audrey; Greenwell, Andrea; Lipsenthal, Lee; Fellingham, Gill W.

2006-01-01

This study examined the effect of the Ornish Program for Reversing Heart Disease and cardiac rehabilitation(CR) on psychosocial risk factors and quality of life in patients with confirmed coronary artery disease. Participants had previously undergone a revascularization procedure. The 84 patients self-selected to participate in the Ornish Program…

Rehabilitation Aspects of Human Sexuality

PubMed Central

Madorsky, Julie G. Botvin; Dixon, Thomas P.

1983-01-01

The PLISSIT model is a comprehensive program that combines educational strategies with behavioral intervention to integrate human sexuality into the initial rehabilitation of spinal cord-injured persons. Sexuality is treated as a health care issue as important as bowel and bladder care, skin care, psychosocial issues, mobility, self-care and vocational concerns. Patients admitted to the Spinal Cord Injury Program are surrounded by a supportive milieu and an interdisciplinary staff who comfortably incorporate sexuality into discussions about catheter care, positioning, communication styles, assistive devices and so forth. Patients are exposed to a behavioral training program that makes available didactic lectures, group and individual sessions, bibliotherapy, films and opportunities for directed overnight sexual exploration within the hospital. We advocate that sex therapy be integrated into comprehensive rehabilitation programs along with physical therapy occupational therapy, recreation therapy and psychotherapy as an integral and effective form of functional restoration for patients with major physical disabilities. PMID:6636728

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...

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

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.

[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.

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…

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...

Work, Recovery, and Comorbidity in Schizophrenia: A Randomized Controlled Trial of Cognitive Remediation

PubMed Central

McGurk, Susan R.; Mueser, Kim T.; DeRosa, Thomas J.; Wolfe, Rosemarie

2009-01-01

Employment is central to the concept of recovery in severe mental illness. However, common comorbid conditions present significant obstacles to consumers seeking employment and benefiting from vocational rehabilitation. We review research on the effects of three common comorbid conditions on work and response to vocational rehabilitation, including cognitive impairment, substance abuse, and medical conditions, followed by research on vocational rehabilitation. We then present the results of a randomized controlled trial evaluating the effects of adding cognitive remediation to a vocational rehabilitation program compared with vocational rehabilitation alone in 34 consumers with severe mental illness. Consumers who received both cognitive remediation and vocational rehabilitation demonstrated significantly greater improvements on a cognitive battery over 3 months than those who received vocational rehabilitation alone and had better work outcomes over the 2-year follow-up period. Substance abuse was associated with worse employment outcomes, but did not interact with treatment group, whereas medical comorbidity was not related to work outcomes. More research is warranted to evaluate the interactions between substance abuse and medical comorbidity with vocational rehabilitation and cognitive remediation. PMID:19269925

Athletic trainers' and physical therapists' perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs.

PubMed

Hamson-Utley, J Jordan; Martin, Scott; Walters, Jason

2008-01-01

Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited. To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes. The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation. Professional member databases of the National Athletic Trainers' Association and the American Physical Therapy Association. Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age = 34.18 +/- 8.32 years, years in profession = 10.67 +/- 7.34) and 356 PTs (age = 38.58 +/- 7.51 years, years in profession = 13.18 +/- 6.17) responded. The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach alphas ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals' education, training experience, and interest. Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P < .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P < .05). Overall, ATs and PTs held positive attitudes on the effectiveness of psychological skills to augment the rehabilitation process. Clinical implications regarding the use of mental skills are discussed.

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

PubMed

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

2005-01-01

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

Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation.

PubMed

Kostka, Joanna; Czernicki, Jan; Pruszyńska, Magdalena; Miller, Elżbieta

The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program. Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (F ext , F flex ) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test. The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both F flex kg -1 and F ext kg -1 had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for F ext kg -1 and, interestingly, even more prominent for F flex kg -1 . MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

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

PubMed

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

2018-03-12

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

The Human Service Scale: A New Measure for Evaluation

ERIC Educational Resources Information Center

Reagles, Kenneth W.; Butler, Alfred S.

1976-01-01

The Human Service Scale is an assessment instrument for measuring the progress of the rehabilitation client and the effectiveness of rehabilitation programs. The theory behind the scale is based on Maslow's hierarchy of human needs. The development and some potential uses of the scale are discussed. (EC)

Report on a Comparison of the Effectiveness of Two Pavement Rehabilitation Strategies on US 281 Near Jacksboro

DOT National Transportation Integrated Search

2001-05-01

Original Report Date: December 1999. The main objective of the most recent MLS test program was to conduct a comparative study of two rehabilitation processes, Remixer and Dustrol, constructed on the southbound and northbound lanes of US 281 near Jac...

[SOCIAL SERVICES ORGANIZATION FOR ELDERLY CITIZENS AND DISABLED PERSONS IN SOUTH FEDERAL DISTRICT OF RUSSIA].

PubMed

Bashkireva, A S; Bogdanov, E A; Shestakov, V P; Svintsov, A A; Chernova, G I; Cherniakina, T S

2015-01-01

The article presents a comparative analysis of the effectiveness of the individual rehabilitation programs among elderly citizens and disabled persons of the Astrakhan region, the part of the South Federal District of Russia. We analyzed the data of the statistical survey of the social services provided rehabilitation facilities for the elderly and disabled people in the Astrakhan region. Analytical results thus obtained shown that the network of agencies and centers of social rehabilitation in the Astrakhan region did not correspond to the needs of elderly people and disabled persons. The negative dynamics in the number of social care centers as well as in the number of people who were provided with their services revealed the need for optimization of the institutional structure and its management. These specific characteristics of the social rehabilitation services in the Astrakhan region thus identified should be taken into consideration in order to improve the rehabilitation programs among elderly citizens and disabled persons in the South Region of the Russian Federation.

A systematic review on how to conduct evaluations in community-based rehabilitation.

PubMed

Grandisson, Marie; Hébert, Michèle; Thibeault, Rachel

2014-01-01

Community-based rehabilitation (CBR) must prove that it is making a significant difference for people with disabilities in low- and middle-income countries. Yet, evaluation is not a common practice and the evidence for its effectiveness is fragmented and largely insufficient. The objective of this article was to review the literature on best practices in program evaluation in CBR in relation to the evaluative process, the frameworks, and the methods of data collection. A systematic search was conducted on five rehabilitation databases and the World Health Organization website with keywords associated with CBR and program evaluation. Two independent researchers selected the articles. Twenty-two documents were included. The results suggest that (1) the evaluative process needs to be conducted in close collaboration with the local community, including people with disabilities, and to be followed by sharing the findings and taking actions, (2) many frameworks have been proposed to evaluate CBR but no agreement has been reached, and (3) qualitative methodologies have dominated the scene in CBR so far, but their combination with quantitative methods has a lot of potential to better capture the effectiveness of this strategy. In order to facilitate and improve evaluations in CBR, there is an urgent need to agree on a common framework, such as the CBR matrix, and to develop best practice guidelines based on the literature available and consensus among a group of experts. These will need to demonstrate a good balance between community development and standards for effective evaluations. Implications for Rehabilitation In the quest for evidence of the effectiveness of community-based rehabilitation (CBR), a shared program evaluation framework would better enable the combination of findings from different studies. The evaluation of CBR programs should always include sharing findings and taking action for the sake of the local community. Although qualitative methodologies have dominated the scene in CBR and remain highly relevant, there is also a call for the inclusion of quantitative indicators in order to capture the progress made by people participating in CBR programs. The production of best practice guidelines for evaluation in CBR could foster accountable and empowering program evaluations that are congruent with the principles at the heart of CBR and the standards for effective evaluations.

A systematic review on how to conduct evaluations in community-based rehabilitation

PubMed Central

Hébert, Michèle; Thibeault, Rachel

2014-01-01

Purpose Community-based rehabilitation (CBR) must prove that it is making a significant difference for people with disabilities in low- and middle-income countries. Yet, evaluation is not a common practice and the evidence for its effectiveness is fragmented and largely insufficient. The objective of this article was to review the literature on best practices in program evaluation in CBR in relation to the evaluative process, the frameworks, and the methods of data collection. Method A systematic search was conducted on five rehabilitation databases and the World Health Organization website with keywords associated with CBR and program evaluation. Two independent researchers selected the articles. Results Twenty-two documents were included. The results suggest that (1) the evaluative process needs to be conducted in close collaboration with the local community, including people with disabilities, and to be followed by sharing the findings and taking actions, (2) many frameworks have been proposed to evaluate CBR but no agreement has been reached, and (3) qualitative methodologies have dominated the scene in CBR so far, but their combination with quantitative methods has a lot of potential to better capture the effectiveness of this strategy. Conclusions In order to facilitate and improve evaluations in CBR, there is an urgent need to agree on a common framework, such as the CBR matrix, and to develop best practice guidelines based on the literature available and consensus among a group of experts. These will need to demonstrate a good balance between community development and standards for effective evaluations. Implications for Rehabilitation In the quest for evidence of the effectiveness of community-based rehabilitation (CBR), a shared program evaluation framework would better enable the combination of findings from different studies. The evaluation of CBR programs should always include sharing findings and taking action for the sake of the local community. Although qualitative methodologies have dominated the scene in CBR and remain highly relevant, there is also a call for the inclusion of quantitative indicators in order to capture the progress made by people participating in CBR programs. The production of best practice guidelines for evaluation in CBR could foster accountable and empowering program evaluations that are congruent with the principles at the heart of CBR and the standards for effective evaluations. PMID:23614357

Urban Telemedicine: The Applicability of Teleburns in the Rehabilitative Phase.

PubMed

Liu, Yuk Ming; Mathews, Katie; Vardanian, Andrew; Bozkurt, Taylan; Schneider, Jeffrey C; Hefner, Jaye; Schulz, John T; Fagan, Shawn P; Goverman, Jeremy

Telemedicine has been successfully used in many areas of medicine, including triage and evaluation of the acute burn patient. The utility of telemedicine during the rehabilitative phase of burn care has yet to be evaluated; therefore, we expanded our telemedicine program to link our burn center with a rehabilitation facility. The goal of this project was to demonstrate cost-effective improvements in the transition and quality of care. A retrospective review was performed on all patients enrolled in our telemedicine/rehabilitation program between March 2013 and March 2014. Data collected included total number of encounters, visits, type of visit, physician time, and readmissions. Transportation costs were based on local ambulance rates between the two facilities. The impact of telemedicine was evaluated with respect to the time saved for the physician, burn center, and burn clinic, as well as rehabilitative days saved. A patient satisfaction survey was also administered. A total of 29 patients participated in 73 virtual visits through the telemedicine project. Virtual visits included new consults, preoperative evaluations, and postoperative follow-ups. A total of 146 ambulance transports were averted during the study period, totaling $101,110. Virtual visits saved 6.8 outpatient burn clinic days, or 73 clinic appointments of 30-min duration. The ability to perform more outpatient surgery resulted in 80 inpatient bed days saved at the burn hospital. The rehabilitation hospital saved an average of 2 to 3 patient days secondary to unnecessary travel. Satisfaction surveys demonstrated patient satisfaction with the encounters, primarily related to time saved. The decrease in travel time for the patient from the rehabilitation hospital to outpatient burn clinic improved adherence to the rehabilitation care plan and resulted in increased throughput at the rehabilitation facility. Videoconferencing between a burn center and rehabilitation hospital streamlined patient care and reduced health care costs, while maintaining quality of care and patient satisfaction. This program has improved inpatient burn rehabilitation by maximizing time spent in therapy and avoiding unnecessary patient travel to offsite appointments.

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

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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...

Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

PubMed

Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

2012-01-01

Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

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.

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...

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. ...

Brain damage treated with non proven intensive training 2003-2011: a Norwegian cost analysis.

PubMed

Norum, Jan; Ramsvik, Arnborg; Tjeldnes, Knut

2012-10-10

There has been an increased request for intensive training and rehabilitation of patients with brain damage in Norway. These programs are demanding with regard to personnel, travelling, time and economic resources. We aimed to indicate cost and gain to make these programs cost-effective. A retrospective study included all patients referred to the Northern Norway Regional Health Authority (NNRHA) trust during the nine years period 2003-2011. All referrals to the NNRHA trust for the economic coverage of foreign based rehabilitation or habilitation programs (The Advanced Bio-Mechanical Rehabilitation (ABR), Institutes of Achievement of Human Potential program (IAHP) (Doman Method), Family Hope Center (FHC) program and the Kozijavkin Method) were included. 17 patients were detected and 15 fulfilled the inclusion criteria for funding. Median age was 8 years (1-31 years). Cost from the specialist health care point of view was calculated. A cut-off limit of €57,000/quality adjusted life year (QALY) and a 4% discount rate was employed. The undiscounted cost per patient enrolled was calculated €133,210 (discounted €121,348). To make these therapies cost effective, a total of at least 2.13 QALYs (2.34 undiscounted QALYs) must be gained per patient enrolled. Such a gain could not be indicated and we doubt it is achievable. Non-proven intensive training programs for patients with brain damage are costly. As long as their effect has not been documented, health care services should not spend resources on these programs outside clinical trials.

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…

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

PubMed

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

2013-10-01

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

Recidivism and Rehabilitation of Criminal Offenders: A Carrot and Stick Evolutionary Game

PubMed Central

Berenji, Bijan; Chou, Tom; D'Orsogna, Maria R.

2014-01-01

Motivated by recent efforts by the criminal justice system to treat and rehabilitate nonviolent offenders rather than focusing solely on their punishment, we introduce an evolutionary game theoretic model to study the effects of “carrot and stick” intervention programs on criminal recidivism. We use stochastic simulations to study the evolution of a population where individuals may commit crimes depending on their past history, surrounding environment and, in the case of recidivists, on any counseling, educational or training programs available to them after being punished for their previous crimes. These sociological factors are embodied by effective parameters that determine the decision making probabilities. Players may decide to permanently reform or continue engaging in criminal activity, eventually reaching a state where they are considered incorrigible. Depending on parameter choices, the outcome of the game is a society with a majority of virtuous, rehabilitated citizens or incorrigibles. Since total resources may be limited, we constrain the combined punishment and rehabilitation costs per crime to be fixed, so that increasing one effort will necessarily decrease the other. We find that the most successful strategy in reducing crime is to optimally allocate resources so that after being punished, criminals experience impactful intervention programs, especially during the first stages of their return to society. Excessively harsh or lenient punishments are less effective. We also develop a system of coupled ordinary differential equations with memory effects to give a qualitative description of our simulated societal dynamics. We discuss our findings and sociological implications. PMID:24454884

Recidivism and rehabilitation of criminal offenders: a carrot and stick evolutionary game.

PubMed

Berenji, Bijan; Chou, Tom; D'Orsogna, Maria R

2014-01-01

Motivated by recent efforts by the criminal justice system to treat and rehabilitate nonviolent offenders rather than focusing solely on their punishment, we introduce an evolutionary game theoretic model to study the effects of "carrot and stick" intervention programs on criminal recidivism. We use stochastic simulations to study the evolution of a population where individuals may commit crimes depending on their past history, surrounding environment and, in the case of recidivists, on any counseling, educational or training programs available to them after being punished for their previous crimes. These sociological factors are embodied by effective parameters that determine the decision making probabilities. Players may decide to permanently reform or continue engaging in criminal activity, eventually reaching a state where they are considered incorrigible. Depending on parameter choices, the outcome of the game is a society with a majority of virtuous, rehabilitated citizens or incorrigibles. Since total resources may be limited, we constrain the combined punishment and rehabilitation costs per crime to be fixed, so that increasing one effort will necessarily decrease the other. We find that the most successful strategy in reducing crime is to optimally allocate resources so that after being punished, criminals experience impactful intervention programs, especially during the first stages of their return to society. Excessively harsh or lenient punishments are less effective. We also develop a system of coupled ordinary differential equations with memory effects to give a qualitative description of our simulated societal dynamics. We discuss our findings and sociological implications.

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.

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

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2012-06-11

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Transcranial direct current stimulation in post-stroke sub-acute aphasia: study protocol for a randomized controlled trial.

PubMed

Spielmann, Kerstin; van de Sandt-Koenderman, W Mieke E; Heijenbrok-Kal, Majanka H; Ribbers, Gerard M

2016-08-02

Transcranial direct current stimulation (tDCS) is a promising new technique to optimize the effect of regular Speech and Language Therapy (SLT) in the context of aphasia rehabilitation. The present study focuses on the effect of tDCS provided during SLT in the sub-acute stage after stroke. The primary aim is to evaluate the potential effect of tDCS on language functioning, specifically on word-finding, as well as generalization effects to verbal communication. The secondary aim is to evaluate its effect on social participation and quality of life, and its cost-effectiveness. We strive to include 58 stroke patients with aphasia, enrolled in an inpatient or outpatient stroke rehabilitation program, in a multicenter, double-blind, randomized controlled trial with two parallel groups and 6 months' follow-up. Patients will participate in two separate intervention weeks, with a pause of 2 weeks in between, in the context of their regular aphasia rehabilitation program. The two intervention weeks comprise daily 45-minute sessions of word-finding therapy, combined with either anodal tDCS over the left inferior frontal gyrus (1 mA, 20 minutes; experimental condition) or sham-tDCS over the same region (control condition). The primary outcome measure is word-finding. Secondary outcome measures are verbal communication, social participation, quality of life, and cost-effectiveness of the intervention. Our results will contribute to the discussion on whether tDCS should be implemented in regular aphasia rehabilitation programs for the sub-acute post-stroke population in terms of (cost-)effectiveness. Nederlands Trail Register: NTR4364 . Registered on 21 February 2014.

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.

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

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

PubMed

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

2018-05-01

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

[Psychotherapy impact on effectiveness of in-hospital physical rehabilitation in patients with acute coronary syndrome].

PubMed

Sumin, A N; Khaĭredinova, O P; Sumina, L Iu; Variushkina, E V; Doronin, D V; Galimzianov, D M; Masin, A N; Gol'dberg, G A

2000-01-01

Of 103 patients with acute coronary syndrome (mean age 51.6 +/- 0.9 years) 47 patients participated in 5 group psychotherapeutic sessions added to conversional rehabilitation program. Psychotherapy included progressive muscular relaxation, neurolinguistic programming, eriksonian hypnosis, therapeutic metaphora. Psychotherapy decreased the hear rate, number of ventricular extrasystoles, stimulated tonicity of the parasympathetic nervous system. Compared to the controls, the test patients developed higher exercise tolerance and lower reactivity of the central hemodynamics in all the exercise tests.

Cognitive and academic achievement changes associated with day hospital rehabilitation in children with acquired brain injury.

PubMed

Goldstein, Gerald; Mayfield, Joan; Thaler, Nicholas S; Walker, Jon; Allen, Daniel N

2018-01-01

An evaluation was made of the outcome of a day hospital rehabilitation program for children who experienced an acquired neurological illness, mainly traumatic brain injury. Participants were administered neuropsychological and academic evaluations upon entry to the program, immediately upon discharge and several months after discharge Repeated measures ANOVA results for variables selected from the Reynolds Intellectual Assessment and the Delis-Kaplan Executive Function System found that comparisons showed significant (≥p < .01) improvement occurred between the first and second assessment, generally with large effect sizes. There were some nonsignificant decrements in performance between the discharge and follow-up assessments. A correlational analysis showed that while the association between cognitive function and academic achievement was robust, correlation coefficients did not differ in strength before and following rehabilitation. The study demonstrates significant improvement in children with acquired neurological disorders following rehabilitation.

Evaluation of an Occupational Therapy Mentorship Program: Effects on Therapists' Skills and Family-Centered Behavior

ERIC Educational Resources Information Center

King, Gillian; Tam, Cynthia; Fay, Linda; Pilkington, Martha; Servais, Michelle; Petrosian, Hasmik

2011-01-01

There is growing interest in understanding the usefulness of mentorship programs for children's rehabilitation service providers. This evaluation study examined the effects of an occupational therapy mentorship program on the skills and behaviors of 8 new and 17 experienced occupational therapists practicing at a regional children's rehabilitation…

Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation.

PubMed

Hara, Karen Walseth; Bjørngaard, Johan Håkon; Brage, Søren; Borchgrevink, Petter Christian; Halsteinli, Vidar; Stiles, Tore Charles; Johnsen, Roar; Woodhouse, Astrid

2018-06-01

Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.

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.

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.

Providing Effective Early Intervention Vocational Rehabilitation at the Community Level

ERIC Educational Resources Information Center

Allaire, Saralynn J.; Niu, Jingbo; Zhu, Yanyan; Brett, Belle

2011-01-01

The purpose of this study was to evaluate the translation of positive research findings about a job retention intervention for persons with chronic illnesses to rehabilitation practice. A program to provide the intervention was developed and marketed in the community. Fifty-seven consumers with chronic illnesses received the intervention provided…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... implemented changes to services provided under 38 U.S.C. chapter 31, which resulted from a court decision and..., for vocational rehabilitation basic entitlement determinations resulting from the Veterans' Benefits... issuing any rule that may result in the expenditure by State, local, and Tribal governments, in the...

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.

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...

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

Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial

PubMed Central

2014-01-01

Background The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient’s home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home. Methods/Design This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants’ quality of life, satisfaction with services received, and cost-effectiveness associated with the provision of both types of services. Study/trial registration ClinicalTrials.gov: NCT01848080 PMID:24479760

Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

PubMed

Tousignant, Michel; Corriveau, Hélène; Kairy, Dahlia; Berg, Katherine; Dubois, Marie-France; Gosselin, Sylvie; Swartz, Richard H; Boulanger, Jean-Martin; Danells, Cynthia

2014-01-30

The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient's home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home. This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants' quality of life, satisfaction with services received, and cost-effectiveness associated with the provision of both types of services. ClinicalTrials.gov: NCT01848080.

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.

Development and exploratory analysis of the Neurorehabilitation Program Styles Survey.

PubMed

McCorkel, Beth A; Glueckauf, Robert L; Ecklund-Johnson, Eric P; Tomusk, Allison B; Trexler, Lance E; Diller, Leonard

2003-01-01

To develop a survey instrument that assesses implementation of key components of outpatient neurorehabilitation programs and test the capacity of this instrument to differentiate between rehabilitation approaches. The Neurorehabilitation Program Styles Survey (NPSS) was administered to 18 outpatient facilities: 10 specialized and 8 discipline-specific outpatient neurorehabilitation programs. Scores were compared between types of programs using independent samples t tests. The NPSS showed good reliability and contrasted groups validity, significantly differentiating between types of programs. The NPSS holds considerable promise as a tool for distinguishing among different types of brain injury programs, and for assessing the differential effectiveness of specialized versus discipline-specific outpatient brain rehabilitation programs. Future research on the NPSS will assess the stability of the instrument over time, its content validity, and capacity to differentiate the full continuum of neurorehabilitation programs.

Evaluation and implementation of highly challenging balance training in clinical practice for people with Parkinson's disease: protocol for the HiBalance effectiveness-implementation trial.

PubMed

Leavy, Breiffni; Kwak, Lydia; Hagströmer, Maria; Franzén, Erika

2017-02-07

If people with progressive neurological diseases are to avail of evidence-based rehabilitation, programs found effective in randomized controlled trials (RCT's) must firstly be adapted and tested in clinical effectiveness studies as a means of strengthening their evidence base. This paper describes the protocol for an effectiveness-implementation trial that will assess the clinical effectiveness of a highly challenging balance training program (the HiBalance program) for people with mild-moderate Parkinson's disease (PD) while simultaneously collecting data concerning the way in which the program is implemented. The HiBalance program is systemically designed to target balance impairments in PD and has been shown effective at improving balance control and gait in a previous RCT. Study aims are to i) determine the effectiveness of the adapted HiBalance program on performance and self-rated outcomes such as balance control, gait and physical activity level ii) conduct a process evaluation of program implementation at the various clinics iii) determine barriers and facilitators to program implementation in these settings. This effectiveness-implementation type 1 hybrid study will use a non-randomized controlled design with consecutive inclusion of people with PD at multiple clinical sites. A mixed method approach will be used to collect clinical effectiveness data and process evaluation data which is both quantitative and qualitative in nature. The consolidated framework for implementation research (CFIR) will be used to guide the planning and collection of data concerning implementation barriers and facilitators. The HiBalance program will be provided by physical therapists as a part of standard rehabilitation care at the clinical sites, while the evaluation of the implementation process will be performed by the research group and funded by research grants. An effectiveness-implementation study design benefits patients by speeding up the process of translating findings from research settings to routine health care. Findings from this study will also be highly relevant for those working with neurological rehabilitation when faced with decisions concerning the translation of training programs from efficacy studies to everyday clinical practice. ClinicalTrials.gov march 2016, NCT02727478 .

Function after spinal treatment, exercise, and rehabilitation: cost-effectiveness analysis based on a randomized controlled trial.

PubMed

Morris, Stephen; Morris, Tim P; McGregor, Alison H; Doré, Caroline J; Jamrozik, Konrad

2011-10-01

Cost-effectiveness analysis alongside a factorial randomized controlled trial. To assess the cost-effectiveness of a rehabilitation program and/or an education booklet each compared with usual care for the postoperative management of patients undergoing discectomy or lateral nerve root decompression surgery. There is little knowledge about the cost-effectiveness of postoperative management of patients after spinal surgery. A total of 338 patients were recruited into the study between June 2005 and March 2009. Patients were randomized to rehabilitation only, booklet only, rehabilitation plus booklet, or usual care only. Interactions between booklet and rehabilitation were nonsignificant; hence, we compare booklet versus no booklet and rehabilitation versus no rehabilitation. We adopt an English National Health Service and personal social services perspective. Data on outcomes and costs are based on patient level data from the trial. A 1-year time horizon was used. Outcomes were measured in terms of quality-adjusted life years. Health-related quality of life was reported by patients using the EuroQol-5D (EQ-5D). A comprehensive range of health service contacts were included in the cost analysis. There were no significant differences in costs or outcomes associated with either intervention. Mean incremental costs and mean quality-adjusted life years gained per patient of booklet versus no booklet were -£87 (95% CI: -£1221 to £1047) and -0.023 (95% CI: -0.068 to 0.023), respectively. Figures for rehabilitation versus no rehabilitation were £160 (95% CI: -£984 to £1304) and 0.002 (95% CI: -0.044 to 0.048), respectively. Neither intervention was cost-effective when compared with the threshold range commonly used to judge whether or not an intervention is cost-effective in the English National Health Service. Cost-effectiveness evidence does not support use of booklet over no booklet or rehabilitation over no rehabilitation for the postoperative management of patients after spinal surgery.

Effects of behavioural exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: study protocol for a randomised controlled trial.

PubMed

Hofmann, Jana; Peters, Stefan; Geidl, Wolfgang; Hentschke, Christian; Pfeifer, Klaus

2013-03-11

In Germany, a multidisciplinary rehabilitation named "behavioural medical rehabilitation" (BMR) is available for treatment of chronic low back pain (clbp). A central component of BMR is standard exercise therapy (SET), which is directed mainly to improve physical fitness. There is a need to address psychosocial factors within SET and therefore to improve behavior change with a focus on the development of self-management skills in dealing with clbp. Furthermore, short-term effectiveness of BMR with a SET has been proven, but the impact of a behavioural exercise therapy (BET) for improvement of the long-term effectiveness of BMR is unclear. To compare the effectiveness of two exercise programs with different approaches within BMR on the effects of BMR a prospective randomized controlled trial (RCT) in two rehabilitation centres will be performed. 214 patients aged 18-65 with clbp will be, based on an "urn randomisation"-algorithm, randomly assigned to a BMR with SET (function-oriented, n=107) and BMR with BET (behaviour-oriented, n=107). Both exercise programs have a mean duration of 26 hours in three weeks and are delivered by a limited number of not-blinded study therapists in closed groups with six to twelve patients who will be masked regarding study group. The main differences of BET lie in its detailed manualised program with a theory-based, goal-orientated combination of exercise, education and behavioural elements, active participation of patients and consideration of their individual preferences and previous experiences with exercise. The primary outcome is functional ability assessed with the Hannover Functional Ability Questionnaire directly before and after the rehabilitation program, as well as a six and twelve-month follow-up. This RCT is designed to explore the effects of BET on the effectiveness of a BMR compared to a BMR with SET in the management of patients with clbp. Methodological challenges arise from conducting a RCT within routine health care as well as from ensuring high treatment integrity. Findings of this study might contribute to a better understanding of the mechanism of action of BMR and the special effects of BET and may be used to improve the quality of these interventions in routine care, therefore reducing the burden to patients with disabling clbp. Current controlled trials NCT01666639.

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...

Relationship of caregiver and family functioning to participation outcomes after postacute rehabilitation for traumatic brain injury: a multicenter investigation.

PubMed

Sander, Angelle M; Maestas, Kacey Little; Sherer, Mark; Malec, James F; Nakase-Richardson, Risa

2012-05-01

To investigate the contribution of caregiver emotional functioning and family functioning to participation outcomes after postacute rehabilitation for traumatic brain injury (TBI). Prospective cohort study. Three postacute comprehensive-integrated postacute rehabilitation programs associated with National Institute on Disability and Rehabilitation Research-funded TBI Model Systems Centers. Persons with medically documented TBI (N=136; 57% with severe TBI, 12% moderate, 31% mild), primarily men and 69% white. Not applicable. Community Integration Questionnaire and Craig Handicap Assessment and Reporting Technique (CHART). After accounting for age, education, sex, and race/ethnicity, there was a significant interaction between caregiver emotional functioning and time since injury for CHART Occupation and Social Integration Scale scores. Better emotional functioning in caregivers was associated with greater occupation and social integration outcomes for persons who entered the postacute rehabilitation program within 6 months of injury, but not for those >6 months postinjury. There was no relationship of family functioning to participation outcomes, and no interaction between family functioning and time since injury. Caregiver distress should be accounted for in studies investigating the effectiveness of postacute rehabilitation after TBI. Screening of caregivers early during postacute rehabilitation can target those who need assistance to improve their support of the person with TBI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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...

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

DOT National Transportation Integrated Search

1977-11-01

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

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.

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

Economic evaluation of adult rehabilitation: a systematic review and meta-analysis of randomized controlled trials in a variety of settings.

PubMed

Brusco, Natasha Kareem; Taylor, Nicholas F; Watts, Jennifer J; Shields, Nora

2014-01-01

To report if there is a difference in costs from a societal perspective between adults receiving rehabilitation in an inpatient rehabilitation setting versus an alternative setting. If there are cost differences, to report whether opting for the least expensive program setting adversely affects patient outcomes. Electronic databases from the earliest possible date until May 2011. All languages were included. Multiple reviewers identified randomized controlled trials with a full economic evaluation that compared adult inpatient rehabilitation with an alternative. There were 29 included trials with 6746 participants. Multiple observers extracted data independently. Trial appraisal included a risk of bias assessment and a checklist to report the strength of the economic evaluation. Results were synthesized using standardized mean differences (SMDs) and meta-analyses for the primary outcome of cost. The Grading of Recommendations Assessment, Development, and Evaluation was applied to assess for risk of bias across studies for meta-analyses. There was high-quality evidence that cost was significantly reduced for rehabilitation in the home versus inpatient rehabilitation in a meta-analysis of 732 patients poststroke (pooled SMD [δ]=-.28; 95% confidence interval [CI], -.47 to -.09), without compromise to patient outcomes. Results of individual trials in other patient groups (orthopedic, rheumatoid arthritis, and geriatric) receiving rehabilitation in the home or community were generally consistent with the meta-analysis. There was moderate quality evidence that cost was significantly reduced for inpatient rehabilitation (stroke unit) versus general acute care in a meta-analysis of 463 patients poststroke (δ=.31; 95% CI, .15-.48), with improvement to patient outcomes. These results were not replicated in 2 individual trials with a geriatric and a mixed cohort, where costs did not differ between general acute care and inpatient rehabilitation. Three of the 4 individual trials, inclusive of a stroke or orthopedic population, reported less cost for an intensive inpatient rehabilitation program compared with usual inpatient rehabilitation. Sensitivity analysis included a health service perspective and varied inflation rates with no change to the significant findings of the meta-analyses. Based on this systematic review and meta-analyses, a single rehabilitation service may not provide health economic benefits for all patient groups and situations. For some patients, inpatient rehabilitation may be the most cost-effective method of providing rehabilitation; yet, for other patients, rehabilitation in the home or community may be the most cost-effective model of care. To achieve cost-effective outcomes, the ideal combination of rehabilitation services and patient inclusion criteria, as well as further data for nonstroke populations, warrants further research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Dual sensory loss: development of a dual sensory loss protocol and design of a randomized controlled trial

PubMed Central

2013-01-01

Background Dual sensory loss (DSL) has a negative impact on health and wellbeing and its prevalence is expected to increase due to demographic aging. However, specialized care or rehabilitation programs for DSL are scarce. Until now, low vision rehabilitation does not sufficiently target concurrent impairments in vision and hearing. This study aims to 1) develop a DSL protocol (for occupational therapists working in low vision rehabilitation) which focuses on optimal use of the senses and teaches DSL patients and their communication partners to use effective communication strategies, and 2) describe the multicenter parallel randomized controlled trial (RCT) designed to test the effectiveness and cost-effectiveness of the DSL protocol. Methods/design To develop a DSL protocol, literature was reviewed and content was discussed with professionals in eye/ear care (interviews/focus groups) and DSL patients (interviews). A pilot study was conducted to test and confirm the DSL protocol. In addition, a two-armed international multi-center RCT will evaluate the effectiveness and cost-effectiveness of the DSL protocol compared to waiting list controls, in 124 patients in low vision rehabilitation centers in the Netherlands and Belgium. Discussion This study provides a treatment protocol for rehabilitation of DSL within low vision rehabilitation, which aims to be a valuable addition to the general low vision rehabilitation care. Trial registration Netherlands Trial Register (NTR) identifier: NTR2843 PMID:23941667

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.

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...

Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment.

PubMed

Lotfi, Younes; Rezazadeh, Nima; Moossavi, Abdollah; Haghgoo, Hojjat Allah; Rostami, Reza; Bakhshi, Enayatollah; Badfar, Faride; Moghadam, Sedigheh Farokhi; Sadeghi-Firoozabadi, Vahid; Khodabandelou, Yousef

2017-12-01

Balance function has been reported to be worse in ADHD children than in their normal peers. The present study hypothesized that an improvement in balance could result in better cognitive performance in children with ADHD and concurrent vestibular impairment. This study was designed to evaluate the effects of comprehensive vestibular rehabilitation therapy on the cognitive performance of children with combined ADHD and concurrent vestibular impairment. Subject were 54 children with combined ADHD. Those with severe vestibular impairment (n=33) were randomly assigned to two groups that were matched for age. A rehabilitation program comprising overall balance and gate, postural stability, and eye movement exercises was assigned to the intervention group. Subjects in the control group received no intervention for the same time period. Intervention was administered twice weekly for 12 weeks. Choice reaction time (CRT) and spatial working memory (SWM) subtypes of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were completed pre- and post-intervention to determine the effects of vestibular rehabilitation on the cognitive performance of the subjects with ADHD and concurrent vestibular impairment. ANCOVA was used to compare the test results of the intervention and control group post-test. The percentage of correct trial scores for the CRT achieved by the intervention group post-test increased significantly compared to those of the control group (p=0.029). The CRT mean latency scores were significantly prolonged in the intervention group following intervention (p=0.007) compared to the control group. No significant change was found in spatial functioning of the subjects with ADHD following 12 weeks of intervention (p>0.05). The study highlights the effect of vestibular rehabilitation on the cognitive performance of children with combined ADHD and concurrent vestibular disorder. The findings indicate that attention can be affected by early vestibular rehabilitation, which is a basic program for improving memory function in such children. Appropriate vestibular rehabilitation programs based on the type of vestibular impairment of children can improve their cognitive ability to some extent in children with ADHD and concurrent vestibular impairment (p>0.05). Copyright © 2017 Elsevier B.V. All rights reserved.

Perceptive rehabilitation and trunk posture alignment in patients with Parkinson disease: a single blind randomized controlled trial.

PubMed

Morrone, Michelangelo; Miccinilli, Sandra; Bravi, Marco; Paolucci, Teresa; Melgari, Jean M; Salomone, Gaetano; Picelli, Alessandro; Spadini, Ennio; Ranavolo, Alberto; Saraceni, Vincenzo M; DI Lazzaro, Vincenzo; Sterzi, Silvia

2016-12-01

Recent studies aimed to evaluate the potential effects of perceptive rehabilitation in Parkinson Disease reporting promising preliminary results for postural balance and pain symptoms. To date, no randomized controlled trial was carried out to compare the effects of perceptive rehabilitation and conventional treatment in patients with Parkinson Disease. To evaluate whether a perceptive rehabilitation treatment could be more effective than a conventional physical therapy program in improving postural control and gait pattern in patients with Parkinson Disease. Single blind, randomized controlled trial. Department of Physical and Rehabilitation Medicine of a University Hospital. Twenty outpatients affected by idiopathic Parkinson Disease at Hoehn and Yahr stage ≤3. Recruited patients were divided into two groups: the first one underwent individual treatment with Surfaces for Perceptive Rehabilitation (Su-Per), consisting of rigid wood surfaces supporting deformable latex cones of various dimensions, and the second one received conventional group physical therapy treatment. Each patient underwent a training program consisting of ten, 45-minute sessions, three days a week for 4 consecutive weeks. Each subject was evaluated before treatment, immediately after treatment and at one month of follow-up, by an optoelectronic stereophotogrammetric system for gait and posture analysis, and by a computerized platform for stabilometric assessment. Kyphosis angle decreased after ten sessions of perceptive rehabilitation, thus showing a substantial difference with respect to the control group. No significant differences were found as for gait parameters (cadence, gait speed and stride length) within Su-Per group and between groups. Parameters of static and dynamic evaluation on stabilometric platform failed to demonstrate any statistically relevant difference both within-groups and between-groups. Perceptive training may help patients affected by Parkinson Disease into restoring a correct midline perception and, in turn, to improve postural control. Perceptive surfaces represent an alternative to conventional rehabilitation of postural disorders in Parkinson Disease. Further studies are needed to determine if the association of perceptive treatment and active motor training would be useful in improving also gait dexterity.

Measurement of functional capacity requirements of police officers to aid in development of an occupation-specific cardiac rehabilitation training program.

PubMed

Adams, Jenny; Schneider, Jonna; Hubbard, Matthew; McCullough-Shock, Tiffany; Cheng, Dunlei; Simms, Kay; Hartman, Julie; Hinton, Paul; Strauss, Danielle

2010-01-01

This study was designed to measure the functional capacity of healthy subjects during strenuous simulated police tasks, with the goal of developing occupation-specific training for cardiac rehabilitation of police officers. A calibrated metabolic instrument and an oxygen consumption data collection mask were used to measure the oxygen consumption and heart rates of 30 Dallas Police Academy officers and cadets as they completed an 8-event obstacle course that simulated chasing, subduing, and handcuffing a suspect. Standard target heart rates (85% of age-predicted maximum heart rate, or 0.85 x [220 - age]) and metabolic equivalents (METs) were calculated; a matched-sample t test based on differences between target and achieved heart rate and MET level was used for statistical analysis. Peak heart rates during the obstacle course simulation were significantly higher than the standard target heart rates (those at which treadmill stress tests in physicians' offices are typically stopped) (t(29) = 12.81, P < 0.001) and significantly higher than the suggested maximum of 150 beats/min during cardiac rehabilitation training (t(29) = 17.84, P < 0.001). Peak MET levels during the obstacle course simulation were also significantly higher than the goal level (8 METs) that patients typically achieve in a cardiac rehabilitation program (t(29) = 14.73, P < 0.001). We conclude that police work requires a functional capacity greater than that typically attained in traditional cardiac rehabilitation programs. Rehabilitation professionals should consider performing maximal stress tests and increasing the intensity of cardiac rehabilitation workouts to effectively train police officers who have had a cardiac event.

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.

Feasibility of the evidence-based cognitive telerehabilitation program Remind for patients with primary brain tumors.

PubMed

van der Linden, Sophie D; Sitskoorn, Margriet M; Rutten, Geert-Jan M; Gehring, Karin

2018-05-01

Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation program developed by our group. We converted the program into the iPad-based cognitive rehabilitation program ReMind, to increase its accessibility. The app incorporates psychoeducation, strategy training and retraining. This pilot study in patients with primary brain tumors evaluates the feasibility of the use of the ReMind-app in a clinical (research) setting in terms of accrual, attrition, adherence and patient satisfaction. The intervention commenced 3 months after resective surgery and patients were advised to spend 3 h per week on the program for 10 weeks. Of 28 eligible patients, 15 patients with presumed low-grade glioma or meningioma provided informed consent. Most important reason for decline was that patients (7) experienced no cognitive complaints. Participants completed on average 71% of the strategy training and 76% of the retraining. Some patients evaluated the retraining as too easy. Overall, 85% of the patients evaluated the intervention as "good" or "excellent". All patients indicated that they would recommend the program to other patients with brain tumors. The ReMind-app is the first evidence-based cognitive telerehabilitation program for adult patients with brain tumors and this pilot study suggests that postoperative cognitive rehabilitation via this app is feasible. Based on patients' feedback, we have expanded the retraining with more difficult exercises. We will evaluate the efficacy of ReMind in an RCT.

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.

77 FR 54943 - Privacy Act of 1974, as Amended; Computer Matching Program (Social Security Administration (SSA...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

..., Education, and Vocational Rehabilitation and Employment Records-VA'' (58VA21/22/28), published at 74 FR.... Inclusive Dates of the Matching Program The effective date of this matching program is October 2, 2012...

75 FR 7648 - Privacy Act of 1974, as Amended; Computer Matching Program (SSA/Department of Veterans Affairs...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-22

..., Education, and Vocational Rehabilitation and Employment Records-VA (58 VA 21/22/28),'' first published at 74.... Inclusive Dates of the Matching Program The matching program will become effective no sooner than 40 days...

A web-based intervention to promote applications for rehabilitation: a study protocol for a randomized controlled trial.

PubMed

Spanier, Katja; Streibelt, Marco; Ünalan, Firat; Bethge, Matthias

2015-09-29

The German welfare system follows the principle "rehabilitation rather than pension," but more than the half of all disability pensioners did not utilize medical rehabilitation before their early retirement. A major barrier is the application procedure. Lack of information about the opportunity to utilize rehabilitation services restricts the chance to improve work ability and to prevent health-related early retirement by rehabilitation programs. The establishment of new access paths to medical rehabilitation services was, therefore, identified as a major challenge for rehabilitation research in a recent expertise. Thus, a web-based information guide was developed to support the application for a medical rehabilitation program. For this study, the development of a web-based information guide was based on the health action process approach. Four modules were established. Three modules support forming an intention by strengthening risk perception (module 1), positive outcome expectancies (module 2) and self-efficacy (module 3). A fourth module aims at the realization of actual behavior by offering instructions on how to plan and to push the application process. The study on the effectiveness of the web-based information guide will be performed as a randomized controlled trial. Persons aged 40 to 59 years with prior sick leave benefits during the preceding year will be included. A sample of 16,000 persons will be randomly drawn from the registers of 3 pension insurance agencies. These persons will receive a questionnaire to determine baseline characteristics. Respondents of this first survey will be randomly allocated either to the intervention or the control group. Both study groups will then receive letters with general information about rehabilitation. The intervention group will additionally receive a link to the web-based information guide. After 1 year, a second survey will be conducted. Additionally, administrative data will be used to determine if participants apply for rehabilitation and finally start a rehabilitation program. The primary outcomes are the proportion of applied and utilized medical rehabilitation services. Secondary outcomes are cognitions on rehabilitation, self-rated work ability, health-related quality of life and perceived disability, as well as days with sick leave benefits and days of regular employment. The randomized controlled trial will provide highest ranked evidence to clarify whether theory-driven web-based information supports access to rehabilitation services for people with prior sickness benefits. German Clinical Trials Register (Identifier: DRKS00005658 , 16 January 2014).

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.

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.

Nordic Walking for the Management of People With Parkinson Disease: A Systematic Review.

PubMed

Cugusi, Lucia; Manca, Andrea; Dragone, Daniele; Deriu, Franca; Solla, Paolo; Secci, Claudio; Monticone, Marco; Mercuro, Giuseppe

2017-11-01

It is well known that physical exercise is the main therapeutic element of rehabilitation programs for people with Parkinson disease (PD). As traditional forms of exercise can guarantee significant health benefits, the emergence of nonconventional physical activities, such as Nordic walking (NW), may add positive effects. To appraise the available evidence on the main effects of NW in the rehabilitation programs for people with PD and to propose a design for upcoming research that might improve the uniformity of future trials. Systematic review. A literature search of 5 established databases (PubMed, MEDLINE, Scopus, Web of Science, and Cochrane) was conducted. Any relevant randomized controlled trials pertinent to NW in PD published in English from inception to February 2017 were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the methodologic quality of each study was assessed by the Physiotherapy Evidence Database scale. Sixty-six studies were retrieved, and 6 randomized controlled trials (221 subjects) were entered into the qualitative synthesis. Overall, these studies portrayed NW as feasible and likely to be effective in improving the functional and clinical outcomes of people with PD. When we compared NW with other exercise-based interventions, such as treadmill training, free walking, a program of standardized whole-body movements with maximal amplitude (Lee Silverman Voice Treatment BIG training), or a home-based exercise program, the findings proved controversial. High heterogeneity and methodologic discrepancies among the studies prevent us from drawing firm conclusions on the effectiveness of NW in comparison with other exercise-based interventions currently used by people with PD. Further investigations with a common design are necessary to verify whether NW may be included within conventional rehabilitation programs commonly recommended to people with PD. II. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-07-11

The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients. One-hundred patients participated in the pulmonary rehabilitation program, 81 of whom served as a control group. Statistically, one- and three-month mortality was associated with NIHSS and MRS scores at admission and three months (p<0.001; r=0.440, r=0.432, r=0.339 and r=0.410, respectively). One and three months mortality- ICU admission had a statistically significant relationship with parenteral nutrition (p<0.001; r=0.346, r=0.300, respectively; r=0.294 and r=0.294, respectively). Similarly, there was also a statistically significant relationship between pneumonia onset and one- and three-month mortality- ICU admission (p<0.05; r=0.217, r=0.127, r=0.185 and r=0.185, respectively). A regression analysis showed that parenteral nutrition (odds ratio [OR] =13.434, 95% confidence interval [CI] =1.148-157.265, p=0.038) was a significant predictor of ICU admission. The relationship between pulmonary physiotherapy (PPT) and ICU admission- pneumonia onset at the end of three months was statistically significant (p=0.04 and p=0.043, respectively). This study showed that PPT improved the prognosis of ischemic stroke patients. We believe that a pulmonary rehabilitation program, in addition to general stroke rehabilitation programs, can play a critical role in improving survival and functional outcomes. NCT03195907 . Trial registration date: 21.06.2017 'Retrospectively registered'.

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

A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP).

PubMed

Walters, Darren L; Sarela, Antti; Fairfull, Anita; Neighbour, Kylie; Cowen, Cherie; Stephens, Belinda; Sellwood, Tom; Sellwood, Bernadette; Steer, Marie; Aust, Michelle; Francis, Rebecca; Lee, Chi-Keung; Hoffman, Sheridan; Brealey, Gavin; Karunanithi, Mohan

2010-01-28

Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT). We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines. The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients. The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with number ACTRN12609000251224.

A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP)

PubMed Central

2010-01-01

Background Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT). Methods/Design We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines. Discussion The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients. Trial registration The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with number ACTRN12609000251224. PMID:20109196

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…

Patients' perceptions of their roles in goal setting in a spinal cord injury regional rehabilitation program.

PubMed

Draaistra, Harriett; Singh, Mina D; Ireland, Sandra; Harper, Theresa

2012-01-01

Goal setting is a common practice in rehabilitation, yet there is a paucity of literature exploring patients' perceptions of their roles in this process. This study was conducted using a qualitative descriptive methodology to explore patients' perceptions of their roles in setting goals in a spinal cord injury regional rehabilitation program. Imogene King's theory of goal attainment was used to frame the study. Data were collected through interviews and analyzed using a content analysis. The results revealed four themes: Visioning, Redefining, Brainstorming, and Rebuilding Participants (n = 13) envisioned their roles as setting an overarching priority goal, defining detailed rehabilitation goals, sharing knowledge with the team, and rebuilding skills to attain goals. Implications for nursing practice include the need to understand patients' experiences and perceptions, share knowledge, and support effective communication to promote collaborative goal setting. A need to enhance health professionals' education to fully understand factors influencing patients' abilities to set rehabilitation goals, and future research in methods to promote patients' engagement in goal setting was also clearly indicated.

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.

Enhancing Your Public Relations. A Guide for Designing Effective Communication Strategies for Community-Based Vocational Rehabilitation Programs.

ERIC Educational Resources Information Center

DePoint, Beth

This document is intended to assist agencies in formulating and initiating a financially realistic public relations plan specifically designed for their community-based vocational rehabilitation organizations. The document consists of 6 chapters, a 43-item bibliography, a glossary, and information about the author. Chapter 1 defines public…

Cost-effectiveness of two vocational rehabilitation programs for persons with severe mental illness.

PubMed

Dixon, Lisa; Hoch, Jeffrey S; Clark, Robin; Bebout, Richard; Drake, Robert; McHugo, Greg; Becker, Deborah

2002-09-01

This study sought to determine differences in the cost-effectiveness of two vocational programs: individual placement and support (IPS), in which employment specialists within a mental health center help patients obtain competitive jobs and provide them with ongoing support, and enhanced vocational rehabilitation (EVR), in which stepwise services that involve prevocational experiences are delivered by rehabilitation agencies. A total of 150 unemployed inner-city patients with severe mental disorders who expressed an interest in competitive employment were randomly assigned to IPS or EVR programs and were followed for 18 months. Wages from all forms of employment and the number of weeks and hours of competitive employment were tracked monthly. Estimates were made of direct mental health costs and vocational costs. Incremental cost-effectiveness ratios (ICERs) were calculated for competitive employment outcomes and total wages. No statistically significant differences were found in the overall costs of IPS and EVR. Participation in the IPS program was associated with significantly more hours and weeks of competitive employment. However, the average combined earnings-earnings from competitive and noncompetitive employment-were virtually the same both programs. The ICER estimates indicated that participants in the IPS program worked in competitive employment settings for an additional week over the 18-month period at a cost of $283 ($13 an hour). The analyses suggest that IPS participants engaged in competitive employment at a higher cost. When combined earnings were used as the outcome, data from the statistical analyses were insufficient to enable any firm conclusions to be drawn. The findings illustrate the importance of choice of outcomes in evaluations of employment programs.

Brain Damage Treated with Non Proven Intensive Training 2003-2011: A Norwegian Cost Analysis

PubMed Central

Norum, Jan; Ramsvik, Arnborg; Tjeldnes, Knut

2012-01-01

Objectives: There has been an increased request for intensive training and rehabilitation of patients with brain damage in Norway. These programs are demanding with regard to personnel, travelling, time and economic resources. We aimed to indicate cost and gain to make these programs cost-effective. Methods: A retrospective study included all patients referred to the Northern Norway Regional Health Authority (NNRHA) trust during the nine years period 2003-2011. All referrals to the NNRHA trust for the economic coverage of foreign based rehabilitation or habilitation programs (The Advanced Bio-Mechanical Rehabilitation (ABR), Institutes of Achievement of Human Potential program (IAHP) (Doman method), Family Hope Center (FHC) program and the Kozijavkin method) were included. 17 patients were detected and 15 fulfilled the inclusion criteria for funding. Median age was 8 years (1-31 years). Cost from the specialist health care point of view was calculated. A cut-off limit of €57,000/quality adjusted life year (QALY) and a 4% discount rate was employed. Results: The undiscounted cost per patient enrolled was calculated €133,210 (discounted €121,348). To make these therapies cost effective, a total of at least 2.13 QALYs (2.34 undiscounted QALYs) must be gained per patient enrolled. Such a gain could not be indicated and we doubt it is achievable. Conclusion: Non-proven intensive training programs for patients with brain damage are costly. As long as their effect has not been documented, health care services should not spend resources on these programs outside clinical trials. PMID:23121754

Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged.

PubMed

Altman, Irwin M; Swick, Shannon; Parrot, Devan; Malec, James F

2010-11-01

To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR). Retrospective analysis of program evaluation data for treatment completers and noncompleters. Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities. Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group). PABIR delivered in home and community settings by certified professional staff on an individualized basis. Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact. Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up. Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of patient compliance, quality of life impact and cost-effectiveness of a "test in-train out" exercise-based rehabilitation program for patients with intermittent claudication.

PubMed

Malagoni, Anna Maria; Vagnoni, Emidia; Felisatti, Michele; Mandini, Simona; Heidari, Mahdi; Mascoli, Francesco; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Manfredini, Fabio

2011-01-01

Patients with intermittent claudication (IC) could benefit from low-cost, effective rehabilitative programs. This retrospective study evaluates compliance, impact on Quality of Life (QoL) and cost-effectiveness of a hospital prescribed, at-home performed (Test-in/Train-out) rehabilitative program for patients with IC. Two-hundred and eighty-nine patients with IC (71 ± 10.1 years, M = 210) were enrolled for a 2-year period. Two daily 10-min home walking sessions at maximal asymptomatic speed were prescribed, with serial check-ups at the hospital. Compliance with the program was assessed by assigning a score of 1 (lowest compliance) to 4 (highest compliance). The SF-36 questionnaire and a constant-load treadmill test were used to evaluate QoL and Initial/Absolute Claudication Distance, respectively. Both direct and indirect costs of the program were considered for cost-effectiveness analysis. Two-hundred and fifty patients (70.5 ± 9.2 years, M = 191), at Fontaine's II-B stage (86%), were included in the study. No adverse events were reported. The average compliance score was 3.1. At discharge, both SF-36 domains and walking performance significantly increased (P < 0.0001). A total of 1,839 in-hospital check-ups (7.36 /patient) were performed. Direct and indirect costs represented 93% and 7% of the total costs, respectively. The average costs of a visit and of a therapy cycle were C68.93 and C507.20, respectively. The cost to walk an additional meter before stopping was C9.22. A Test-in/Train-out program provided favourable patient compliance, QoL impact and cost-effectiveness in patients with IC.

Recommendations for KYTC's railway/highway at-grade crossing management practices.

DOT National Transportation Integrated Search

2014-12-01

An ideal Railway/Highway At-Grade Crossing Management program involves selecting cost-effective : practices when designing new crossings and rehabilitating existing crossings. This report outlines two : strategies to enhance KYTCs existing program...

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)

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.

The Effectiveness Paradox: Institutional vs Community Placement of Offenders.

ERIC Educational Resources Information Center

Sarri, Rosemary

1981-01-01

Empirical data show that there are more negative consequences for youth offenders committed to institutional rather than community-based programs. However, public policy, governed by political factors rather than knowledge of the relative effectiveness of alternative programs, favors punishment and retribution over rehabilitation goals.…

Using Bibliotherapy to Enhance Probation and Reduce Recidivism

ERIC Educational Resources Information Center

Schutt, Russell K.; Deng, Xiaogang; Stoehr, Taylor

2013-01-01

Prior research indicates that probation programs that include efforts to change cognitive orientations and social patterns can enhance their effectiveness. This article reports an evaluation of an enhanced probation program, Changing Lives Through Literature, which uses a form of bibliotherapy to increase its rehabilitative effect. Controlling for…

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…

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

ERIC Educational Resources Information Center

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

2011-01-01

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

An international comparative overview on the rehabilitation of offenders and effective measures for the prevention of recidivism.

PubMed

Someda, Kei

2009-04-01

The prevention of recidivism has long been a central issue in criminal justice policy. This is justified because an offender who repeatedly commits crime inflicts far greater damage on society than an offender who commits a crime just once in his/her lifetime. For instance, research by the Ministry of Justice of Japan (2007) reveals that only approximately 30% of repeat offenders were responsible for around 60% of the crime committed in Japan from 1948 to 2006. It has been proven that the realization of the rehabilitation of offenders contributes to the reduction of recidivism. The successful rehabilitation of offenders depends in large part upon the effectiveness of the community-based treatment given to offenders based upon an appropriate assessment of multidimensional risk factors and a multidisciplinary approach. In exploring effective community-based treatment of offenders using a multidisciplinary approach, the author touches upon several effective programs from an international comparative view, including: intensive supervision probation/parole (ISP), Drug Court, cognitive behavioral treatment programs and some recent developments related to this field in Japan.

Planning, Implementing, and Maintaining an Effective In-School Suspension Program.

ERIC Educational Resources Information Center

Sullivan, Judy S.

1989-01-01

Notes that many in-school suspension (ISS) programs are used as a temporary controlling technique, rather than a truly rehabilitative measure. Presents 12 steps in planning and implementing, and 10 steps in maintaining, an ISS program that is a positive disciplinary strategy. (NH)

78 FR 21395 - Announcement of Funding Awards, Choice Neighborhoods Grant Program, Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... Program employs a comprehensive approach to community development centered on housing transformation. The... leveraging investments in well-functioning services, effective schools and education programs, public assets... transformation of public and/or HUD-assisted housing developments through preservation, rehabilitation, and...

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...

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...

Home-Based Cardiac Rehabilitation.

ERIC Educational Resources Information Center

Fardy, Paul S.

1987-01-01

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

[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.

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...

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

PubMed

Toonstra, Amy L; Nelliot, Archana; Aronson Friedman, Lisa; Zanni, Jennifer M; Hodgson, Carol; Needham, Dale M

2017-06-01

Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session. Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline. An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

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.

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.

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

Vertical integration strategies: revenue effects in hospital and Medicare markets.

PubMed

Cody, M

1996-01-01

The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.

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...

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...

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.

[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.

Depression Predicts Functional Outcome in Geriatric Inpatient Rehabilitation.

PubMed

Shahab, Saba; Nicolici, Diana-Felicia; Tang, Alva; Katz, Paul; Mah, Linda

2017-03-01

To evaluate the effect of depression on functional recovery in geriatric patients who have completed an inpatient rehabilitation program. Prospective cohort study. Inpatient rehabilitation unit of a university-affiliated geriatric hospital. Convenience sample of patients (N=65; mean age, 81.6y; 25 men) admitted to rehabilitation over a 10-month period. Patients >60 years of age who were proficient in English and capable of providing informed consent were eligible to participate in the study. Depression was assessed using both the Geriatric Depression Scale-short form (GDS-15) and the Patient Health Questionnaire (9-item screen for depression) (PHQ-9). Measures of well-established predictors of rehabilitation outcome, which may interact with depression, were also obtained, and multiple regression linear modeling was used to evaluate the relation between depression and functional outcome over and above the contribution of these other factors. FIM (Functional Independence Measure) at discharge from the rehabilitation program. Depression, as assessed by the GDS-15, but not the PHQ-9, was predictive of functional outcome (standardized beta=-.151, P=.030) after controlling for other significant predictors, which included baseline disability, pain, cognition, and educational level. Participation in recreational, but not physio- or occupational, therapy additionally contributed to a small amount of variance in the functional outcome. Our findings suggest that self-report of depression is an independent predictor of functional outcome in high-tolerance, short-duration geriatric rehabilitation. Routine assessment of depressive symptoms in older adults using an instrument (eg, GDS-15) may help identify those at risk for poorer outcomes in rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

"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.

The Use of Footstep Sounds as Rhythmic Auditory Stimulation for Gait Rehabilitation in Parkinson's Disease: A Randomized Controlled Trial.

PubMed

Murgia, Mauro; Pili, Roberta; Corona, Federica; Sors, Fabrizio; Agostini, Tiziano A; Bernardis, Paolo; Casula, Carlo; Cossu, Giovanni; Guicciardi, Marco; Pau, Massimiliano

2018-01-01

The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson's disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs. The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS. An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5-3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed. www.ClinicalTrials.gov, identifier NCT03228888.

77 FR 22326 - Privacy Act of 1974, as Amended by Public Law 100-503; Notice of a Computer Matching Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

... (OMB). The dates for the matching program will be effective as indicated in ``E. Inclusive Dates of the... Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records--VA (58VA21/22/28... addresses, etc. E. Inclusive Dates of the Matching Program The effective date of the matching agreement and...

Self-management education for rehabilitation inpatients suffering from inflammatory bowel disease: a cluster-randomized controlled trial.

PubMed

Reusch, A; Weiland, R; Gerlich, C; Dreger, K; Derra, C; Mainos, D; Tuschhoff, T; Berding, A; Witte, C; Kaltz, B; Faller, H

2016-12-01

Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management skills, delivered in an interactive manner, and evaluated it in a large, cluster-randomized trial. We assigned 540 rehabilitation inpatients suffering from IBD (mean age 43 years, 66% female) to either the new intervention or a control group comprising the same overall intensity and the same medical information, but only general psychosocial information. The primary outcome was patient-reported IBD-related concerns. Secondary outcomes included disease knowledge, coping, self-management skills, fear of progression, anxiety, depression and quality of life. Assessments took place at baseline, end of rehabilitation and after 3 and 12 months.The psychoeducational self-management program did not prove superior to the control group regarding primary and secondary outcomes. However, positive changes over time occurred in both groups regarding most outcomes. The superior effectiveness of the newly developed psychoeducational program could not be demonstrated. Since the intervention and control groups may have been too similar, this trial may have been too conservative to produce between-group effects. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Augmentative and alternative communication in adolescents with severe intellectual disability: a clinical experience.

PubMed

Uliano, D; Falciglia, G; Del Viscio, C; Picelli, A; Gandolfi, M; Passarella, A

2010-06-01

Augmentative and alternative communication devices proved to be effective in patients with severe intellectual disability to overcome their communication impairments. In order to give a contribution for design of augmentative and alternative communication systems that better meet the needs of beginning communicators we decided to report our clinical experience about using augmentative and alternative communication in adolescents with severe intellectual disability. Five patients who underwent a long time traditional speech rehabilitation program (at least 5 years) with scant improvements in linguistic function were recruited and evaluated by means of the Vineland Adaptive Behaviour Scale before and after a three years augmentative and alternative communication intervention carried out by a multidisciplinary team. After the rehabilitative intervention patients showed an improvement in communication, daily living skills and socialization as measured by the Vineland Adaptive Behaviour Scale. Augmentative and alternative communication is an effective rehabilitation approach to people with severe intellectual disability and impairments in linguistic expression. Moreover augmentative and alternative communication is a useful tool allowing these patients to increase their social participation also enhancing their self-esteem. Our clinical experience confirmed these topics also in adolescents who underwent a long time traditional speech rehabilitation program with scant improvements, providing practical information to clinicians.

An acceptance-oriented cognitive-behavioral therapy in multimodal rehabilitation: a pre-post test evaluation in highly distressed patients with rheumatic diseases.

PubMed

Vriezekolk, Johanna E; Eijsbouts, Agnes M M; van Lankveld, Wim G J M; Beenackers, Hanneke; Geenen, Rinie; van den Ende, Cornelia H M

2013-06-01

To examine the potential effectiveness of a multimodal rehabilitation program including an acceptance-oriented cognitive-behavioral therapy for highly distressed patients with rheumatic diseases. An observational study employing a one-group pre-post test design (N=25). The primary outcome was psychological distress. Secondary outcomes were quality of life, illness acceptance, and coping flexibility. Group pre-to-post and pre-to-12 months follow-up treatment changes were evaluated by paired-samples t-tests and Cohen's effect sizes (d). Individual changes were evaluated by the reliable change index (RCI) and clinically significant change (CSC) parameters. Significant effects were found post-treatment and maintained at 12 months in psychological distress (d>0.80), illness acceptance (d=1.48) and the SF-36 subscales role physical, vitality, and mental health (d ≥ 0.65). No significant effects were found for coping flexibility and the SF-36 subscales physical functioning, bodily pain, social functioning, and role emotional. Both a reliable (RCI) and clinically significant (CSC) improvement was observed for almost half of the highly distressed patients. The patients enrolled in the multimodal rehabilitation program showed improved psychological health status from pre to post-treatment. A randomized clinical trial is needed to confirm or refute the added value of an acceptance-oriented cognitive-behavioral therapy for highly distressed patients in rehabilitation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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 influence of a ten-week Nordic walking training-rehabilitation program on the level of lipids in blood in overweight and obese postmenopausal women

PubMed Central

Hagner-Derengowska, Magdalena; Kałużny, Krystian; Hagner, Wojciech; Kochański, Bartosz; Plaskiewicz, Anna; Borkowska, Alina; Bronisz, Agata; Budzyński, Jacek

2015-01-01

[Purpose] The aim of this study was to evaluate the effect of a ten-week Nordic Walking (NW) rehabilitation program on chosen anthropometric parameters and the level of basic lipids in overweight and obese postmenopausal women’s blood. [Subjects and Methods] The subjects were 32 women aged 50–68 (average: 59.7 ± 5.9 years). The study was carried out following a non-randomized model and entailed NW rehabilitation 5 times a week, which lasted for 10 weeks, as well as a low-calorie 1,500 kcal diet. The therapeutic results of the study were measured through changes in anthropometric and biochemical parameters. The results were subjected to a statistical analysis. [Results] After 10 weeks of NW rehabilitation it was observed that participants lost weight and their body mass index dropped. Additionally, whereas levels of total cholesterol, LDL and triglycerides dropped, and the level of HDL increased. [Conclusion] Rehabilitation carried out according to the NW model resulted in statistically significant changes in basic lipids in blood which, considerably increased the percentage of persons who achieved the recommended level of blood lipids. Obese persons were characterised by a smaller rehabilitation weight loss. More intense workouts and cooperation with a dietician are required. PMID:26644639

[The application of cardiorespiratory training in the framework of the comprehensive programs for the medical rehabilitation of the patients presenting with chronic obstructive pulmonary disease].

PubMed

Mukharlyamov, F Yu; Sycheva, M G; Rassulova, M A

2015-01-01

This article is concerned with the modern concepts of chronic obstructive pulmonary disease. Also, it presents the international definition of "pulmonary rehabilitation". Especially much attention is given to the physical rehabilitation as one of the main and fundamental components of medical rehabilitation of the patients presenting with chronic obstructive pulmonary disease. The up-to-date approaches to the application of fitness gymnastics for the purpose of scientific research and clinical practice are considered with special reference to the combination of cyclic, static, and dynamic loads with the use of relevant modern equipment. The data on the effectiveness and safety of these rehabilitative technologies are discussed in the context of their application for further research in the field of rehabilitative medicine. Recommendations are proposed on the implementation of these methods in the current practical work.

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).

The Transcendental Meditation Program and Rehabilitation at Folsom State Prison

ERIC Educational Resources Information Center

Abrams, Allan I.; Siegel, Larry M.

1978-01-01

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

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

PubMed

Ebrahimi, Amir Abbas; Jamshidi, Ali Ashraf; Movallali, Guita; Rahgozar, Mehdi; Haghgoo, Hojjat Allah

2017-11-01

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

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.

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.

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.

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...

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.

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)

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.

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.

Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis.

PubMed

Khan, Fary; Ng, Louisa; Turner-Stokes, Lynne

2009-01-21

Multiple sclerosis is a neurological disease that frequently affects adults of working age, resulting in a range of physical, cognitive and psychosocial deficits that impact on workforce participation. Although, the literature supports vocational rehabilitation (VR) approaches in persons with multiple sclerosis (pwMS), the evidence for its effectiveness is yet to be established. To evaluate the effectiveness of VR programs compared to alternative programs or care as usual on return to work, workability and employment in pwMS; to evaluate the cost effectiveness of these programs. Electronic searches included: Cochrane Central Register of Controlled Trials "CENTRAL" 2008 issue 3, MEDLINE (PubMed) (1966- 2008), EMBASE (1988- 2008), CINAHL (1982- 2008), PEDro (1990- 2008), the Cochrane Rehabilitation and Related Therapies Field trials Register and the National Health Service National Research Register. Randomized and controlled clinical trials, including before - after controlled trials, that compare VR rehabilitation with alternative intervention such as standard or a lesser form of intervention or waitlist controls. Two reviewers selected trials and rated their methodological quality independently. A 'best evidence' synthesis was performed, based on methodological quality. Trials were grouped in terms of type and setting of VR programs. Two trials (one RCT and one CCT) (total 80 participants) met the review criteria. Both trials scored poorly on the methodological quality assessment. There was 'insufficient evidence' for VR programs for (a)'competitive employment', in altering rates of job retention, changes in employment, improvement in rates of re-entry into the labour force; (b) for altering 'work ability' by improving participants' confidence in the accommodation request process, or employability maturity or job seeking activity. No evidence could be assimilated for changes in proportions of persons in supported employment or on disability pensions, nor for cost-effectiveness. There was inconclusive evidence to support VR for pwMS. However, the review highlights some of the challenges in providing VR for pwMS. Clinicians need to be aware of vocational issues, and to understand and manage barriers for maintaining employment. Proactive and timely VR programs should incorporate practical solutions to deal with work disability, workplace accommodation and educate employers, and the wider community. Liaison with policy makers is imperative for government initiatives that encourage work focused VR programs. Future research in VR should focus on improving methodological and scientific rigour of clinical trials; on the development of appropriate and valid outcome measures; and on cost effectiveness of VR programs.

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.

[Effectiveness of therapeutic education and respiratory rehabilitation programs for the patient with asthma].

PubMed

Cano-De La Cuerda, Roberto; Useros-Olmo, Ana Isabel; Muñoz-Hellín, Elena

2010-11-01

Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. The education of the asthmatic patient and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in the scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient. Copyright © 2010 SEPAR. Published by Elsevier Espana. All rights reserved.

The effect of static scanning and mobility training on mobility in people with hemianopia after stroke: A randomized controlled trial comparing standardized versus non-standardized treatment protocols

PubMed Central

2011-01-01

Background Visual loss following stroke impacts significantly on activities of daily living and is an independent risk factor for becoming dependent. Routinely, allied health clinicians provide training for visual field loss, mainly with eye movement based therapy. The effectiveness of the compensatory approach to rehabilitation remains inconclusive largely due to difficulty in validating functional outcome with the varied type and dosage of therapy received by an individual patient. This study aims to determine which treatment is more effective, a standardized approach or individualized therapy in patients with homonymous hemianopia post stroke. Methods/Design This study is a double-blind randomized controlled, multicenter trial. A standardised scanning rehabilitation program (Neuro Vision Technology (NVT) program) of 7 weeks at 3 times per week, is compared to individualized therapy recommended by clinicians. Discussion The results of the trial will provide information that could potentially inform the allocation of resources in visual rehabilitation post stroke. Trial Registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000494033 PMID:21767413

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

ERIC Educational Resources Information Center

Rehabilitation Services Administration (ED), Washington, DC.

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

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

PubMed

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

2011-02-01

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

Neuropsychological benefits of computer-assisted cognitive rehabilitation (using FORAMENRehab program) in children with mild traumatic brain injury or partial epilepsy: A pilot study.

PubMed

Kaldoja, Mari-Liis; Saard, Marianne; Lange, Kirsi; Raud, Triin; Teeveer, Ott-Kaarel; Kolk, Anneli

2015-01-01

The number of children with different cognitive difficulties is constantly increasing. Still, too few evidence-based pediatric neurocognitive rehabilitation programs exist. The main aim of the study was to assess the efficiency and usability of computer-assisted FORAMENRehab program for training specific components of attention in children with mild traumatic brain injury (mTBI) and partial epilepsy (PE). The second aim was to specify short- and long-term effects of the intervention. Eight children between the ages of 9-12 years with attention impairment (3 with PE and 5 with mTBI) and 18 healthy controls participated. FORAMENRehab Attention software, adapted by the authors, was used for intervention. Strict intervention protocol consisting of patients completing 10 sessions over a 6-week-period to train four components of attention (sustaining, focusing, dividing, tracking) was designed and applied. Follow-up assessments were conducted after the end of the last training and 1.63 years later. After the intervention patients' sustained and complex attention improved. Long-term follow-up revealed continuing positive rehabilitation effects. 100% compliance suggested that the used method is attractive for children. These preliminary results of the pilot study give reason to presume that the method is effective in attention impairment remediation. However, more thorough research is needed.

NASA Musculoskeletal Space Medicine and Reconditioning Program

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Scheuring, Richard

2011-01-01

The Astronaut Strength, Conditioning, and Rehabilitation (ASCR) group is comprised of certified strength and conditioning coaches and licensed and certified athletic trainers. The ASCR group works within NASA s Space Medicine Division providing direction and supervision to the astronaut corp with regards to physical readiness throughout all phases of space flight. The ASCR group is overseen by flight surgeons with specialized training in sports medicine or physical medicine and rehabilitation. The goals of the ASCR group include 1) designing and administering strength and conditioning programs that maximize the potential for physical performance while minimizing the rate of injury, 2) providing appropriate injury management and rehabilitation services, 3) collaborating with medical, research, engineering, and mission operations groups to develop and implement safe and effective in-flight exercise countermeasures, and 4) providing a structured, individualized post-flight reconditioning program for long duration crew members. This Panel will present the current approach to the management of musculoskeletal injuries commonly seen within the astronaut corp and will present an overview of the pre-flight physical training, in-flight exercise countermeasures, and post-flight reconditioning program for ISS astronauts.

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.

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.

Impact of Obesity and Other Chronic Conditions on Lifestyle Exercise During the Year After Completion of Cardiac Rehabilitation.

PubMed

Sattar, Abdus; Josephson, Richard; Moore, Shirley M

2017-07-01

Patients who attend cardiac rehabilitation programs have a high prevalence of multiple chronic conditions (MCCs). The extent to which different constellations of MCC influence lifestyle exercise in the year after completion of an outpatient phase 2 cardiac rehabilitation program (CRP) is unknown. Our objective was to examine the effects of MCC on lifestyle exercise in the year after completion of a CRP. The effects of different constellations of comorbidities on objectively measured lifestyle exercise were examined using data from a randomized controlled trial testing lifestyle behavior change interventions in patients with cardiac events (n = 379) who completed a phase 2 CRP. Adjusting for important covariates, the relationships between the primary outcome, exercise amount, and the presence of common chronic conditions (hypertension, obesity, diabetes, and arthritis) were studied using robust linear mixed-effects models. Diabetes, hypertension, obesity, and their dyads, triads, and quads have a negative impact on amount of exercise. For example, the cooccurrences of obesity and hypertension reduced lifestyle exercise by 2.83 hours per month (95% CI, 1.33-4.33) after adjustment for the effects of covariates. The presence of obesity was a major factor in the comorbid constellations affecting lifestyle exercise. The presence of obesity and other chronic conditions negatively impacts lifestyle exercise in the year after a CRP. The magnitude of the effect depends on the comorbidities. Different constellations of comorbid conditions can be used to identify those persons at greatest risk for not exercising after cardiac rehabilitation.

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.

Examining the Hospital Elder Life Program in a rehabilitation setting: a pilot feasibility study.

PubMed

Huson, Kelsey; Stolee, Paul; Pearce, Nancy; Bradfield, Corrie; Heckman, George A

2016-07-18

The Hospital Elder Life Program (HELP) has been shown to effectively prevent delirium and functional decline in older patients in acute care, but has not been examined in a rehabilitation setting. This pilot study examined potential successes and implementation factors of the HELP in a post-acute rehabilitation hospital setting. A mixed methods (quantitative and qualitative) evaluation, incorporating a repeated measures design, was used. A total of 100 patients were enrolled; 58 on the pilot intervention unit and 42 on a usual care unit. Group comparisons were made using change scores (pre-post intervention) on outcome measures between pilot unit patients and usual care patients (separate analyses compared usual care patients with pilot unit patients who did or did not receive the HELP). Qualitative data were collected using focus group and individual interviews, and analyzed using emergent coding procedures. Delirium prevalence reduced from 10.9 % (n = 6) to 2.5 % (n = 1) in the intervention group, while remaining the same in the usual care group (2.5 % at both measurement points). Those who received the HELP showed greater improvement on cognitive and functional outcomes, particularly short-term memory and recall, and a shorter average length of stay than patients who did not. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP in a rehabilitation setting. This study adds to the limited research on delirium and the effectiveness of the HELP in post-acute rehabilitation settings. The HELP was found to be feasible and have potential benefits for reduced delirium and improved outcomes among rehabilitation patients.

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

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.

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.

Home-based hand rehabilitation with a robotic glove in hemiplegic patients after stroke: a pilot feasibility study.

PubMed

Bernocchi, Palmira; Mulè, Chiara; Vanoglio, Fabio; Taveggia, Giovanni; Luisa, Alberto; Scalvini, Simonetta

2018-03-01

To evaluate the feasibility and safety of home rehabilitation of the hand using a robotic glove, and, in addition, its effectiveness, in hemiplegic patients after stroke. In this non-randomized pilot study, 21 hemiplegic stroke patients (Ashworth spasticity index ≤ 3) were prescribed, after in-hospital rehabilitation, a 2-month home-program of intensive hand training using the Gloreha Lite glove that provides computer-controlled passive mobilization of the fingers. Feasibility was measured by: number of patients who completed the home-program, minutes of exercise and number of sessions/patient performed. Safety was assessed by: hand pain with a visual analog scale (VAS), Ashworth spasticity index for finger flexors, opponents of the thumb and wrist flexors, and hand edema (circumference of forearm, wrist and fingers), measured at start (T0) and end (T1) of rehabilitation. Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip test) were also measured at T0 and T1. Patients performed, over a mean period 56 (49-63) days, a total of 1699 (1353-2045) min/patient of exercise with Gloreha Lite, 5.1 (4.3-5.8) days/week. Seventeen patients (81%) completed the full program. The mean VAS score of hand pain, Ashworth spasticity index and hand edema did not change significantly at T1 compared to T0. The MI, NHPT and Grip test improved significantly (p = 0.0020, 0.0156 and 0.0024, respectively) compared to baseline. Gloreha Lite is feasible and safe for use in home rehabilitation. The efficacy data show a therapeutic effect which need to be confirmed by a randomized controlled study.

The effect of radical treatment and rehabilitation on muscle mass and strength: a randomized trial in stages I-III lung cancer patients.

PubMed

Salhi, B; Huysse, W; Van Maele, G; Surmont, V F; Derom, E; van Meerbeeck, J P

2014-04-01

Little is known about the impact of an oncological treatment on muscle mass and strength in patients with lung cancer and the impact of a subsequent rehabilitation program. This study investigates the effect of radical treatment and post-treatment pulmonary rehabilitation on muscle mass and strength in patients with lung cancer and the relationship between muscle mass and strength. Lung cancer patients, candidate for radical treatment, were randomly (2:1) allocated after radical treatment to either standard follow up (CON) or a 12-week rehabilitation training program (RT). Muscle mass was estimated by bioelectric impedance and CT-scan. Muscle strength was estimated by measuring quadriceps force (QF) with a hand held dynamometer. All variables were measured before (M1) and after radical treatment (M2), and at the earliest 12 weeks after randomization (M3). Data are presented as means with standard deviation. 45 lung cancer patients (age: 65 years (9)) participated in the study. At M2, both muscle cross sectional area (MCSA) and QF were significantly decreased (p<0.05). 28 patients were randomized. 13/18 RT and 9/10 CON patients ended the trial. At M3, RT-patients improved significantly their MCSA compared to CON-patients (ΔMCSA: 6 cm(2) (6) (p=0.003) vs. 1cm(2) (11) (p=0.8)). Muscle mass and strength: (1) are decreased at presentation in a substantial part of lung cancer patients; (2) are significantly negatively affected by radical treatment and (3) completely recover after a 12 week structured rehabilitation program, whereas a further decline was observed in CON-patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cognitive rehabilitation therapies for Alzheimer's disease: A review of methods to improve treatment engagement and self-efficacy

PubMed Central

Choi, Jimmy; Twamley, Elizabeth W.

2013-01-01

Cognitive rehabilitation therapies for Alzheimer’s disease (AD) are becoming more readily available to the geriatric population in an attempt to curb the insidious decline in cognitive and functional performance. However, people with AD may have difficulty adhering to these cognitive treatments due to denial of memory deficits, compromised brain systems, cognitive incapacity for self-awareness, general difficulty following through on daily tasks, lack of motivation, hopelessness, and apathy, all of which may be either due to the illness or be secondary to depression. Cognitive rehabilitation training exercises are also labor intensive and, unfortunately, serve as a repeated reminder about the memory impairments and attendant functional consequences. In order for cognitive rehabilitation methods to be effective, patients must be adequately engaged and motivated to not only begin a rehabilitation program but also to remain involved in the intervention until a therapeutic dosage can be attained. We review approaches to cognitive rehabilitation in AD, neuropsychological as well as psychological obstacles to effective treatment in this population, and methods that target adherence to treatment and may therefore be applicable to cognitive rehabilitation therapies for AD. The goal is to stimulate discussion among researchers and clinicians alike on how treatment effects may be mediated by engagement in treatment, and what can be done to enhance patient adherence for cognitive rehabilitation therapies in order to obtain greater cognitive and functional benefits from the treatment itself. PMID:23400790

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

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

PubMed Central

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

2014-01-01

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

Review of self-awareness and its clinical application in stroke rehabilitation.

PubMed

Leung, Daniel P K; Liu, Karen P Y

2011-09-01

The objectives of this study were (i) to explore, following a literature review, the concepts of self-awareness, its assessment, and intervention for self-awareness deficits, as well as its clinical significance in stroke rehabilitation; and (ii) to apply the concepts of self-awareness in the context of a rehabilitation program. The search was conducted by the electronic databases Web of Science, Science Direct, MEDLINE, and PsychcInfo. A systematic literature search of publications written in English between 1980 and 2010 was conducted using the keywords, self-awareness or self-regulation. The search was limited to the following keywords: stroke, deficits, assessment, intervention, and rehabilitation. Two important conceptual models, namely, the Pyramid Model of Self-Awareness and the Dynamic Comprehensive Model of Awareness, were reviewed. Suggestions were made to the constraint-induced movement therapy for enhancement of both assessment and treatment of self-awareness deficits. In conclusion, self-awareness is essential for the success of rehabilitation. It is hoped that more studies can be conducted on the effectiveness of awareness enhancement programs incorporated in on-going therapies can be conducted, so that the evidence base can be further built up in this evolving area of practice.

Between suffering and hope: rehabilitation from urinary incontinence as an intervening component.

PubMed

Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini

2013-07-01

This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI) and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope--rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS) in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.

Study protocol: to investigate effects of highly specialized rehabilitation for patients with multiple sclerosis. A randomized controlled trial of a personalized, multidisciplinary intervention

PubMed Central

2012-01-01

Background Multiple sclerosis (MS) is a complex, chronic and progressive disease and rehabilitation services can provide important support to patients. Few MS rehabilitation programs have been shown to provide health improvements to patients in a cost-effective manner. The objective of this study is to assess the effects in terms of changes measured by a variety of standardized quality of life, mastery, coping, compliance and individual goal-related endpoints. This combination provides the basis for analyzing the complexity of MS and outcomes of a personalized rehabilitation. Methods/Design Patients with MS referred to hospital rehabilitation services will be randomized to either early admission (within two months) or usual admission (after an average waiting time of eight months). They will complete a battery of standardized health outcome instruments prior to randomization, and again six and twelve months after randomization, and a battery of goal-related outcome measures at admission and discharge, and again one, six and twelve months after randomization. Discussion The results of the study are expected to contribute to further development of MS rehabilitation services and to discussions about the design and content of such services. The results will also provide additional information to health authorities responsible for providing and financing rehabilitation services. Trial registration Current Controlled Trials (ISRCTN05245917) PMID:22954027

[The painful hemiplegic shoulder: effects of exercises program according to Bobath].

PubMed

Gialanella, B; Benvenuti, P; Santoro, R

2004-01-01

To verify whether a shoulder exercises program according to Bobath reduced the shoulder pain in hemiplegic patients. We studied a total of 20 patients with pain shoulder. Ten patients are assigned to group R (submitted to rehabilitation) and ten to group R+E (submitted to rehabilitation and shoulder exercises program according to Bobath). Shoulder exercises program was self-performed by the patients after training in occupational rehabilitation unit. The assessment of patients was performed at admission to hospital, at discharge and three months after discharge. Shoulder pain (VAS), shoulder range of motion, disability (FIM), motor function (Fugl-Meyer scale) and spasticity (Ashworth scale) of paretic arm were evaluated in all patients. VAS was similar in both groups at admission and decreased in group R+E at discharge without reaching significant differences (p=0.253). On the contrary, VAS and Shoulder range of motion improved statistically in group R+E (p=0.0001, p<0.04 respectively) after three months. The others variables measured did not change. This study showed that a shoulder exercises program according to Bobath reduces shoulder pain of patients with hemiplegia if it is performed daily and for a long period of time.

Behavior change outcomes in an outpatient cardiac rehabilitation program.

PubMed

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

2002-05-01

To evaluate the effectiveness of nutrition education within an outpatient cardiac rehabilitation program. Subjects were assigned, according to participation in cardiac rehabilitation programs in two community hospitals within an integrated healthcare system, to either a treatment (n=54), or a control group (n=50). One hundred four men and women, age range 35 to 85 years, participating in a 6-week cardiac rehabilitation program. Most were men (80%) and overweight. The majority presented with the diagnosis of myocardial infarction followed by coronary artery bypass surgery or percutaneous transluminal coronary angiography procedure. Subjects in the control group received usual nonindividualized nutrition education from cardiac rehabilitation therapists. Subjects in the treatment group attended two group nutrition education classes and one individual diet counseling session, all led by the same dietitian. Changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey; changes in cardiac diet self-efficacy; and changes in health-related quality of life. Statistical analyses performed Group-by-time analysis of variance with repeated measures, chi2 test. The treatment group had greater improvement in Restaurant and Recipes scores on the Diet Habit Survey (2.6 vs 1.0) and a greater cardiac diet self-efficacy mean score (4.3) compared with the control group (3.8), with the greatest change in items related to eating in restaurants, away from home, or when alone. From entry into the program to discharge, the cholesterol-saturated fat index decreased significantly in the control group (from 57 to 48), and in the treatment group (from 51 to 42). The percent of energy from carbohydrate increased significantly in the control group (from 51% to 55%) and in the treatment group (from 53% to 57%). There were no differences between groups over the 3 time periods (baseline, 6 weeks, and 3-month follow-up) (n=39 for control group and n=47 for treatment group for all 3 time periods). Nutrition education within an outpatient cardiac rehabilitation program can improve dietary choices at restaurants and boost self confidence in the ability to adhere to a lipid-lowering diet.

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

PubMed

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

2017-05-01

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

Effects of a 4-Week Biomechanical Ankle Platform System Protocol on Balance in High School Athletes With Chronic Ankle Instability.

PubMed

Cain, Mary Spencer; Garceau, Stacy Watt; Linens, Shelley W

2017-01-01

Chronic ankle instability (CAI) describes the residual symptoms present after repetitive ankle sprains. Current rehabilitation programs in the high school population focus on a multistation approach or general lower-extremity injury-prevention program. Specific rehabilitation techniques for CAI have not been established. To determine the effectiveness of a 4-wk biomechanical ankle platform system (BAPS) board protocol on the balance of high school athletes with CAI. Randomized control trial. Athletic training facility. Twenty-two high school athletes with "giving way" and a history of ankle sprains (ie, CAI) were randomized into a rehabilitation (REH) (166.23 ± 0.93 cm, 67.0 ± 9.47 kg, 16.45 ± 0.93 y) or control (CON) (173.86 ± 8.88 cm, 84.51 ± 21.28 kg, 16.55 ± 1.29 y) group. After baseline measures, the REH group completed a progressive BAPS rehabilitation program (3 times/wk for 4 wk), whereas the CON group had no intervention. Each session consisted of 5 trials of clockwise/counterclockwise rotations changing direction every 10 s during each 40-s trial. After 4 wk, baseline measurements were repeated. Dependent measures included longest time (time-in-balance test), average number of errors (foot lift test), average reach distance (cm) normalized to leg length for each reach direction (Star Excursion Balance Test [SEBT]), and fastest time (side hop test [SHT]). Significant group-by-time interactions were found for TIB (F 1,20 = 9.89, P = .005), FLT (F 1,20 = 41.18, P < .001), SEBT-anteromedial (F 1,20 = 5.34, P = .032), SEBT-medial (F 1,20 = 7.51, P = .013), SEBT-posteromedial (F 1,20 = 12.84, P = .002), and SHT (F 1,20 = 7.50, P = .013). Post hoc testing showed that the REH group improved performance on all measures at posttest, whereas the CON group did not. A 4-wk BAPS rehabilitation protocol improved balance in high school athletes suffering from CAI. These results can allow clinicians to rehabilitate in a focused manner by using 1 rehabilitation tool that allows benefits to be accomplished in a shorter time.

Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial.

PubMed

Beemster, Timo T; van Velzen, Judith M; van Bennekom, Coen A M; Frings-Dresen, Monique H W; Reneman, Michiel F

2015-07-28

Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the design of a non-inferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain. A non-inferiority study design will be applied. The study population consists of workers who are on part-time or full-time sick leave due to subacute or chronic nonspecific musculoskeletal pain. Two multidisciplinary vocational rehabilitation programs following the bio-psychosocial approach will be evaluated in this study: 40-h vocational rehabilitation and 100-h vocational rehabilitation, both delivered over a maximum of 15 weeks. The 100-h vocational rehabilitation comprises five modules: work participation coordination, graded activity, cognitive behavioral therapy, group education, and relaxation. The 40-h vocational rehabilitation comprises work participation coordination and a well-reasoned choice from the other four modules. Four rehabilitation centers will participate in this study, each delivering both interventions. Patients will be randomized into one of the interventions, stratified for the duration of sick leave (<6 weeks or ≥ 6 weeks) and type of sick leave (part-time or full-time). The primary outcome is work participation, measured by self-reported sick leave days, and will be assessed at baseline, mid-term, discharge, and at 2, 4, 6, 8, 10, and 12 months follow-up. Secondary outcomes are work ability, disability, quality of life, and physical functioning and will be assessed at baseline, discharge, and at 6 and 12 months follow-up. Cost outcomes are absenteeism, presenteeism, healthcare usage, and travelling costs. Cost-effectiveness will be evaluated from the societal and employer perspectives. The results obtained from this study will be useful for vocational rehabilitation practice and will provide stakeholders with relevant insights into two versions of vocational rehabilitation. Dutch Trial Register identifier: NTR4362 (registered 17 March 2014).

75 FR 39431 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... Information; 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; Notice Inviting...

75 FR 39429 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... 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...

75 FR 27324 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... 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...

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...

Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain?

PubMed

Maharaj, Sonill S; Yakasai, Abdulsalam M

2018-05-01

Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain. A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman and Wilcoxon signed rank tests. There were 136 participants (mean [SD] age = 36.79 [8.23] yrs) and the exercise groups completed the protocols without any adverse effects. Pain scores within and between aerobic exercise and progressive resisted exercise groups showed significant improvement (P < 0.05) from baseline to 6 and 12 wks compared with the control (P > 0.05). This study supports a rehabilitation program of moderate-intensity aerobic exercise and progressive resisted exercise being safe and effective for reducing neuropathic pain and is beneficial with analgesics for HIV-induced distal symmetrical polyneuropathy.

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.

Effects of Timing and Intensity of Neurorehabilitation on Functional Outcome After Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

PubMed

Königs, Marsh; Beurskens, Eva A; Snoep, Lian; Scherder, Erik J; Oosterlaan, Jaap

2018-06-01

To systematically review evidence on the effects of timing and intensity of neurorehabilitation on the functional recovery of patients with moderate to severe traumatic brain injury (TBI) and aggregate the available evidence using meta-analytic methods. PubMed, Embase, PsycINFO, and Cochrane Database. Electronic databases were searched for prospective controlled clinical trials assessing the effect of timing or intensity of multidisciplinary neurorehabilitation programs on functional outcome of patients with moderate or severe TBI. A total of 5961 unique records were screened for relevance, of which 58 full-text articles were assessed for eligibility by 2 independent authors. Eleven articles were included for systematic review and meta-analysis. Two independent authors performed data extraction and risk of bias analysis using the Cochrane Collaboration tool. Discrepancies between authors were resolved by consensus. Systematic review of a total of 6 randomized controlled trials, 1 quasi-randomized trial, and 4 controlled trials revealed consistent evidence for a beneficial effect of early onset neurorehabilitation in the trauma center and intensive neurorehabilitation in the rehabilitation facility on functional outcome compared with usual care. Meta-analytic quantification revealed a large-sized positive effect for early onset rehabilitation programs (d=1.02; P<.001; 95% confidence interval [CI], 0.56-1.47) and a medium-sized positive effect for intensive neurorehabilitation programs (d=.67; P<.001; 95% CI, .38-.97) compared with usual care. These effects were replicated based solely on studies with a low overall risk of bias. The available evidence indicates that early onset neurorehabilitation in the trauma center and more intensive neurorehabilitation in the rehabilitation facility promote functional recovery of patients with moderate to severe TBI compared with usual care. These findings support the integration of early onset and more intensive neurorehabilitation in the chain of care for patients with TBI. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An interactive game-based shoulder wheel system for rehabilitation

PubMed Central

Chang, Chun-Ming; Chang, Yen-Ching; Chang, Hsiao-Yun; Chou, Li-Wei

2012-01-01

Background: Increases in the aging population and in the number of accidents have resulted in more people suffering from physical impairments or disabilities. Rehabilitation therapy thus attracts greater attention as a means of helping patients recover and return to a normal life. With the extremely long and tedious nature of traditional rehabilitation, patients are reluctant to continue the entire process, thus the expected effects of the therapy cannot be obtained. Games are well known to help patients improve their concentration and shift their attention away from the discomfort of their injuries during rehabilitation. Thus, incorporating game technology into a rehabilitation program may be a promising approach. Methods: In this study, a gaming system used for shoulder rehabilitation was developed. The mechanical parts and electric circuits were integrated to mimic the functionalities of a shoulder wheel. Several games were also designed to suit the rehabilitation needs of the patients based on the age and gender differences among the individual users, enabling individuals to undergo the rehabilitation process by playing games. Two surveys were conducted to evaluate the satisfaction of the participants regarding the gaming system. Results: The results of the online survey among a larger population coincide with the responses of the hands-on participants through a paper-and-pencil survey. Statistical results suggest that the participants are willing to accept this novel approach. Conclusion: This gaming system can distract a patient from the sensation of pain or anxiety, and increase their motivation to participate in the therapeutic program. Advantages in terms of low-cost and easy setup increase the attractiveness of this new equipment for various potential users. PMID:23226005

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...

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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...

Global Mobility Task: index for evaluating motor impairment and motor rehabilitation programs in Parkinson's disease patients.

PubMed

Peppe, A; Ranaldi, A; Chiavalon, C; Gasbarra, A; Collepardo, A; Romeo, R; Pasqualetti, P; Caltagirone, C

2007-09-01

In this study, the validity of a motor task, i.e., the Global Mobility Task (GMT), was assessed in a group of Parkinson's disease (PD) patients. Fifty-eight PD patients (mean age: 68.7 years) and 18 healthy subjects (mean age: 65.8 years) were enrolled in the study. The GMT measures the ability of an adult to roll over on the floor and stand up in five steps using two parameters: 'Time' and 'Score', i.e., the time needed and the ability to perform each step of the task. As the GMT has never been evaluated before, internal consistency and concurrent and discriminative validity were considered in assessing its characteristics in a group of PD patients at the beginning and at the end of a motor rehabilitation program. To determine whether the GMT could also quantify the extrapyramidal impairment, we compared data collected using this task with data obtained using clinical scales such as the Unified Parkinson's Disease Rating Scale III (UPDRS part III) and Hoehn & Yahr's score. Results showed that the GMT had good consistency and inter-rater reproducibility, was closely related to clinical scales and was able to detect the amelioration of extrapyramidal symptoms at the end of the motor rehabilitation program. we propose the GMT as a tool for measuring impaired mobility in PD patients and for evaluating the objective effects of motor rehabilitation programs.

Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials.

PubMed

In, Taesung; Lee, Kyeongjin; Song, Changho

2016-10-28

BACKGROUND Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. MATERIAL AND METHODS Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. RESULTS There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). CONCLUSIONS Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training.

Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials

PubMed Central

In, Taesung; Lee, Kyeongjin; Song, Changho

2016-01-01

Background Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. Material/Methods Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. Results There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). Conclusions Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training. PMID:27791207

Influence of ambient music on perceived exertion during a pulmonary rehabilitation session: a randomized crossover study.

PubMed

Reychler, Gregory; Mottart, Florian; Boland, Maelle; Wasterlain, Emmanuelle; Pieters, Thierry; Caty, Gilles; Liistro, Giuseppe

2015-05-01

Pulmonary rehabilitation is a key element in the treatment of COPD. Music has been shown to have a positive effect on parameters related to a decrease in exercise tolerance. The aim of this study was to evaluate the effect of listening to ambient music on perceived exertion during a pulmonary rehabilitation session for COPD subjects. COPD subjects randomly performed a session of pulmonary rehabilitation with or without ambient music. Perceived exertion (Borg scales), anxiety (Hospital Anxiety and Depression Scale-Anxiety Subscale), dyspnea (visual analog scale), and cardiorespiratory parameters were compared at the end of both sessions. Forty-one subjects were analyzed. The characteristics of the COPD subjects were as follows: age, 70.5 ± 8.4 y; body mass index, 22.7 ± 3.9 kg/m(2); and FEV1, 38.6 ± 12.5 % predicted. Perceived exertion was not modified by ambient music, but anxiety was improved (P = .02). Dyspnea, fatigue and cardiorespiratory parameters were not influenced by music during a typical session of the pulmonary rehabilitation program. This study demonstrates that perceived exertion during one pulmonary rehabilitation session was not influenced by ambient music. However, a positive effect on anxiety was observed. (ClinicalTrials.gov registration NCT01833260.). Copyright © 2015 by Daedalus Enterprises.

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).

Cost-effectiveness of early versus delayed functional restoration for chronic disabling occupational musculoskeletal disorders.

PubMed

Theodore, Brian R; Mayer, Tom G; Gatchel, Robert J

2015-06-01

Despite extensive evidence for the treatment effectiveness of interdisciplinary functional restoration (FR) for chronic disabling occupational musculoskeletal disorders (CDOMD), there is little documentation on the cost-effectiveness of early rehabilitation using FR. A total of 1,119 CDOMD patients were classified according to duration of disability on FR entry, corresponding to early rehabilitation (ER: 4-8 months of disability, N = 373), intermediate duration (ID: 9-18 months, N = 373), and delayed rehabilitation (DR: >18 months, N = 373). Groups were matched on sex, age, ethnicity, and injured musculoskeletal region. One-year post-rehabilitation outcomes included return-to-work, work retention and healthcare utilization. Economic analyses included a cost-effectiveness analysis of the FR program, and estimation of the total cost-of-illness. At 1-year post-rehabilitation, all groups were comparable on return-to-work (overall 88%), work retention (overall 80%), and additional healthcare utilization (overall, 2.2% of patients received re-operations/new surgeries, 2 visits to new healthcare provider). Savings of up to 64% in medical costs, and up to 80% in disability benefits and productivity losses was associated with the ER group. The cost of rehabilitation was also up to 56% lower when administered early. Overall, ER resulted in estimated cost savings of up to 72% (or almost $170,000 per claim). Duration of disability does not negatively impact objective work or healthcare utilization outcomes following interdisciplinary FR. However, early rehabilitation is more likely to be a cost-effective solution compared to cases that progress >8 months and receiving FR as a treatment of "last resort".

EFFECTS OF DIFFERENT DURATION EXERCISE PROGRAMS IN CHILDREN WITH SEVERE BURNS

PubMed Central

Clayton, Robert P.; Wurzer, Paul; Andersen, Clark R.; Mlcak, Ronald P.; Herndon, David N.; Suman, Oscar E.

2016-01-01

Introduction Burns lead to persistent and detrimental muscle breakdown and weakness. Standard treatment at our institution includes a voluntary 12-week rehabilitative exercise program to limit and reverse the effects of increased muscle catabolism. In the present work, we investigated if different durations of exercise, 6 or 12 weeks, produce comparable improvements in muscle strength, body composition, and cardiopulmonary fitness. Methods We prospectively enrolled and randomized patients with ≥30% total body surface area (TBSA) burned to receive 6- or 12-weeks of exercise rehabilitation. Patients were evaluated for muscle strength, oxygen consumption capacity, and lean body mass at discharge (n = 42) and post exercise. After 6 weeks (n = 18) or 12 weeks (n = 24) of exercise training, leg muscle strength was assessed as peak torque per body weight using a Biodex Isokinetic Dynamometer. Oxygen consumption capacity, measured as peak VO2, was studied using a standard treadmill-based test, and lean body mass was determined using dual-energy X-ray absorptiometry. Results Significant improvements in muscle strength, peak VO2, and lean body mass were seen after 6 weeks of exercise training (p<0.001), with only significant improvements in peak VO2 being seen after 6 weeks more of training. Conclusion These data suggest that a 6-week rehabilitative exercise program is sufficient for improving muscle strength, body composition, and cardiopulmonary fitness in pediatric burn patients. However, continuation of at- or near-home cardiopulmonary training following the 6 weeks of at-hospital rehabilitation may be useful. PMID:27908464

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

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

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... DEPARTMENT OF EDUCATION Applications for New Awards; Disability and Rehabilitation Research... Rehabilitative Services, National Institute on Disability and Rehabilitation Research (NIDRR), Department of Education. ACTION: Notice. Overview Information Disability and Rehabilitation Research Projects and Centers...

78 FR 14947 - Proposed Priorities-National Institute on Disability and Rehabilitation Research-Disability and...

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...-the-science conferences, webinars, Web sites, and other dissemination methods; and Coordinate research... and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers AGENCY: Office of Special Education and Rehabilitative Services...

Motions and functional performance after supervised physical therapy program versus home-based program after arthroscopic anterior shoulder stabilization: a randomized clinical trial.

PubMed

Ismail, M M; El Shorbagy, K M

2014-01-01

To compare the effects of a standardized supervised physical therapy versus a controlled home-based programs on the rate of shoulder motion and functional recovery after arthroscopic anterior shoulder stabilization. Twenty-seven patients (18-35years) underwent arthroscopic anterior shoulder stabilization. Patients were randomized into two groups. A supervised group (n=14) received a rehabilitation program, 3 sessions/week for 24 weeks and a controlled home treated group (n=13) who followed a home-based program for same period. Range of motion (ROM) of the shoulder was assessed 4 times after each phase of rehabilitation and function was assessed after the 3rd and 4th phase of rehabilitation. Both groups achieved a significant progressive increase in all shoulder motions throughout the study period. Patients in the supervised group achieved 92.6% and 94.2% of the contralateral side in abduction and forward elevation respectively. The controlled home-based group achieved 87.1% and 94.7% of abduction and forward elevation respectively. For external rotation, the percentage ROM achieved was 81.1% for the supervised group and 76.4% for the controlled home-based group. For function assessment, the two groups showed a significant improvement. However, the two groups were not significantly different from each other in all measured variables. A controlled home-based physical therapy program is as effective as a supervised program in increasing shoulder range of motion and function after arthroscopic anterior shoulder stabilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Effect of a virtual reality-enhanced exercise protocol after coronary artery bypass grafting.

PubMed

Chuang, Tien-Yow; Sung, Wen-Hsu; Chang, Hwa-Ann; Wang, Ray-Yau

2006-10-01

Virtual reality (VR) technology has gained importance in many areas of medicine. Knowledge concerning the application and the influence of VR-enhanced exercise programs is limited for patients receiving coronary artery bypass grafting. The purpose of this study was to evaluate the effect of a virtual "country walk" on the number of sessions necessary to reach cardiac rehabilitation goals in patients undergoing coronary artery bypass grafting. Twenty subjects who were seen for cardiac rehabilitation between January and June 2004 comprised the study sample. The protocol for this study included an initial maximum graded exercise tolerance test, given to determine the subsequent training goals for the subject, followed by biweekly submaximal endurance training sessions. All subjects were assigned by lot to 1 of 2 submaximal endurance training programs, one (group 2) with and the other (group 1) without the added VR environment. In all other respects, the 2 programs were identical. Each training session lasted for 30 minutes and was carried out twice per week for about 3 months. The primary outcome measures were maximum load during the work sessions, target oxygen consumption, target heart rate (beats per minute), and number of training sessions required to reach rehabilitation goals. By the end of 20 training sessions, only 4 of the 10 control subjects had reached the heart rate target goal of 85% their maximum heart rate. In contrast, 9 of the 10 subjects in the VR program had attained this goal by 9 or fewer training sessions. When target metabolic cost (75% peak oxygen consumption) was used as the training goal, all 10 subjects in the VR program had reached this target after 2 training sessions (or, in some cases, 1 training session), but not until training session 15 did a cumulative number of 9 control subjects reach this goal. These study outcomes clearly support the notion that incorporating a VR environment into cardiac rehabilitation programs will accelerate maximum recovery of patients' cardiovascular function.

Impact of a Home Leisure Educational Program for Older Adults Who Have Had a Stroke (Home Leisure Educational Program).

ERIC Educational Resources Information Center

Nour, Kareen; Desrosiers, Johanne; Gauthier, Pierre; Carbonneau, Helene

2002-01-01

Examined the effectiveness of leisure education for older adults having difficulty adjusting psychologically after a stroke. Participants received either an experimental home leisure education program (intervention group) or a friendly home visit (control group) after discharge from rehabilitation. The intervention group performed significantly…

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.

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.

Evaluation of a self-management patient education program for patients with fibromyalgia syndrome: study protocol of a cluster randomized controlled trial.

PubMed

Musekamp, Gunda; Gerlich, Christian; Ehlebracht-König, Inge; Faller, Hermann; Reusch, Andrea

2016-02-03

Fibromyalgia syndrome (FMS) is a complex chronic condition that makes high demands on patients' self-management skills. Thus, patient education is considered an important component of multimodal therapy, although evidence regarding its effectiveness is scarce. The main objective of this study is to assess the effectiveness of an advanced self-management patient education program for patients with FMS as compared to usual care in the context of inpatient rehabilitation. We conducted a multicenter cluster randomized controlled trial in 3 rehabilitation clinics. Clusters are groups of patients with FMS consecutively recruited within one week after admission. Patients of the intervention group receive the advanced multidisciplinary self-management patient education program (considering new knowledge on FMS, with a focus on transfer into everyday life), whereas patients in the control group receive standard patient education programs including information on FMS and coping with pain. A total of 566 patients are assessed at admission, at discharge and after 6 and 12 months, using patient reported questionnaires. Primary outcomes are patients' disease- and treatment-specific knowledge at discharge and self-management skills after 6 months. Secondary outcomes include satisfaction, attitudes and coping competences, health-promoting behavior, psychological distress, health impairment and participation. Treatment effects between groups are evaluated using multilevel regression analysis adjusting for baseline values. The study evaluates the effectiveness of a self-management patient education program for patients with FMS in the context of inpatient rehabilitation in a cluster randomized trial. Study results will show whether self-management patient education is beneficial for this group of patients. German Clinical Trials Register, DRKS00008782 , Registered 8 July 2015.

75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

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2010-10-01

... Respiratory Care Services; Medicaid Program: Accreditation for Providers of Inpatient Psychiatric Services... Conditions of Participation for Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation... Participation for Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation for Providers of...

Physical Medicine and Rehabilitation Resident Use of iPad Mini Mobile Devices.

PubMed

Niehaus, William; Boimbo, Sandra; Akuthota, Venu

2015-05-01

Previous research on the use of tablet devices in residency programs has been undertaken in radiology and medicine or with standard-sized tablet devices. With new, smaller tablet devices, there is an opportunity to assess their effect on resident behavior. This prospective study attempts to evaluate resident behavior after receiving a smaller tablet device. To evaluate whether smaller tablet computers facilitate residents' daily tasks. Prospective study that administered surveys to evaluate tablet computer use. Residency program. Thirteen physical medicine and rehabilitation residents. Residents were provided 16-GB iPad Minis and surveyed with Redcap to collect usage information at baseline, 3, and 6 months. Survey analysis was conducted using SAS (SAS, Cary, NC) for descriptive analysis. To evaluate multiple areas of resident education, the following tasks were selected: accessing e-mail, logging duty hours, logging procedures, researching clinical information, accessing medical journals, reviewing didactic presentations, and completing evaluations. Then, measurements were taken of: (1) residents' response to how tablet computers made it easier to access the aforementioned tasks; and (2) residents' response to how tablet computers affected the frequency they performed the aforementioned tasks. After being provided tablet computers, our physical medicine and rehabilitation residents reported significantly greater access to e-mail, medical journals, and didactic material. Also, receiving tablet computers was reported to increase the frequency that residents accessed e-mail, researched clinical information, accessed medical journals, reviewed didactic presentations, and completed evaluations. After receiving a tablet computer, residents reported an increase in the use of calendar programs, note-taking programs, PDF readers, online storage programs, and file organization programs. These physical medicine and rehabilitation residents reported tablet computers increased access to e-mail, presentation material, and medical journals. Tablet computers also were reported to increase the frequency residents were able to complete tasks associated with residency training. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of a tele-prehabilitation program or an in-person prehabilitation program in surgical candidates awaiting total hip or knee arthroplasty: Protocol of a pilot single blind randomized controlled trial.

PubMed

Doiron-Cadrin, Patrick; Kairy, Dahlia; Vendittoli, Pascal-André; Lowry, Véronique; Poitras, Stéphane; Desmeules, François

2016-12-15

The accessibility for total joint arthroplasty often comes up against long wait lists, and may lead to deleterious effects for the awaiting patients. This pilot single blind randomized controlled trial aims to evaluate the impact of a telerehabilitation prehabilitation program before a hip or knee arthroplasty compared to in-person prehabilitation or to usual wait for surgery. Thirty-six patients on a wait list for a total hip or knee arthroplasty will be recruited and randomly assigned to one of three groups. The in-person prehabilitation group (n = 12) will receive a 12-week rehabilitation program (2 sessions/week) including education, exercises of the lower limb and cardiovascular training. Patients in the tele-prehabilitation group (n = 12) will receive the same intervention using a telecommunication software. The control group (n = 12) will be provided with the hospital's usual documentation before surgery. The Lower Extremity Functional Scale (LEFS) will be the primary outcome measure taken at baseline and at 12 weeks. Secondary measures will include self-reported function and quality of life as well as performance tests. A mixed-model, 2-way repeated-measure ANOVA will be used to analyse the effects of the rehabilitation programs. This pilot study is the first to evaluate the feasibility and the impact of a telerehabilitation prehabilitation program for patients awaiting a total joint arthroplasty. The results of this pilot-RCT will set the foundations for further research in the fields of rehabilitation and tele-medicine for patients suffering from lower limb osteoarthritis. ClinicalTrials.gov: NCT02636751.

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...

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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...

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2013-05-20

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Yoga-Based Rehabilitation Program in Reducing Physical and Emotional Side Effects in Patients With Cancer

ClinicalTrials.gov

2017-01-23

Alopecia; Anxiety; Breast Carcinoma; Cognitive Side Effects of Cancer Therapy; Colorectal Carcinoma; Depression; Fatigue; Lung Carcinoma; Nausea and Vomiting; Pain; Psychological Impact of Cancer; Sleep Disorder; Weight Change

Observational study of the effectiveness of spinal cord injury rehabilitation using the Spinal Cord Injury-Ability Realization Measurement Index.

PubMed

Scivoletto, G; Bonavita, J; Torre, M; Baroncini, I; Tiberti, S; Maietti, E; Laurenza, L; China, S; Corallo, V; Guerra, F; Buscaroli, L; Candeloro, C; Brunelli, E; Catz, A; Molinari, M

2016-06-01

Retrospective observational study. The objective of this study was to determine the rehabilitation potential and the extent to which it is realized in a cohort of spinal cord injury patients using the Spinal Cord Injury-Ability Realization Measurement Index (SCI-ARMI) and to study the clinical factors that influence this realization. Two spinal units in Italy. Consecutive patients were assessed at the end of an in-patient rehabilitation program using the Spinal Cord Independence Measure and the International Standards for Neurological Classification of Spinal Cord Injury. On the basis of these data and of the age and gender of the patients, we calculated the SCI-ARMI score. Regression analyses were performed to study the relationship between clinical factors and the extent to which rehabilitation potential is realized. We examined the data for 306 patients. Most patients were discharged without having reached their rehabilitation potential, with an SCI-ARMI score <80%. SCI-ARMI scores at discharge were positively influenced by etiology and the lesion level and correlated negatively with lesion severity and the presence of complications during rehabilitation. The SCI-ARMI is an effective tool that can be used to measure the achievement of rehabilitation potential in SCI patients and to identify groups of patients who are at risk of not meeting their rehabilitative potential.

Role of Self-Efficacy in Rehabilitation Outcome among Chronic Low Back Pain Patients.

ERIC Educational Resources Information Center

Altmaier, Elizabeth M.; And Others

1993-01-01

Examined role of self-efficacy beliefs in rehabilitation of 45 low back pain patients participating in 3-week rehabilitation program. Increments in self-efficacy beliefs during program were not associated with improved patient functioning at discharge. However, in support of theorized role of self-efficacy in behavior change, increments in…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

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

78 FR 69839 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... DEPARTMENT OF EDUCATION Applications for New Awards; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving Institution Field- Initiated Projects Program Correction In notice document 2013-27559 appearing on pages 69398-69402 in the issue of November 19,...

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

ERIC Educational Resources Information Center

Faver, Edward

2011-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain: a multicentre, quasi-experimental study.

PubMed

Semrau, Jana; Hentschke, Christian; Buchmann, Jana; Meng, Karin; Vogel, Heiner; Faller, Hermann; Bork, Hartmut; Pfeifer, Klaus

2015-01-01

Improvement of the long-term effectiveness of multidisciplinary ortho-paedic rehabilitation (MOR) in the management of chronic non-specific low back pain (CLBP) remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named "PASTOR" to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR. A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group), were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group). It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome) using the Hannover Functional Ability Questionnaire (FFbH-R) and vari-ous secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions). In total 536 participants were consecutively assigned to PASTOR (n=266) or MOR (n=270). At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78) using complete data and 3.56 (95% CI 0.45 to 6.67) using available da-ta, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001) and d=0.10 (p=0.025) in favour of PASTOR. Further improvements in secondary out-comes were also observed in favour of PASTOR. The interprofessional and interdisciplinary, biopsychosocial rehabilita-tion program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults with CLBP. Further insights into mechanisms of action of complex intervention programs are required. ClinicalTrials.gov NCT02056951.

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

PubMed

Des Roches, Carrie A; Mitko, Annette; Kiran, Swathi

2017-01-01

An advantage of rehabilitation administered on computers or tablets is that the tasks can be self-administered and the cueing required to complete the tasks can be monitored. Though there are many types of cueing, few studies have examined how participants' response to rehabilitation is influenced by self-administered cueing, which is cueing that is always available but the individual decides when and which cue to administer. In this study, participants received a tablet-based rehabilitation where the tasks were selfpaced and remotely monitored by a clinician. The results of the effectiveness of this study were published previously (Des Roches et al., 2015). The current study looks at the effect of cues on accuracy and rehabilitation outcomes. Fifty-one individuals with aphasia completed a 10-week program using Constant Therapy on an iPad targeted at improving language and cognitive deficits. Three questions were examined. The first examined the effect of cues on accuracy collapsed across time. Results showed a trend where the greater the cue use, the lower the accuracy, although some participants showed the opposite effect. This analysis divided participants into profiles based on cue use and accuracy. The second question examined how each profile differed in percent cue use and on standardized measures at baseline. Results showed that the four profiles were significantly different in frequency of cues and scores on WAB-R, CLQT, BNT, and ASHA-FACS, indicating that participants with lower scores on the standardized tests used a higher percentage of cues, which were not beneficial, while participants with higher scores on the standardized tests used a lower frequency of cues, which were beneficial. The third question examined how the relationship between cues and accuracy was affected by the course of treatment. Results showed that both more and less severe participants showed a decrease in cue use and an increase in accuracy over time, though more severe participants continued to used a greater number of cues. It is possible that self-administered cues help some individuals to access information that is otherwise inaccessible, even if there is not an immediate effect. Ultimately, the results demonstrate the need for individually modifying the levels of assistance during rehabilitation. time, though more severe participants continued to used a greater number of cues. It is possible that self-administered cues help some individuals to access information that is otherwise inaccessible, even if there is not an immediate effect. Ultimately, the results demonstrate the need for individually modifying the levels of assistance during rehabilitation.

Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty.

PubMed

Lee, Minyoung; Suh, Dongwon; Son, Jaebum; Kim, Jungjin; Eun, Seon-Deok; Yoon, BumChul

2016-01-01

This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

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.

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.

RECAP (Rock County Education and Criminal Addictions Program) Program Manual Prepared to be of Assistance in Program Replication.

ERIC Educational Resources Information Center

Blackhawk Technical Coll., Janesville, WI.

This document, which is designed for practitioners involved in the vocational education/rehabilitation of incarcerated adults, contains materials to facilitate replication of the Rock County Education and Criminal Additions Program (RECAP), a comprehensive, integrated training/rehabilitation program that was developed and implemented through the…

Reduction of water losses by rehabilitation of water distribution network.

PubMed

Güngör, Mahmud; Yarar, Ufuk; Firat, Mahmut

2017-09-11

Physical or real losses may be indicated as the most important component of the water losses occurring in a water distribution network (WDN). The objective of this study is to examine the effects of piping material management and network rehabilitation on the physical water losses and water losses management in a WDN. For this aim, the Denizli WDN consisting of very old pipes that have exhausted their economic life is selected as the study area. The fact that the current network is old results in the decrease of pressure strength, increase of failure intensity, and inefficient use of water resources thus leading to the application of the rehabilitation program. In Denizli, network renewal works have been carried out since the year 2009 under the rehabilitation program. It was determined that the failure rate at regions where network renewal constructions have been completed decreased down to zero level. Renewal of piping material enables the minimization of leakage losses as well as the failure rate. On the other hand, the system rehabilitation has the potential to amortize itself in a very short amount of time if the initial investment cost of network renewal is considered along with the operating costs of the old and new systems, as well as water loss costs. As a result, it can be stated that renewal of piping material in water distribution systems, enhancement of the physical properties of the system, provide significant contributions such as increase of water and energy efficiency and more effective use of resources.

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…

Degraded dryland rehabilitation: boosting seedling survival using zeolitic tuff

NASA Astrophysics Data System (ADS)

Alhamad, Mohammad Noor; Alrbabah, Mohammad; Athamneh, Hana

2016-04-01

More than 90% of Jordan is broadly defined as rangelands. Most rangelands are located within the arid zone of the country. Extensive grazing occurs across much of the natural pastures resulting in serious environmental degradation of natural resources in these rangelands. Several programs were carried out for rangeland conservation and rehabilitation in the country. However, these programs face a major challenge of the low survival rate of transplanted shrub seedlings. Seeking innovative approaches to assure healthy establishment of seedling is a big challenge to achieve successful rehabilitation programs. Drought is considered one of the major problems in rehabilitation. Promoting survival and growth, using zeolitic tuff added to planting holes is suggested to be a possible solution. The experiment was conducted on a factorial arrangement within RCBD design. Two shrub species (Atriplex halimus, Atriplex nummularia) were transplanted into holes prepared with three levels of tuff treatments (mulching, mixing and control) under rainfed condition. The result showed insignificant effect of tuff on seedling survival percentage, when mixing tuff with plantation soil or adding tuff as mulch. Also, the two species showed similar survival percentages over two measured dates. However, mixing tuff with soil during hole preparation significantly enhanced seedling heights. Furthers, The Australian atriplex (Atriplex nummularia) species significantly grow higher than Atriplex halimus. The study results suggested that mixing zeoltic tuff with soil during transplantation of seedling is promising in improving the success of rangeland rehabilitation in dry areas in Jordan.

Effects of rhythmic exercise performed to music on the rheological properties of blood in women over 60 years of age.

PubMed

Marchewka, Anna; Filar-Mierzwa, Katarzyna; Dąbrowski, Zbigniew; Teległó, Aneta

2015-01-01

The aim of this study was to analyze the effects of motor rehabilitation, in the form of rhythmic exercise to music, on the rheological characteristics of blood in older women. The study included 30 women (65-80 years of age), and the control group was comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month rehabilitation program, in the form of rhythmic exercise performed to music (three 30-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. The rehabilitation program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, an improvement of erythrocyte deformability was observed by lower shear stress levels, while no significant changes were noted by the higher shear stress values. The rehabilitation resulted in a marked decrease of the aggregation amplitude while no significant changes were observed in aggregation index and total aggregation half-time. Additionally, the training regimen was reflected by a significant increase in the plasma viscosity, while no significant changes in fibrinogen levels were noted.

INTEGRATION OF STRENGTH AND CONDITIONING PRINCIPLES INTO A REHABILITATION PROGRAM

PubMed Central

Lorenz, Daniel S.

2011-01-01

Background and Purpose: Rehabilitation and strength and conditioning are often seen as two separate entities in athletic injury recovery. Traditionally an athlete progresses from the rehabilitation environment under the care of a physical therapist and/or athletic trainer to the strength and conditioning coach for specific return to sport training. These two facets of return to sport are often considered to have separate goals. Initial goals of each are often different due to the timing of their implementation encompassing different stages of post-injury recovery. The initial focus of post injury rehabilitation includes alleviation of dysfunction, enhancement of tissue healing, and provision of a systematic progression of range-of-motion and strength. During the return to function phases, specific return to play goals are paramount. Understanding of specific principles and program parameters is necessary when designing and implementing an athlete's rehabilitation program. Communication and collaboration amongst all individuals caring for the athlete is a must. The purpose of this review is to outline the current evidence supporting utilization of training principles in athletic rehabilitation, as well as provide suggested implementation of such principles throughout different phases of a proposed rehabilitation program. Evidence Acquisition: The following electronic databases were used to identify research relevant to this clinical commentary: MEDLINE (from 1950–June 2011) and CINAHL (1982–June 2011), for all relevant journal articles written in English. Additional references were accrued by independent searching of references from relevant articles. Results: Currently evidence is lacking in the integration of strength and conditioning principles into the rehabilitation program for the injured athlete. Numerous methods are suggested for possible utilization by the clinician in practice to improve strength, power, speed, endurance, and metabolic capacity. Conclusion: Despite abundance of information on the implementation of training principles in the strength and conditioning field, investigation regarding the use of these principles in a properly designed rehabilitation program is lacking. PMID:21904701

36 CFR 72.44 - Fundable elements: Rehabilitation and Innovation grant common elements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: Rehabilitation and Innovation grant common elements. 72.44 Section 72.44 Parks, Forests, and Public Property... Recovery Action Program Development, Rehabilitation and Innovation § 72.44 Fundable elements: Rehabilitation and Innovation grant common elements. (a) All Rehabilitation and Innovation proposals must be...

36 CFR 72.44 - Fundable elements: Rehabilitation and Innovation grant common elements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...: Rehabilitation and Innovation grant common elements. 72.44 Section 72.44 Parks, Forests, and Public Property... Recovery Action Program Development, Rehabilitation and Innovation § 72.44 Fundable elements: Rehabilitation and Innovation grant common elements. (a) All Rehabilitation and Innovation proposals must be...

36 CFR 72.44 - Fundable elements: Rehabilitation and Innovation grant common elements.

Code of Federal Regulations, 2010 CFR

2010-07-01

...: Rehabilitation and Innovation grant common elements. 72.44 Section 72.44 Parks, Forests, and Public Property... Recovery Action Program Development, Rehabilitation and Innovation § 72.44 Fundable elements: Rehabilitation and Innovation grant common elements. (a) All Rehabilitation and Innovation proposals must be...

36 CFR 72.44 - Fundable elements: Rehabilitation and Innovation grant common elements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...: Rehabilitation and Innovation grant common elements. 72.44 Section 72.44 Parks, Forests, and Public Property... Recovery Action Program Development, Rehabilitation and Innovation § 72.44 Fundable elements: Rehabilitation and Innovation grant common elements. (a) All Rehabilitation and Innovation proposals must be...

36 CFR 72.44 - Fundable elements: Rehabilitation and Innovation grant common elements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: Rehabilitation and Innovation grant common elements. 72.44 Section 72.44 Parks, Forests, and Public Property... Recovery Action Program Development, Rehabilitation and Innovation § 72.44 Fundable elements: Rehabilitation and Innovation grant common elements. (a) All Rehabilitation and Innovation proposals must be...

78 FR 35886 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers... notice of final priorities for the Disability and Rehabilitation Research Projects and Centers Program... included in the notice of final priorities for the Disability and Rehabilitation Research Projects and...

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.

Whole-body strength training with Huber Motion Lab and traditional strength training in cardiac rehabilitation: A randomized controlled study.

PubMed

Guiraud, Thibaut; Labrunée, Marc; Besnier, Florent; Sénard, Jean-Michel; Pillard, Fabien; Rivière, Daniel; Richard, Lisa; Laroche, Davy; Sanguignol, Frédéric; Pathak, Atul; Gayda, Mathieu; Gremeaux, Vincent

2017-01-01

Isometric strengthening has been rarely studied in patients with coronary heart disease (CHD), mainly because of possible potential side effects and lack of appropriate and reliable devices. We aimed to compare 2 different modes of resistance training, an isometric mode with the Huber Motion Lab (HML) and traditional strength training (TST), in CHD patients undergoing a cardiac rehabilitation program. We randomly assigned 50 patients to HML or TST. Patients underwent complete blinded evaluation before and after the rehabilitation program, including testing for cardiopulmonary exercise, maximal isometric voluntary contraction, endothelial function and body composition. After 4 weeks of training (16 sessions), the groups did not differ in body composition, anthropometric characteristics, or endothelial function. With HML, peak power output (P=0.035), maximal heart rate (P<0.01) and gain of force measured in the chest press position (P<0.02) were greater after versus before training. Both protocols appeared to be well tolerated, safe and feasible for these CHD patients. A training protocol involving 6s phases of isometric contractions with 10s of passive recovery on an HML device could be safely implemented in rehabilitation programs for patients with CHD and improve functional outcomes. Copyright © 2016. Published by Elsevier Masson SAS.

Improvement of walking speed and gait symmetry in older patients after hip arthroplasty: a prospective cohort study.

PubMed

Rapp, Walter; Brauner, Torsten; Weber, Linda; Grau, Stefan; Mündermann, Annegret; Horstmann, Thomas

2015-10-12

Retraining walking in patients after hip or knee arthroplasty is an important component of rehabilitation especially in older persons whose social interactions are influenced by their level of mobility. The objective of this study was to test the effect of an intensive inpatient rehabilitation program on walking speed and gait symmetry in patients after hip arthroplasty (THA) using inertial sensor technology. Twenty-nine patients undergoing a 4-week inpatient rehabilitation program following THA and 30 age-matched healthy subjects participated in this study. Walking speed and gait symmetry parameters were measured using inertial sensor device for standardized walking trials (2*20.3 m in a gym) at their self-selected normal and fast walking speeds on postoperative days 15, 21, and 27 in patients and in a single session in control subjects. Walking speed was measured using timing lights. Gait symmetry was determined using autocorrelation calculation of the cranio-caudal (CC) acceleration signals from an inertial sensor placed at the lower spine. Walking speed and gait symmetry improved from postoperative days 15-27 (speed, female: 3.2 and 4.5 m/s; male: 4.2 and 5.2 m/s; autocorrelation, female: 0.77 and 0.81; male: 0.70 and 0.79; P <0.001 for all). After the 4-week rehabilitation program, walking speed and gait symmetry were still lower than those in control subjects (speed, female 4.5 m/s vs. 5.7 m/s; male: 5.2 m/s vs. 5.3 m/s; autocorrelation, female: 0.81 vs. 0.88; male: 0.79 vs. 0.90; P <0.001 for all). While patients with THA improved their walking capacity during a 4-week inpatient rehabilitation program, subsequent intensive gait training is warranted for achieving normal gait symmetry. Inertial sensor technology may be a useful tool for evaluating the rehabilitation process during the post-inpatient period.

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

PubMed

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

2017-07-01

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

Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial.

PubMed

Eskilsson, Therese; Slunga Järvholm, Lisbeth; Malmberg Gavelin, Hanna; Stigsdotter Neely, Anna; Boraxbekk, Carl-Johan

2017-09-02

Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program. In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity. In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls. Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group. ClinicalTrials.gov: NCT03073772 . Retrospectively registered 21 February 2017.

Effects of a sensory-motor orthotic on postural instability rehabilitation in Parkinson's disease: a pilot study.

PubMed

Volpe, Daniele; Pelosin, Elisa; Bakdounes, Leila; Masiero, Stefano; Bertagnoni, Giannettore; Sorbera, Chiara; Giantin, Maria Giulia

2017-01-01

Proprioceptive deficits have been largely documented in PD patients, thus external sensory signals (peripheral sensory feedback) are often used to compensate the abnormalities of proprioceptive integration. This pilot study aims to evaluate the feasibility and the effectiveness of a rehabilitation-training program, combined with the use of a sensory-motor orthotic in improving balance in a small sample of PD patients. Twenty PD patients were randomly allocated into two groups: (i) the Experimental group , where participants were asked to wear a sensory-motor orthotic during the balance training program and (ii) the Control group , where subjects performed an identical training program without wearing any kind of orthotics. In all, the training program lasted 10 sessions (5 days a week for 2 weeks) and the clinical and instrumental assessments were performed at baseline, immediately after the end of the training and 4 weeks after the rehabilitative program was stopped. All clinical outcome measures tested improved significantly at post and follow-up evaluations in both groups. Interestingly, at the end of the training, only the experimental group obtained a significant improvement in the functional reaching test (sway area - eyes closed) measured by means of stabilometric platform and this result was maintained in the follow-up evaluation. Our preliminary results suggested that the use of a sensory-motor orthotic, in combination with a tailored balance training, is feasible and it seems to positively impact on balance performance in Parkinson's disease. EudraCT N. 003020-36 - 2013.

Whakawhanaungatanga: the importance of culturally meaningful connections to improve uptake of pulmonary rehabilitation by Māori with COPD - a qualitative study.

PubMed

Levack, William Mm; Jones, Bernadette; Grainger, Rebecca; Boland, Pauline; Brown, Melanie; Ingham, Tristram R

2016-01-01

Pulmonary rehabilitation is known to improve function and quality of life for people with chronic obstructive pulmonary disease (COPD). However, little research has been conducted on the influence of culture on experiences of pulmonary rehabilitation. This study examined factors influencing uptake of pulmonary rehabilitation by Māori with COPD in New Zealand. Grounded theory nested within kaupapa Māori methodology. Transcripts were analyzed from interviews and focus groups with 15 Māori and ten New Zealand non-Māori invited to attend pulmonary rehabilitation for COPD. Māori participants had either attended a mainstream hospital-based program, a community-based program designed "by Māori, for Māori", or had experienced both. Several factors influencing uptake of pulmonary rehabilitation were common to all participants regardless of ethnicity: 1) participants' past experiences (eg, of exercise; of health care systems), 2) attitudes and expectations, 3) access issues (eg, time, transport, and conflicting responsibilities), and 4) initial program experiences. These factors were moderated by the involvement of family and peers, interactions with health professionals, the way information on programs was presented, and by new illness events. For Māori, however, several additional factors were also identified relating to cultural experiences of pulmonary rehabilitation. In particular, Māori participants placed high value on whakawhanaungatanga: the making of culturally meaningful connections with others. Culturally appropriate communication and relationship building was deemed so important by some Māori participants that when it was absent, they felt strongly discouraged to attend pulmonary rehabilitation. Only the more holistic services offered a program in which they felt culturally safe and to which they were willing to return for ongoing rehabilitation. Lack of attention to cultural factors in the delivery of pulmonary rehabilitation may be a barrier to its uptake by indigenous, minority ethnic groups, such as New Zealand Māori. Indigenous-led or culturally responsive health care interventions for COPD may provide a solution to this issue.

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).

WORKMEN'S COMPENSATION—Emphasis on Rehabilitation

PubMed Central

Shepard, William P.

1956-01-01

Since the first law was enacted in 1911 major emphasis has been placed on monetary satisfaction of liability with insufficient attention to rehabilitation of the occupationally disabled. An effective workmen's compensation program must have three basic goals: (1) Rehabilitation of the occupationally disabled; (2) assured, prompt, and adequate indemnity for the occupationally disabled or their survivors; and (3) minimal costs to employers and society commensurate with the first two goals. It is suggested that the medical societies of each state provide a broadly representative committee to advise the administrative agency on medical policies and practices. This committee would prepare registers of all physicians in each locality who are willing and qualified to accept calls for service to injured employees, would mediate complaints originating with the employee, the employer, the insurance carrier or the administrative agency, and would cooperate with the administrative agency in educational programs for all concerned. It is the physician's responsibility to help the administrative agency in shifting the emphasis from indemnity to rehabilitation. The disabled employee is entitled to all services available to restore him to an earning capacity. PMID:13356180

[Physical therapy].

PubMed

Chohnabayashi, Naohiko

2008-01-01

Recently, pulmonary rehabilitation program is widely considered one of the most effective and evidence-based treatment for not only chronic obstructive pulmonary disease (COPD) but many clinical situations including neuro-muscular disease, post-operative status and weaning period from the ventilator, etc. The essential components of a pulmonary rehabilitation program are team assessment, patient training, psycho-social intervention, exercise, and follow-up. In 2003, Japanese medical societies (J. Thoracic Society, J. Pul. Rehabilitation Society and J. Physiotherapist Society) made a new guideline for pulmonary rehabilitation, especially how to aproach the execise training. As for the duration after surgical operation, airway cleaning is the important technique to prevent post-operative complications including pneumonia. Postural dranage technique is well known for such condition, at the same time, several instruments (flutter vulve, positive expiratory mask, high frequecy oscillation, etc) were also used for the patient to expectrate airway mucus easier. Lung transplantation is a new method of treatment for the critically-ill patients with chronic respiratoy failure. Several techniques of physical therapy are must be needed before and after lung transplantation to prevent both pulmonary infection and osteoporosis.

Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) program: A new standard of care for injured workers in Hong Kong.

PubMed

Law, S W; Szeto, G P Y; Chau, W W; Chan, Carol; Kwok, Anthony W L; Lai, H S; Lee, Ryan K L; Griffith, James F; Hung, L K; Cheng, J C Y

2016-08-10

The objective of this study is to evaluate the effects of the Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) Program on reducing chronic disability among injured workers and improving efficiency of work rehabilitation process. A cohort of patients with workplace injuries in the lower back were recruited from orthopaedics clinics and assigned to either MORE group (n= 139) or control group (n= 106). Patients in MORE group received an early MRI screening and a coordinated multi-disciplinary management, while patients in the control group received conventional care. Outcome variables are time to return-to-work (RTW) from date of injury, waiting time for MRI screening and time to medical assessment board (MAB). Patients in the MORE Program had significantly shorter duration for RTW (MORE: 6.1 months, 12.8 months, p< 0.01), and more RTW cases (n= 64, 46.0%) compared to CONTROL group (n= 29, 27.4%). The MORE group also had much shorter waiting time for MRI scans (91.85 vs. 309.2 days, p< 0.001) and MAB referral after MRI scans (97.2 vs. 178.9 days, p= 0.001) compared to CONTROL group. The MORE Program which emphasizes early intervention and early MRI screening, is shown to be effective in shortening sick leave and improving RTW outcomes of injured workers.

34 CFR 361.17 - Requirements for a state rehabilitation council.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM State Plan and Other Requirements for Vocational Rehabilitation Services Administration... with disabilities and organizations interested in individuals with disabilities. In selecting members...

Are Virtual Rehabilitation Technologies Feasible Models to Scale an Evidence-Based Fall Prevention Program? A Pilot Study Using the Kinect Camera.

PubMed

Shubert, Tiffany E; Basnett, Jeanna; Chokshi, Anang; Barrett, Mark; Komatireddy, Ravi

2015-11-05

Falls in older adults are a significant public health issue. Interventions have been developed and proven effective to reduce falls in older adults, but these programs typically last several months and can be resource intensive. Virtual rehabilitation technologies may offer a solution to bring these programs to scale. Off-the-shelf and custom exergames have demonstrated to be a feasible adjunct to rehabilitation with older adults. However, it is not known if older adults will be able or willing to use a virtual rehabilitation technology to participate in an evidence-based fall prevention program. To have the greatest impact, virtual rehabilitation technologies need to be acceptable to older adults from different backgrounds and level of fall risk. If these technologies prove to be a feasible option, they offer a new distribution channel to disseminate fall prevention programs. Stand Tall (ST) is a virtual translation of the Otago Exercise Program (OEP), an evidence-based fall prevention program. Stand Tall was developed using the Virtual Exercise Rehabilitation Assistant (VERA) software, which uses a Kinect camera and a laptop to deliver physical therapy exercise programs. Our purpose in this pilot study was to explore if ST could be a feasible platform to deliver the OEP to older adults from a variety of fall risk levels, education backgrounds, and self-described level of computer expertise. Adults age 60 and over were recruited to participate in a one-time usability study. The study included orientation to the program, navigation to exercises, and completion of a series of strength and balance exercises. Quantitative analysis described participants and the user experience. A diverse group of individuals participated in the study. Twenty-one potential participants (14 women, 7 men) met the inclusion criteria. The mean age was 69.2 (± 5.8) years, 38% had a high school education, 24% had a graduate degree, and 66% classified as "at risk for falls". Eighteen participants agreed they would like to use ST to help improve their balance, and 17 agreed or strongly agreed they would feel confident using the system in either the senior center or the home. Thirteen participants felt confident they could actually set up the system in their home. The mean System Usability Scale (SUS) score was 65.5 ± 21.2 with a range of 32.5 to 97.5. Ten participants scored ST as an above average usability experience compared to other technologies and 5 participants scored a less than optimal experience. Exploratory analysis revealed no significant relationships between user experience, education background, self-described computer experience, and fall risk. Results support the virtual delivery of the OEP by a Kinect camera and an avatar may be acceptable to older adults from a variety of backgrounds. Virtual technologies, like Stand Tall, could offer an efficient and effective approach to bring evidence-based fall prevention programs to scale to address the problem of falls and fall-related injuries. Next steps include determining if similar or better outcomes are achieved by older adults using the virtual OEP, Stand Tall, compared to the standard of care. ©Tiffany E Shubert, Jeanna Basnett, Anang Chokshi, Mark Barrett, Ravi Komatireddy. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 05.11.2015.

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.

Effects of Pilates method in elderly people: Systematic review of randomized controlled trials.

PubMed

de Oliveira Francisco, Cristina; de Almeida Fagundes, Alessandra; Gorges, Bruna

2015-07-01

The Pilates method has been widely used in physical training and rehabilitation. Evidence regarding the effectiveness of this method in elderly people is limited. Six randomized controlled trials studies involving the use of the Pilates method for elderly people, published prior to December 2013, were selected from the databases PubMed, MEDLINE, Embase, Cochrane, Scielo and PEDro. Three articles suggested that Pilates produced improvements in balance. Two studies evaluated the adherence to Pilates programs. One study assessed Pilates' influence on cardio-metabolic parameters and another study evaluated changes in body composition. Strong evidence was found regarding beneficial effects of Pilates over static and dynamic balance in women. Nevertheless, evidence of balance improvement in both genders, changes in body composition in woman and adherence to Pilates programs were limited. Effects on cardio-metabolic parameters due to Pilates training presented inconclusive results. Pilates may be a useful tool in rehabilitation and prevention programs but more high quality studies are necessary to establish all the effects on elderly populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Lower reinjury rate with a coach-controlled rehabilitation program in amateur male soccer: a randomized controlled trial.

PubMed

Hägglund, Martin; Waldén, Markus; Ekstrand, Jan

2007-09-01

Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury. The rate of reinjury is reduced using a coach-controlled rehabilitation program. Randomized controlled trial; Level of evidence, 1. Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups. There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16-0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11-0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%). The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.

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.

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.

78 FR 3864 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

...; Kochkin, 2010a; Chisolm et al., 2007b; Sweetow and Sabes, 2007; Pirzanski, 2006). For example, research... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers CFDA Number: 84.133E-1. AGENCY: Office of Special Education and Rehabilitative...

34 CFR 350.30 - What requirements must a Rehabilitation Engineering Research Center meet?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false What requirements must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.30 What requirements must a Rehabilitation Engineering Research...

34 CFR 350.31 - What collaboration must a Rehabilitation Engineering Research Center engage in?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false What collaboration must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.31 What collaboration must a Rehabilitation Engineering Research...

34 CFR 350.31 - What collaboration must a Rehabilitation Engineering Research Center engage in?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false What collaboration must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.31 What collaboration must a Rehabilitation Engineering Research...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

34 CFR 350.31 - What collaboration must a Rehabilitation Engineering Research Center engage in?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What collaboration must a Rehabilitation Engineering... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Rehabilitation Engineering Research Centers Does the Secretary Assist? § 350.31 What collaboration must a Rehabilitation Engineering Research...