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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

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

48 CFR 871.208 - Rehabilitation facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...

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...

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...

Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

PubMed

Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

2017-12-01

Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

PubMed

Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

2017-01-01

To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

Costs after hip fracture in independently living patients: a randomised comparison of three rehabilitation modalities.

PubMed

Lahtinen, A; Leppilahti, J; Vähänikkilä, H; Harmainen, S; Koistinen, P; Rissanen, P; Jalovaara, P

2017-05-01

To evaluate costs and cost-effectiveness of physical and geriatric rehabilitation after hip fracture. Prospective randomised study (mean age 78 years, 105 male, 433 female) in different rehabilitation settings: physically oriented (187 patients), geriatrically oriented (171 patients), and healthcare centre hospital (control, 180 patients). At 12 months post-fracture, we collected data regarding days in rehabilitation, post-rehabilitation hospital treatment, other healthcare service use, number of re-operations, taxi use by patient or relative, and help from relatives. Control rehabilitation (4945,2€) was significantly less expensive than physical (6609.0€, p=0.002) and geriatric rehabilitation (7034.7€ p<0.001). Total institutional care costs (primary treatment, rehabilitation, and post-rehabilitation hospital care) were lower for control (13,438.4€) than geriatric rehabilitation (17,201.7€, p<0.001), but did not differ between control and physical rehabilitation (15659.1€, p=0.055) or between physical and geriatric rehabilitation ( p=0.252). Costs of help from relatives (estimated as 30%, 50% and 100% of a home aid's salary) with physical rehabilitation were lower than control ( p=0.016) but higher than geriatric rehabilitation ( p=0.041). Total hip fracture treatment costs were lower with physical (36,356€, 51,018€) than control rehabilitation (38,018€, 57,031€) at 50% and 100% of salary ( p=0.032, p=0.014, respectively). At one year post-fracture, 15D-score was significantly higher in physical rehabilitation group (0.697) than geriatric rehabilitation group (0.586, p=0.008) and control group (0.594, p=0.009). Considering total costs one year after hip fracture the treatment including physical rehabilitation is significantly more cost-effective than routine treatment. This effect could not be seen between routine treatment and treatment including geriatric rehabilitation.

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...

[Main ways of improvements of the systems of medical rehabilitation of military servicemen after cardiovascular surgery].

PubMed

Iudin, V E; Klimko, V V; Shkarupa, O F; Guzenko, I E

2014-08-01

For better improvement of medical rehabilitation referred to effective restoration of functional status of servicemen after cardiovascular surgery it is necessary to introduce standards of medical rehabilitation at all stages of rehabilitation, syndrome-pathologic principle of grouping patients, multidisciplinary organisation of medical activity: cardiologist-physician, specialist of functional diagnostics, specialist of physical therapy, psychotherapist, physical therapeutic, surgeon and specialist of professional rehabilitation. Basic ways of improvement of the system of rehabilitation were organisational technologies of interaction during early and late stages of rehabilitation and persistent control of quality and effectiveness of rehabilitation. Optimization of organisation of late stage of hospitalisation allowed to reduce the average time of rehabilitation to 33,3% and at the same time to improve effectiveness of rehabilitation.

[Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

PubMed

Schmidt-Ohlemann, M; Schweizer, C

2009-02-01

Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database.

PubMed

Lin, Heui-Fen; Wu, Ying-Tai; Tsauo, Jau-Yih

2012-08-16

Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients' functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet.

Developing post-disaster physical rehabilitation: role of the World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine.

PubMed

Gosney, James; Reinhardt, Jan Dietrich; Haig, Andrew J; Li, Jianan

2011-11-01

This special report presents the role of the World Health Organization (WHO) Liaison Sub-Committee on Rehabilitation Disaster Relief (CRDR) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in developing an enhanced physical rehabilitation relief response to large-scale natural disasters. The CRDR has stated that disaster rehabilitation is an emerging subspecialty within physical and rehabilitation medicine (PRM). In reviewing the existing literature it was found that large natural disasters result in many survivors with disabling impairments, that these survivors may have better clinical outcomes when they are treated by PRM physicians and teams of rehabilitation professionals, that the delivery of these rehabilitation services to disaster sites is complicated, and that their absence can result in significant negative consequences for individuals, communities and society. To advance its agenda, the CRDR sponsored an inaugural Symposium on Rehabilitation Disaster Relief as a concurrent scientific session at the 2011 ISPRM 6th World Congress in San Juan, Puerto Rico. The symposium included oral and poster presentations on a range of relevant topics and concluded with an international non-governmental organization panel discussion that addressed the critical question "How can rehabilitation actors coordinate better in disaster?" Building upon the symposium, the CRDR is developing a disaster rehabilitation evidence-base, which will inform and educate the global professional rehabilitation community about needs and best practices in disaster rehabilitation. The Journal of Rehabilitation Medicine (JRM) has commissioned this special report to announce a series of papers on disaster rehabilitation from the symposium's scientific programme. Authors are invited to submit papers on the topic for inclusion in this special series. JRM also encourages expert commentary in the form of Letters to the Editor.

Advances in rehabilitation medicine.

PubMed

Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

2013-10-01

Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

Rehabilitation: 25 Years of Concepts, Principles, Perspectives. A Collection of Articles Published in "Rehabilitation Literature," 1959-1984.

ERIC Educational Resources Information Center

Regnier, Stephen J., Comp.; Petkovsek, Marian, Comp.

Twenty-five articles from the bimonthly journal "Rehabilitation Literature" (1959-1984) are presented. The articles were chosen to represent key concepts, principles, and perspectives in rehabilitation. The following authors and titles are represented: "A Concept of Rehabilitation" (H. Talbot); "Rehabilitation: Prospect and Retrospect" (H.…

Clients becoming teachers: Speech-language pathology students' understanding of rehabilitation following clinical practicum in a rehabilitation setting.

PubMed

Attrill, Stacie; Gunn, Simon

2010-04-01

There has been limited research investigating the conceptual development of rehabilitation in speech-language pathology (SLP) students. The aim of this study was to describe SLP students' understanding of rehabilitation following completion of a clinical practicum in a rehabilitation setting. This study was conducted using a qualitative approach according to grounded theory methodology. Semi-structured interviews were conducted with 10 SLP students who had completed a practicum in a rehabilitation setting. Interview data analysis revealed the emergence of five axial categories. Clients becoming teachers was identified as the core category, as the notion that clients were fundamental to students' understanding of rehabilitation occurred reliably throughout the data and related to all other categories. A theoretical model was proposed that demonstrated successive levels of support to students in the acquisition of their understanding of rehabilitation on practicum. Students' understanding of rehabilitation was derived from client-related interactions and factors experienced on practicum in rehabilitation settings. Rehabilitation practicum provided students with a rich and complex learning environment that may facilitate the development of the "core skills" identified for rehabilitation practice.

Postacute Care in Cancer Rehabilitation.

PubMed

Guo, Ying; Fu, Jack B; Guo, Hong; Camp, Jennifer; Shin, Ki Y; Tu, Shi-Ming; Palmer, Lynn J; Yadav, Rajesh

2017-02-01

Acute care is usually associated with disease progression, treatments for cancer, and medical comorbidities. Patients with cancer may develop sudden functional deficits that require rehabilitation. Some of these patients benefit from acute rehabilitation, others benefit from subacute rehabilitation. After acute rehabilitation, continuous care for these patients has not been well described. Three studies are presented to demonstrate that cancer rehabilitation is a continuous process. Rehabilitation professionals should know how to detect fall risk, monitor symptoms, and render symptom management. Patients with cancer often require rehabilitation services during their entire disease trajectory. Copyright © 2016 Elsevier Inc. All rights reserved.

[Comparison of medical rehabilitation in various European countries and the impact of European law on rehabilitation practice in Germany].

PubMed

Mittag, Oskar; Welti, Felix

2017-04-01

Medical rehabilitation practice differs substantially among European countries. In most countries, rehabilitation is predominantly carried out on an outpatient basis. It is funded by health care, and rehabilitation facilities are not very specialized in terms of specific indications. In contrast, medical rehabilitation in Germany is mostly carried out on an in-patient basis as a contained 3‑week treatment. European law and European policies merely have an indirect impact on rehabilitation practice in Germany. In this article, the advantages and disadvantages of the various forms of rehabilitation services are discussed.

Using RFID Positioning Technology to Construct an Automatic Rehabilitation Scheduling Mechanism.

PubMed

Wang, Ching-Sheng; Hung, Lun-Ping; Yen, Neil Y

2016-01-01

Accurately and efficiently identifying the location of patients during the course of rehabilitation is an important issue. Wireless transmission technology can reach this goal. Tracking technologies such as RFID (Radio frequency identification) can support process improvement and improve efficiencies of rehabilitation. There are few published models or methods to solve the problem of positioning and apply this technology in the rehabilitation center. We propose a mechanism to enhance the accuracy of positioning technology and provide information about turns and obstacles on the path; and user-centered services based on location-aware to enhanced quality care in rehabilitation environment. This paper outlines the requirements and the role of RFID in assisting rehabilitation environment. A prototype RFID hospital support tool is established. It is designed to provide assistance for monitoring rehabilitation patients. It can simultaneously calculate the rehabilitant's location and the duration of treatment, and automatically record the rehabilitation course of the rehabilitant, so as to improve the management efficiency of the rehabilitation program.

[Motivational and Volitional Determinants of Applying for Psychosomatic Rehabilitation: Findings of a Cohort Study].

PubMed

Bethge, M; Peters, E; Michel, E; Radoschewski, F M; Spanier, K

2016-12-01

Objective: Analyses of motivational and volitional determinants of applying for psychosomatic rehabilitation Methods: Determinants of a rehabilitation request were assessed by a questionnaire in 2013. Applications for psychosomatic rehabilitation measures until the end of 2014 were extracted from administrative data records. Included were employees with mental disorders. Results: Only 55 of 974 persons requested a rehabilitation measure. The intention to apply for a rehabilitation measure was strongest determined by self-efficacy and family and professional support. Planning was explained by intention and to a lesser extent by family and physician support. Persons with higher planning scores were more likely to apply for a rehabilitation measure. Physician support also increased the likelihood of a rehabilitation request. Conclusion: The analyses identified determinants of rehabilitation claims that are modifiable. This gives opportunities to support rehabilitation claims. However, the contribution of these factors to explain rehabilitation requests is only limited. © Georg Thieme Verlag KG Stuttgart · New York.

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)…

Geriatric and physically oriented rehabilitation improves the ability of independent living and physical rehabilitation reduces mortality: a randomised comparison of 538 patients.

PubMed

Lahtinen, Antti; Leppilahti, Juhana; Harmainen, Samppa; Sipilä, Jaakko; Antikainen, Riitta; Seppänen, Maija-Liisa; Willig, Reeta; Vähänikkilä, Hannu; Ristiniemi, Jukka; Rissanen, Pekka; Jalovaara, Pekka

2015-09-01

To examine effects of physical and geriatric rehabilitation on institutionalisation and mortality after hip fracture. Prospective randomised study. Physically oriented (187 patients), geriatrically oriented (171 patients), and health centre hospital rehabilitation (180 patients, control group). A total of 538 consecutively, independently living patients with non-pathological hip fracture. Patients were evaluated on admission, at 4 and 12 months for social status, residential status, walking ability, use of walking aids, pain in the hip, activities of daily living (ADL) and mortality. Mortality was significantly lower at 4 and 12 months in physical rehabilitation (3.2%, 8.6%) than in geriatric rehabilitation group (9.6%, 18.7%, P=0.026, P=0.005, respectively) or control group (10.6%, 19.4%, P=0.006, P=0.004, respectively). At 4 months more patients in physical (84.4%) and geriatric rehabilitation group (78.0%) were able to live at home or sheltered housing than in control group (71.9%, P=0.0012 and P<0.001, respectively). No significant difference was found between physical rehabilitation and geriatric rehabilitation (P=0.278). Analysis of femoral neck and trochanteric fractures showed that significant difference was true only for femoral neck fractures (physical rehabilitation vs geriatric rehabilitation P=0.308, physical rehabilitation vs control group P<0,001 and geriatric rehabilitation vs control group P<0.001). Effects of intensified rehabilitations disappeared at 12 months. No impact on walking ability or ADL functions was observed. Physical rehabilitation reduced mortality. Physical and geriatric rehabilitation significantly improved the ability of independent living after 4 months especially among the femoral neck fracture patients but this effect could not be seen after 12 months. © The Author(s) 2014.

Sense of coherence and mental health rehabilitation.

PubMed

Griffiths, Christopher Alan

2009-01-01

To provide an understanding of Antonovsky's sense of coherence theory in relation to rehabilitation and to explain how applying his theory in rehabilitation practice can be beneficial. The focus of this paper will be on the rehabilitation and recovery of those with mental health issues. Sense of coherence theory helps explain the process of recovery for those with mental health issues. There is substantial evidence that sense of coherence plays a central role in coping with stressors in the rehabilitation/recovery process and that it contributes to mental health and psychosocial functioning. If rehabilitation services adopt a salutogenic approach and seek to enhance a client's sense of coherence then this can be beneficial in terms of the client's rehabilitation and recovery. Rehabilitation services should ensure that they have rehabilitation goals that strengthen individuals' sense of coherence. Further investigation is required into the development of rehabilitation programmes with sense of coherence theory as part of their foundation.

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

PubMed

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

2008-10-01

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

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

PubMed

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

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

PubMed

Bach-y-Rita, Paul

2003-08-01

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

Association of Early Outpatient Rehabilitation With Health Service Utilization in Managing Medicare Beneficiaries With Nontraumatic Knee Pain: Retrospective Cohort Study.

PubMed

Stevans, Joel M; Fitzgerald, G Kelley; Piva, Sara R; Schneider, Michael

2017-06-01

Nontraumatic knee pain (NTKP) is highly prevalent in adults 65 years of age and older. Evidence-based guidelines recommend early use of rehabilitation; however, there is limited information comparing differences in health care utilization when rehabilitation is included in the management of NTKP. To describe the overall health care utilization associated with the management of NTKP; estimate the proportion of people who receive outpatient rehabilitation services; and evaluate the timing of outpatient rehabilitation and its association with other health care utilization. Rretrospective cohort study was conducted using a random 10% sample of 2009-2010 Medicare claims. The sample included 52,504 beneficiaries presenting within the ambulatory setting for management of NTKP. Exposure to outpatient rehabilitative services following the NTKP index ambulatory visit was defined as 1) no rehabilitation; 2) early rehabilitation (1-15 days); 3) intermediate rehabilitation (16-120 days); and 4) late rehabilitation (>120 days). Logistic regression models were fit to analyze the association of rehabilitation timing with narcotic analgesic use, utilization of nonsurgical invasive procedure, and knee surgery during a 12-month follow-up period. Only 11.1% of beneficiaries were exposed to outpatient rehabilitation services. The likelihood of using narcotics, nonsurgical invasive procedures, or surgery was significantly less (adjusted odds ratios; 0.67, 0.50, 0.58, respectively) for those who received early rehabilitation when compared to no rehabilitation. The exposure-outcome relationships were reversed in the intermediate and late rehabilitation cohorts. This was an observational study, and residual confounding could affect the observed relationships. Therefore, definitive conclusions regarding the causal effect of rehabilitation exposure and reduced utilization of more aggressive interventions cannot be determined at this time. Early referral for outpatient rehabilitation may reduce the utilization of health services that carry greater risks or costs in those with NTKP. © 2017 American Physical Therapy Association

Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database

PubMed Central

2012-01-01

Background Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients’ functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Methods Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. Results The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). Conclusions In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet. PMID:22898402

Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

PubMed

Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

2016-02-01

In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions

PubMed Central

2014-01-01

Background The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable. Methods Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research. Results Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues. Conclusions Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors. PMID:24606911

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

PubMed

Krauth, Christian; Bartling, Tim

2017-04-01

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

Comparative cost analysis of outpatient and inpatient rehabilitation for musculoskeletal diseases in Germany.

PubMed

Zeidler, J; Mittendorf, T; Vahldiek, G; Zeidler, H; Merkesdal, S

2008-10-01

To examine the costs of inpatient and outpatient rehabilitation for musculoskeletal disorders from the perspective of a major statutory health insurance fund in Germany. A nation-wide database from a major health insurance fund in Germany was used to evaluate all rehabilitation cases in 2005. In addition, to all direct cost domains of the rehabilitation itself, costs incurred in the preceding and the following year for hospital treatment, drugs and physical therapy were analysed. A cost-cost analysis in different institutional settings was chosen for the cost comparison of inpatient and outpatient rehabilitation. To minimize the influence of possible confounders, a statistical control system was implemented. After a preceding hospital stay, inpatient and outpatient rehabilitation results in mean costs of euro2047 and euro1111, respectively. If the rehabilitation was not preceded by a directly related hospital treatment, mean costs for inpatient (outpatient) rehabilitation were euro2067 (euro1310). No systematic differences could be found between inpatient and outpatient rehabilitation evaluating costs for hospital treatment, drugs or physical therapy in the year preceding and the year directly following the rehabilitation. Assuming comparable medical outcomes, outpatient rehabilitation seems to be a superior alternative compared with inpatient rehabilitation from an economic perspective. Hence, from the perspective of the statutory health insurance, fostering a higher market share of outpatient rehabilitation may add to a better allocation of overall health care resources. For this, regional differences in rehabilitation infrastructure have to be taken into account.

'The horse has bolted I suspect': A qualitative study of clinicians' attitudes and perceptions regarding palliative rehabilitation.

PubMed

Runacres, Fiona; Gregory, Heidi; Ugalde, Anna

2017-07-01

Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. Qualitative study utilizing semi-structured interviews. Transcribed interviews were analysed using thematic analysis and major themes reported as results. Australian palliative medicine physicians working in inpatient palliative care units. In total, 20 physicians participated, representing specialist palliative care services across Australia. A total of 11 (55%) were males with an average of 12.5 years' experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care; however, few felt adequate rehabilitation programmes were available. Participants varied in their concepts of what palliative rehabilitation entailed. The term rehabilitation was seen by some as helpful (fostering hope and aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians' attitudes, including (1) integrating rehabilitation within palliative care, (2) the intervention, (3) possibilities and (4) the message of rehabilitation. A lack of consensus exists among palliative medicine specialists regarding the definition and scope of palliative rehabilitation. Participants generally expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base for palliative rehabilitation, to support its acceptance and widespread integration within specialist inpatient palliative care.

75 FR 21273 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Rehabilitation of Individuals Who are Mentally Ill. 84.129J Rehabilitation Psychology. 84.129P Specialized... Mentally Ill. 84.129J Rehabilitation 100,000 2 Psychology. 84.129P Specialized Personnel 100,000 3 for...

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...

20 CFR 702.501 - Vocational rehabilitation; objective.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Vocational rehabilitation; objective. 702.501 Section 702.501 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR LONGSHOREMEN... Rehabilitation § 702.501 Vocational rehabilitation; objective. The objective of vocational rehabilitation is the...

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...

Private Rehabilitation.

ERIC Educational Resources Information Center

McMahon, Brian T., Ed.

1983-01-01

Discusses the expanding role of the rehabilitation counselor into private sector rehabilitation in the seven articles of this special issue. Topics cover private rehabilitation in an insurance context including forensics issues, computer applications, recent trends, services in a multiprogram private clinic, and rehabilitation counselor training.…

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...

Hand Rehabilitation Robotics on Poststroke Motor Recovery

PubMed Central

2017-01-01

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

Outpatient spinal cord injury rehabilitation: managing costs and funding in a changing health care environment.

PubMed

Riis, V; Verrier, M C

2007-10-15

To examine the literature describing the cost of outpatient rehabilitation for patients with spinal cord injury (SCI) as well as the effect of funding type on cost and outcome. A SCI rehabilitation planning and funding model is presented that calls for structured assessment of the client's economic environment, with follow through to promote full access to funding for rehabilitation plans. Literature review of specific outpatient rehabilitation intervention costs and effect of funding type, followed by development of a funding model to improve access to available funding for SCI rehabilitation. There is insufficient economic data to draw conclusions about the relationship between an individual's rehabilitation needs and access to appropriate funding for outpatient rehabilitation. Consequently, health providers and payers need to adopt an approach that will improve consistency of payment decisions and access to necessary funding for rehabilitation. A model for a more formal approach to: (a) Assessment of a client's economic environment; (b) use of evidence-based SCI rehabilitation; and (c) use of available financial resources should promote better access to appropriate rehabilitation following SCI.

Strengthening health-related rehabilitation services at national levels.

PubMed

Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

2018-04-18

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

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.

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...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... 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...

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...

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...

Exemplar Rehabilitation Educators' Defining Moments and Career Reflections

ERIC Educational Resources Information Center

Graf, Noreen M.; Marini, Irmo; Reed, Bruce; Sharma, Manisha

2018-01-01

Objective: To discover senior and retired exemplary rehabilitation educators' defining career moments and to provide doctoral students and early career rehabilitation educators with insights from widely recognized and successful rehabilitation educators in the field. Method: Twenty-seven exemplary rehabilitation educators answered qualitative…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

...-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...

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...

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

PubMed

Walther, A L; Deck, R

2015-08-01

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

Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants.

PubMed

Saltychev, Mikhail; Laimi, Katri; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2014-06-01

To investigate the changes in rehabilitants' perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics. Prospective cohort study based on register and repeated survey data. Public sector employees in ten towns and five hospital districts. A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009. Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland. Differences in perceived work ability level before and after rehabilitation. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation. Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval -0.98 to -0.67) in the short-term and by 1.26 (95% confidence interval -1.45 to -1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants' baseline characteristics. Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation. © The Author(s) 2014.

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.

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

PubMed

Beyer, Joachim; Seidel, Egbert J

2017-08-01

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

Effects of Transferring to the Rehabilitation Ward on Long-Term Mortality Rate of First-Time Stroke Survivors: A Population-Based Study.

PubMed

Chen, Chien-Min; Yang, Yao-Hsu; Chang, Chia-Hao; Chen, Pau-Chung

2017-12-01

To assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward. Long-term mortality rates of first-time stroke survivors during hospitalization were compared among the following sets of patients: patients transferred to the rehabilitation ward, patients receiving rehabilitation without being transferred to the rehabilitation ward, and patients receiving no rehabilitation. Retrospective cohort study. Patients (N = 11,419) with stroke from 2005 to 2008 were initially assessed for eligibility. After propensity score matching, 390 first-time stroke survivors were included. None. Cox proportional hazards regression model was used to assess differences in 5-year poststroke mortality rates. Based on adjusted hazard ratios (HRs), the patients receiving rehabilitation without being transferred to the rehabilitation ward (adjusted HR, 2.20; 95% confidence interval [CI], 1.36-3.57) and patients receiving no rehabilitation (adjusted HR, 4.00; 95% CI, 2.55-6.27) had significantly higher mortality risk than the patients transferred to the rehabilitation ward. Mortality rate of the stroke survivors was affected by age ≥65 years (compared with age <45y; adjusted HR, 3.62), being a man (adjusted HR, 1.49), having ischemic stroke (adjusted HR, 1.55), stroke severity (Stroke Severity Index [SSI] score≥20, compared with SSI score<10; adjusted HR, 2.68), and comorbidity (Charlson-Deyo Comorbidity Index [CCI] score≥3, compared with CCI score=0; adjusted HR, 4.23). First-time stroke survivors transferred to the rehabilitation ward had a 5-year mortality rate 2.2 times lower than those who received rehabilitation without transfer to the rehabilitation ward and 4 times lower than those who received no rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Is a rehabilitation treatment taxonomy the right answer to the rehabilitation black box?

PubMed

Cieza, Alarcos; Bickenbach, Jerome

2014-01-01

In this commentary on the development of an interventions taxonomy for medical rehabilitation, a rehabilitation treatment taxonomy (RTT), we acknowledge the authors' valuable contribution to rehabilitation science, and at the same time interrogate the assumption that a taxonomy has essential added value to address the challenge of rehabilitation's black box. The tripartite analytical structure of action of treatment, active ingredient, and mechanism of action, and not an RTT, is the key to addressing the rehabilitation black box. There is a need for clearly defined operationalized requirements of how the 3 components have to be expressed. We also recommend that this concerted effort be linked to all relevant stakeholders and all international endeavors that are pursuing a common goal of enhancing rehabilitation research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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…

Client Aggression toward Rehabilitation Counselors Employed by State Vocational Rehabilitation Agencies

ERIC Educational Resources Information Center

Trice, April Lynette

2011-01-01

Through a series of interviews this transcendental phenomenological study explored how rehabilitation counselors employed by state vocational rehabilitation agencies experienced client aggression. More specifically, it examined the circumstances involved when client aggression manifested in the work lives of rehabilitation counselors. This study…

Professional Identity and the Future of Rehabilitation Counseling

ERIC Educational Resources Information Center

Patterson, Jeanne B.

2009-01-01

This article describes a vision of rehabilitation counseling, wherein both the profession of rehabilitation counseling and the diverse roles of rehabilitation counselors are recognized and valued by rehabilitation counselors, the general public, and other professionals in promoting social justice and equal opportunity for individuals with…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

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

78 FR 13597 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... and rehabilitation research; (2) foster an exchange of expertise, information, and training methods to... refined analyses of data, producing observational findings, and creating other sources of research-based... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Center AGENCY...

78 FR 29234 - Final Priority; National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and... Center (RRTC) on Disability Statistics and Demographics under the Disability and Rehabilitation Research Projects and Centers program administered by the National Institute on Disability and Rehabilitation...

77 FR 13575 - Disability and Rehabilitation Research Project; National Data and Statistical Center for the Burn...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... the Science Review. American Journal of Physical Medicine and Rehabilitation, 85 (2006) 383-413... DEPARTMENT OF EDUCATION Disability and Rehabilitation Research Project; National Data and... Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers...

Rehabilitation Engineering Sourcebook [and] Rehabilitation Engineering Sourcebook Supplement I.

ERIC Educational Resources Information Center

Institute for Information Studies, Falls Church, VA.

Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…

78 FR 22780 - Final 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 Center (RERC) on Hearing Enhancement under the Disability and Rehabilitation Research Projects and...

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...

38 CFR 21.6080 - Requirement for an individualized written rehabilitation or employment assistance plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... individualized written rehabilitation or employment assistance plan. 21.6080 Section 21.6080 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND... Rehabilitation Plan § 21.6080 Requirement for an individualized written rehabilitation or employment assistance...

[Willingness of Patients with Obesity to Use New Media in Rehabilitation Aftercare].

PubMed

Dorow, M; Löbner, M; Stein, J; Kind, P; Markert, J; Keller, J; Weidauer, E; Riedel-Heller, S G

2017-06-01

Digital media offer new possibilities in rehabilitation aftercare. This study investigates the rehabilitants' willingness to use new media (sms, internet, social networks) in rehabilitation aftercare and factors that are associated with the willingness to use media-based aftercare. 92 rehabilitants (patients with obesity) filled in a questionnaire on the willingness to use new media in rehabilitation aftercare. In order to identify influencing factors, binary logistic regression models were calculated. 3 quarters of the rehabilitants (76.1%) reported that they would be willing to use new media in rehabilitation aftercare. The binary logistic regression model yielded two factors that were associated with the willingness to use media-based aftercare: the possession of a smartphone and the willingness to receive telephone counseling for aftercare. The majority of the rehabilitants was willing to use new media in rehabilitation aftercare. The reasons for refusal of media-based aftercare need to be examined more closely. © Georg Thieme Verlag KG Stuttgart · New York.

[The prospects of research on VR rehabilitation engineering].

PubMed

Huang, J; Liu, H; Li, H; Sun, Q; Xu, Y; Ling, D

1999-06-01

In this paper, we present the recent development of Vitual Reality (VR) technology and rehabilitation engineering and discuss the rationality and feasibility of the application of VR to rehabilitation. With VR technology, psychological induction can be better introduced in rehabilitating exercises and patients can be tremendously released from fret during traditional physical training for rehabilitation. The VR is expected to bring about a technological revolution in rehabilitation engineering.

Mobility Functional Outcomes of Neurofibromatosis Patients: A Preliminary Report.

PubMed

Ngo-Huang, An; Yadav, Rajesh; Fu, Jack B; Liu, Diane; Williams, Janet L; Bruera, Eduardo; Guo, Ying

2018-01-01

The aim of the study was to describe the mobility outcomes of neurofibromatosis (NF) patients who received acute inpatient rehabilitation. This is a retrospective study of 62 consecutive neurofibromatosis patients of any age who received physical medicine and rehabilitation consultations at a comprehensive cancer center. Postoperative, inpatient rehabilitation admission and discharge functional independence measures (FIM scores) of transfers and gait and length of hospital stay were obtained from 37 patients who were transferred to inpatient rehabilitation (acute rehabilitation) and 25 who had an alternative disposition (consultation only). Mean age was 34 yrs. Both groups had similar postoperative FIM transfer and gait scores; however, at approximately postoperative day 10, the consultation only group was discharged with median FIM of 5 (supervision level) as compared with the acute rehabilitation group FIM of 4 (P = 0.000). The acute rehabilitation group had improved mobility FIM scores from postoperative to rehabilitation admission and again from rehabilitation admission to discharge (P < 0.0001). At discharge, the acute rehabilitation group ambulated a significantly longer distance (500 f. vs. 300 ft) (P = 0.04). The median length of hospital stay for the acute rehabilitation and consultation only groups was 20 and 10 days, respectively (P = 0.004). Acute inpatient rehabilitation leads to improvement in mobility-associated FIM scores for neurofibromatosis patients minimizing caregiver needs at home.

Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care.

PubMed

Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

2017-01-01

Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

PubMed

Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

2013-01-01

This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p < 0.05). This study highlights the importance of pre-morbid function and social factors in addition to post-stroke function in the decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

Patient perspectives on navigating the field of traumatic brain injury rehabilitation: a qualitative thematic analysis.

PubMed

Graff, Heidi J; Christensen, Ulla; Poulsen, Ingrid; Egerod, Ingrid

2018-04-01

This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury. We used a qualitative explorative design with semi-structured in-depth interviews. Twenty participants with TBI were included from a level I Trauma Center in Denmark at 1-4 years post-injury. Qualitative thematic analysis was applied for data analysis. Three main themes emerged during analysis: A new life, Family involvement, and Rehabilitation impediments. These themes and their sub-themes described the patient perspective of TBI and rehabilitation post hospitalization. Participants reassessed their values and found a new life after TBI. Family caregivers negotiated rehabilitation services and helped the participant to overcome barriers to rehabilitation. Although participants were entitled to TBI rehabilitation, they had to fight for the services they were entitled to. Individuals with TBI found ways of coping after injury and created a meaningful life. Barriers to TBI rehabilitation were overcome with help from family caregivers rather than health care professionals. Future studies need to find ways to ease the burden on family caregivers and pave the way for more accessible rehabilitation in this vulnerable group of patients. Implications for rehabilitation TBI rehabilitation might benefit from:    • Increased transparency in rehabilitation options    • More systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation.

Rehabilitation strategies enhancing participation in shopping malls for persons living with a disability.

PubMed

Alary Gauvreau, Christine; Kairy, Dahlia; Mazer, Barbara; Guindon, Andréanne; Le Dorze, Guylaine

2018-04-01

After rehabilitation, it is not clear the extent to which persons living with a disability return to their former activities in the community, such as going to shopping malls. Rehabilitation professionals are faced with the challenge to adequately prepare their clients to resume community participation. The purpose of this study was to identify rehabilitation strategies aimed at preparing clients to engage in activities in shopping malls. Twenty-two participants including 16 rehabilitation clinicians and 6 persons living with a disability participated in four nominal group sessions. Participants were questioned on current or potential rehabilitation strategies carried out to enhance participation in shopping malls for persons living with a disability. Discussions were audio-recorded and qualitative content analysis was conducted. Participants mentioned strategies that were either carried out by the clinician, or in collaboration with other parties. The latter type of strategies was either carried out with the collaboration of the client, the interdisciplinary team, the relatives, or community organizations. Rehabilitation clinicians have a role to play in preparing persons living with a disability to resume activities in a shopping mall. Additionally, therapeutic interventions in community settings may enhance the participation of rehabilitation clients in their everyday activities. Implications for rehabilitation Many strategies are currently used in rehabilitation to prepare persons living with a disability to resume shopping activities. Clinicians could implement shopping-oriented rehabilitation strategies with the client and/or with other rehabilitation partners. Involving clients in activities related to shopping might enhance their participation in shopping malls after rehabilitation. Rehabilitation clinicians can be facilitators for people living with a disability to reach optimal participation.

Important Clinical Rehabilitation Principles Unique to People with Non-traumatic Spinal Cord Dysfunction.

PubMed

New, Peter Wayne; Eriks-Hoogland, Inge; Scivoletto, Giorgio; Reeves, Ronald K; Townson, Andrea; Marshall, Ruth; Rathore, Farooq A

2017-01-01

Background: Non-traumatic spinal cord dysfunction (SCDys) is caused by a large range of heterogeneous etiologies. Although most aspects of rehabilitation for traumatic spinal cord injury and SCDys are the same, people with SCDys have some unique rehabilitation issues. Purpose: This article presents an overview of important clinical rehabilitation principles unique to SCDys. Methods: Electronic literature search conducted (January 2017) using MEDLINE and Embase (1990-2016) databases for publications regarding SCDys. The focus of the literature search was on identifying publications that present suggestions regarding the clinical rehabilitation of SCDys. Results: The electronic search of MEDLINE and Embase identified no relevant publications, and the publications included were from the authors' libraries. A number of important clinical rehabilitation principles unique to people with SCDys were identified, including classification issues, general rehabilitation issues, etiology-specific issues, and a role for the rehabilitation physician as a diagnostic clinician. The classification issues were regarding the etiology of SCDys and the International Standards for Neurological Classification of Spinal Cord Injury. The general rehabilitation issues were predicting survival, improvement, and rehabilitation outcomes; admission to spinal rehabilitation units, including selection decision issues; participation in rehabilitation; and secondary health conditions. The etiology-specific issues were for SCDys due to spinal cord degeneration, tumors, and infections. Conclusions: Although there are special considerations regarding the rehabilitation of people with SCDys, such as the potential for progression of the underlying condition, functional improvement is typically significant with adequate planning of rehabilitation programs and special attention regarding the clinical condition of patients with SCDys.

Survey of referring veterinarians' perceptions of and reasons for referring patients to rehabilitation facilities.

PubMed

Alvarez, Leilani X; Fox, Philip R; Van Dyke, Janet B; Grigsby, Patrick

2016-10-01

OBJECTIVE To identify patterns of referral to US small animal rehabilitation facilities, document referring veterinarians' perceptions of rehabilitation services, and examine factors that encouraged and impeded referral of veterinary patients to rehabilitation facilities. DESIGN Cross-sectional survey. SAMPLE 461 completed surveys. PROCEDURES Referral lists were obtained from 9 US rehabilitation facilities, and surveys were emailed or mailed to 2, 738 veterinarians whose names appeared on those lists. Data obtained from respondents were used to generate descriptive statistics and perform χ(2) tests to determine patterns for referral of patients to rehabilitation facilities. RESULTS 461 surveys were completed and returned, resulting in a response rate of 16.8%. The margin of error was < 5% for all responses. Most respondents (324/461 [70.3%]) had referred patients for postoperative rehabilitation therapy. Respondents ranked neurologic disorder as the condition they would most likely consider for referral for future rehabilitation therapy. The most frequently cited reason for not referring a patient for rehabilitation therapy was perceived cost (251/461 [54.4%]) followed by distance to a rehabilitation facility (135/461 [29.3%]). Specialists were more likely than general practitioners to refer patients for rehabilitation therapy. The majority (403/461 [87.4%]) of respondents felt that continuing education in the field of veterinary rehabilitation was lacking. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated a need for continuing education in small animal rehabilitation for veterinarians. Improved knowledge of rehabilitation therapy will enable veterinarians to better understand and more specifically communicate indications and benefits for pets receiving this treatment modality.

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

PubMed

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

2011-01-01

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

Inpatient rehabilitation diabetes consult service: a rehabilitation psychology approach to assessment and intervention.

PubMed

Schumann, Kristina P; Touradji, Pegah; Hill-Briggs, Felicia

2010-11-01

Diabetes clinical practice recommendations call for assessment and intervention on diabetes self-management during inpatient hospitalization. Although diabetes is prevalent in inpatient rehabilitation settings, diabetes self-management has not traditionally been a focus of inpatient rehabilitation psychology care. This is because diabetes is often a secondary diagnosis when an individual is admitted to rehabilitation for an acute event. The authors provide a rationale for a role for rehabilitation psychologists in assessing and intervening on the psychosocial, behavioral, and functional self-management needs of individuals with diabetes within the rehabilitation setting. The development of a rehabilitation psychology Inpatient Rehabilitation Diabetes Consultation Service is described. Theoretical and empirical bases for compilation of the assessment and intervention materials are provided. Format and implementation of the service on a university-affiliated inpatient rehabilitation unit is described, with special consideration given to professional issues faced by rehabilitation psychologists and teams. A flexible consultation model was implemented using a guided diabetes psychosocial assessment with brief educational handouts addressing selected key topics (i.e., hyperglycemia, hypoglycemia, blood sugar monitoring, nutrition, physical activity, medication, and, A1C and average blood sugar). The consultation service was feasible and well-accepted by treated individuals and the rehabilitation team. Rehabilitation psychologists are uniquely positioned to address the functional, psychosocial, and behavioral needs of individuals with diabetes. With further research to assess clinical outcomes, this approach may further address practice recommendations for inpatient diabetes care. Moreover, such a diabetes consultation model may be useful on an outpatient rehabilitation basis as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Ambivalence in rehabilitation: thematic analysis of the experiences of lower limb amputated veterans.

PubMed

Christensen, Jan; Langberg, Henning; Doherty, Patrick; Egerod, Ingrid

2017-06-20

Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. We used a qualitative exploratory design, triangulating interviews and participant observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post-hospitalization rehabilitation and included field notes in the dataset. Two main themes emerged: "experiencing different identities" and "experiencing discontinuity in rehabilitation." The first theme illustrated how veterans actively shift between the identities of disabled person, wounded veteran and athlete according to the context. The second theme illustrated the frustration of negotiating military versus civilian mindsets during rehabilitation and lack of coordination between the public healthcare system, municipal services and the military. Veterans live with shifting identities after returning to civilian life, increasing their awareness of the transition from active service to a new life as a civilian. During rehabilitation, it is important to acknowledge the disparities between the military and civilian mindsets and to integrate the different sets of values, such as structure versus autonomy. IMPLICATIONS FOR REHABILITATION Recommendations for the improvement of rehabilitation of amputated veterans include: Rehabilitation professionals working with veterans should focus on abilities instead of disabilities, in order to support their active identity. Rehabilitation professionals working with veterans should understand and integrate military key components, such as autonomy, structure, clear expectations, goal setting and ongoing testing and adjustment of goals. Rehabilitation professionals working with veterans should facilitate collaboration between civilian and military rehabilitation services, in order to secure both physical and psychosocial reintegration.

What Do Stroke Patients Look for in Game-Based Rehabilitation

PubMed Central

Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

2016-01-01

Abstract Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients’ places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey – interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey – a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected) games to be operated on commodity hardware and brings cost-effective rehabilitation systems to more and more patients’ home for long-term recovery. PMID:26986120

Between ideals and reality in home-based rehabilitation

PubMed Central

Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

2016-01-01

Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were collected through 24 individual interviews and seven group interviews with employees – service providers and managers – in the home-based service of two boroughs in Oslo, Norway. The data were analysed using a systematic text-condensation method. Results The results show that rehabilitation receives little attention in the boroughs and that patients are seldom rehabilitated at home. There is disagreement among professional staff as to what rehabilitation is and should be. The purchaser–provider organization, high speed of service delivery, and scarcity of resources are reported to hamper rehabilitation work. Conclusion and implications A discrepancy exists between the high level of ambitious goals of Norwegian health authorities and the possibilities that practitioners have to achieve them. This situation results in healthcare staff being squeezed by the increasing expectations and demands of the population and the promises and statutory rights coming from politicians and administrators. For the employees in the municipalities to place rehabilitation on the agenda, it is a requirement that authorities understand the clinical aspect of rehabilitation and provide the municipalities with adequate framework conditions for successful rehabilitation work. Key pointsHome-based rehabilitation is documented to be effective, and access to rehabilitation has been established in Norwegian law.The purchaser–provider organization, high rate of speed, and a scarcity of resources in home-based services hamper rehabilitation work.Healthcare providers find themselves squeezed between the health authorities’ overarching guidelines and requirements and the possibilities of achieving them.Rehabilitation must be placed on the agenda on the condition that authorities understand the clinical aspect of rehabilitation. PMID:26828898

What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

PubMed

Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

2016-03-01

Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected) games to be operated on commodity hardware and brings cost-effective rehabilitation systems to more and more patients' home for long-term recovery.

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...

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...

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... workshop or rehabilitation facility may be an institutional, on-job, or combination course which has been... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation...

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...

24 CFR 203.50 - Eligibility of rehabilitation loans.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., based upon the sum of the estimated cost of rehabilitation and the Commissioner's estimate of the value... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Eligibility of rehabilitation loans... Properties § 203.50 Eligibility of rehabilitation loans. A rehabilitation loan which meets the requirements...

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...

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...

78 FR 14480 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... and rehabilitation research; (2) foster an exchange of expertise, information, and training methods to... disabilities, as well as to build the research capacity of entities with close cultural and social connections... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Center on Research...

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...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 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 350.30 - What requirements must a Rehabilitation Engineering Research Center meet?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true 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, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true 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 350.30 - What requirements must a Rehabilitation Engineering Research Center meet?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 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 350.30 - What requirements must a Rehabilitation Engineering Research Center meet?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true 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 350.32 - What activities must a Rehabilitation Engineering Research Center conduct?

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

2011-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

Counseling in the Rehabilitation Process: Community Services for Mental and Physical Disabilities. Second Edition.

ERIC Educational Resources Information Center

Gandy, Gerald L.; Martin, E. Davis, Jr.; Hardy, Richard E.

This text provides an overview of vocational rehabilitation counseling and services. Part 1 lays the foundation. "Foundations of Rehabilitation" (Martin) describes bases of the process. "Historical Antecedents of the Rehabilitation Enterprise in America" and "Development of the Rehabilitation Enterprise in America" (Lassiter, Lassiter) describe…

Vocational Rehabilitation Outcomes: Relationship between Individualized Plan for Employment Goals and Employment Outcomes

ERIC Educational Resources Information Center

Beveridge, Scott; Fabian, Ellen

2007-01-01

This study examined the relationship between attaining a job congruent with the Individualized Plan for Employment (IPE) vocational rehabilitation goal and vocational rehabilitation outcomes. Study participants were 171 vocational rehabilitation clients served by the Maryland State Department of Education Division of Rehabilitation Services (DORS)…

76 FR 33744 - Final Priority; National Institute on Disability and Rehabilitation Research (NIDRR)-Disability...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... and Rehabilitation Research (NIDRR)--Disability Rehabilitation Research Project (DRRP)--Disability in... Rehabilitative Services announces a funding priority for the Disability and Rehabilitation Research Projects and...) 2011 and later years. We take this action to focus research attention on areas of national need. We...

[Neuroplasticity as a basis for early rehabilitation of stroke patients].

PubMed

Putilina, M V

2011-01-01

The review is devoted to the current state of the problem of early rehabilitation of stroke patients. The rate of primary disability in patients after stroke is 3.2 per 10000 population but only 20% of previously working patients return to work. Early rehabilitation is treatment actions during a period following stroke. Adequate treatment during this period may decrease the extent of brain damage and improve disease outcome. The complexity of rehabilitation consists in using several complementary pharmacological and non-pharmacological rehabilitation measures. Appearance of new techniques of rehabilitation treatment aimed at neuroplasticity stimulation increases treatment potential of rehabilitative technologies.

[Subjective Level of Information and Information Needs of Patients with an Approved Rehabilitation Application and Patients at the End of Rehabilitation Results of a Written Survey].

PubMed

Walther, Anna Lena; Schreiber, Dora; Falk, Johannes; Deck, Ruth

2017-08-01

Aim The aim of the study was to identify the subjective level of information and information needs of patients with an approved rehabilitation application and patients at the end of rehabilitation with regard to preferred subjects and kind of information transfer. Method Written survey with N=283 patients with approved rehabilitation application and N=388 patients at the end of rehabilitation. Results Both groups reported high information needs particularly regarding treatments during rehabilitation, rehabilitation aftercare and rehabilitation aims. A conversation with their physician, a brochure and a website are the preferred information pathways. Conclusion Taking into account the topics for which both groups require information and the preference regarding the kind of information transfer can make a valuable contribution for the development of needs-oriented information material. © Georg Thieme Verlag KG Stuttgart · New York.

Strengthening rehabilitation services in Indonesia: A brief situation analysis.

PubMed

Nugraha, Boya; Setyono, Garry Rahardian; Defi, Irma Ruslina; Gutenbrunner, Christoph

2018-04-18

People with disability (PWD) in Indonesia are often neglected by society. Improving their life situation towards full participation in society is crucial. As a health strategy, rehabilitation can improve func-tioning, quality of life and participation in society. However, rehabilitation services in Indonesia need improvement. Making a situation analysis of rehabilitation services and their provision in the country is a pre-requisite to taking any action towards improvement. This paper compiles available data related to disability and rehabilitation services in Indonesia, using the Rehabilitation Services Assessment Tool (RSAT) as a framework. Gaps in provision were analysed, resulting in the compilation of a list of generic recommendations to improve rehabilitation services in the country. Indonesia faces many challenges in rehabilitation services, including the health workforce and the provision of services. This situation analysis and list of generic recommendations may be used in further discussions with relevant stakeholders in the country to develop a national strategy to strengthen rehabilitation services.

[In-patient (early) rehabilitation].

PubMed

Wallesch, Claus-W; Lautenschläger, Sindy

2017-04-01

It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession. Whereas geriatric and neurological early rehabilitation are reflected in the DRG system, the former provided in many general hospitals and the latter mainly in specialized institutions, interdisciplinary early rehabilitation has only occasionally been represented in the DRG system so far. If all acute in-patients who require early rehabilitation should receive such an intervention, an additional fee must be implemented for this this interdisciplinary service.

Mental health assessment in rehabilitation: a descriptive study through an international internet survey.

PubMed

Juengst, Shannon; Nordvik, Jan E; Junttila, Ilkka S; Smith, Jason; Kew, Chung L; Laukkala, Tanja

2018-06-16

This cross-sectional study assessed international rehabilitation practitioners' views of mental health assessment (MHA), related specifically to assessment tools and needs in the field. We delivered an anonymous web-based survey capturing rehabilitation practioners' perspectives on MHA practices, assessment tools, and needs through the American Congress of Rehabilitation Medicine in the USA and through national rehabilitation networks in Finland and Norway. Altogether, 355 rehabilitation professionals answered the survey. Unmet MHA needs, most often attributed to insufficient time (112/269 responders), were recognized among rehabilitation professionals irrespective of the country of practice. When professional experience was weighed against barriers to conducting MHA, cost was statistically significantly linked to professional experience, with those with less experience viewing cost more as a barrier (P=0.019). Rehabilitation professionals from different professions, in different countries, and working with a variety of clinical populations recognize defined barriers to MHA in rehabilitation.

[First Results of Analysis of Russian Part of the European Register on Cardiac Rehabilitation EuroCaReD (European Cardiac Rehabilitation Database)].

PubMed

Pogosova, N V; Sokolova, O Iu; Iufereva, Iu M; Osipova, I V; Riamzina, I N

2015-01-01

The joint European Registry of patients with cardiovascular diseases participating in cardiac rehabilitation programs (European Cardiac Rehabilitation Database, EuroCaReD) is conducted in collaboration between the ESC and EACPR). It's main goals were to improve the routine use of cardiac rehabilitation, to develop joint standards for cardiac rehabilitation in all European countries and evidence based rehabilitation programs and to monitor any changes. In the EuroCaReD registry participated a total of 44 centers from 13 countries, including 3 centers from Russia, which enrolled 151 patients during 2010-2012. This paper is comparing the baseline demographics, clinical data and risk factors in Russian patients versus the rest of Europe. It was shown that cardiac rehabilitation patients in Russia, as in the whole cohort, are predominantly male. Elderly patients from Russia were 3 times less likely to be referred for rehabilitation than in Europe. Unlike the whole cohort Russian patients were almost never sent to rehabilitation because of heart failure or stable angina. Likewise the whole Europe Russian patients had an average of 3 cardiovascular risk factors before rehabilitation, but with some national differences in their prevalence and severity.

[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.

A framework for the role of Registered Nurses in the specialty practice of rehabilitation nursing in Australia.

PubMed

Pryor, Julie; Smith, Clair

2002-08-01

This study sought to explore systematically the role of Registered Nurses working in rehabilitation in Australia. Rehabilitation has been identified as an important aspect of health care. However, evidence of a comprehensive investigation of the nurses' role in rehabilitation cannot be found. From Australia, in particular, no research has been published in this area. This study used a qualitative approach by engaging 13 nurses in one-to-one interviews and a further 21 in focus group discussions. Thematic analysis was conducted on the interview and focus group data. Seven domains of practice were identified and are suggested as a framework for the specialty practice of rehabilitation nursing. They capture the 'how' and 'what' of rehabilitation nursing practice. Central to this practice is a rehabilitative approach to patient care, teaching and coaching, and continual assessment. The nurses explained in detail how these aspects of rehabilitation nursing differentiate their practice from that of their acute care colleagues. The rehabilitative approach is one of a variety of approaches to nursing care, but should not be seen as the exclusive domain of rehabilitation nurses. Rehabilitation belongs in every nurse's toolkit.

Association between Self-Reported Participation in Decision Making and Inpatient Rehabilitation Outcomes.

PubMed

Wylegala, Juli A; Graham, James E; Karmarkar, Amol M; Illig, Caitlin; Illig, Sandra Bennett; Ottenbacher, Kenneth J

2015-09-01

Retrospective cross sectional. The purpose of this study was to assess the independent associations between perceived participation in clinical decision making on rehabilitation length of stay, discharge functional status, and discharge setting following inpatient rehabilitation. Active participation in the inpatient rehabilitation process, which is the most intense post-acute rehabilitation service, should lead to better patient experiences and outcomes. Self-reported information from participant interviews was linked with data in administrative medical records for Medicare beneficiaries discharged from inpatient rehabilitation facilities in 2007-2009. The decision making variable assessed participants' perceived participation in decision making during their inpatient rehabilitation stays. The three outcome variables were inpatient rehabilitation length of stay, discharge functional status, and discharge setting. Among the 41,110 participants interviewed, approximately 89% strongly agreed or agreed , and 12% disagreed that they participated in decision making during their rehabilitation stays. The multivariable regression models showed that greater participation in decision making was associated (p < .05) with slightly longer lengths of stay, higher discharge functional status, and increased likelihood of community discharge. Nearly nine in 10 Medicare beneficiaries report participating in decision making when receiving inpatient rehabilitation services. Increasing participation may lead to improvements in fundamental rehabilitation outcomes.

Does effect of rehabilitation based on sensory conflicts in patients with vestibular deficits exceed learning effect?

PubMed

Pierchała, Katarzyna; Lachowska, Magdalena; Morawski, Krzysztof; Niemczyk, Kazimierz

2014-01-01

The purpose was to assess learning and rehabilitation effect and their influence on Sensory Organization Test results in young and elderly patients with peripheral, central and mixed vestibular pathology. 26 patients with different vestibular system deficits participated in this study. Rehabilitation was held five days a week, for two weeks. To assess learning effect, SOT was administered to each patient twice and compared: 1) on the day preceding the beginning of rehabilitation (SOT1), and 2) on the first day of rehabilitation (SOT2). To evaluate rehabilitation effect, results of SOT2 were compared to SOT3 (administered on the last day of rehabilitation). Learning effect showed similar improvement in CS in all groups but young. Rehabilitation caused further improvement in CS in all groups but central pathology. This improvement was similar between those groups. There was no significant difference found between learning and rehabilitation effect in CS. The results of our study indicate that none of the groups achieved significant benefit from rehabilitation based on sensory conflicts that would overcome the learning effect. However, the lack of significant advantage of rehabilitation over learning does not mean that it does not exist.

[Need for Information about Medical Rehabilitation of Persons with German Pension Insurance: a Written Survey].

PubMed

Walther, Anna Lena; Falk, Johannes; Deck, Ruth

2017-07-26

Aim In order to acquire target group-specific information on rehabilitation for members of the German pension insurance, they were asked about their ideas about medical rehabilitation and desired information regarding subjects and kind of information transfer. Method The core of the project was a written survey of members of the German pension insurance. N=600 insured people were invited to participate in the study. The questionnaire was developed in a qualitative pre-study. Results N=196 questionnaires were evaluated. Recovery of working ability was mentioned by most persons as the aim of medical rehabilitation. The most common idea regarding indication for rehabilitation was a specific operation. Physiotherapy was most often considered as therapy during medical rehabilitation. Information about formal steps, realistic aims and rehabilitation clinics were important. A conversation with their physician, written information material and a website were the preferred information pathways. Two-thirds of participants thought that information about medical rehabilitation was important even though they had no rehabilitation indication at the time of survey. Conclusion The identified target-related information needs can be considered in a need-oriented development of information material. These can contribute to an informed decision for members of the German pension insurance for or against medical rehabilitation or an application for rehabilitation. Moreover, patient-oriented information can contribute to more successful rehabilitation participation, higher satisfaction with and a better rating of medical rehabilitation. © Georg Thieme Verlag KG Stuttgart · New York.

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.

Medical rehabilitation after natural disasters: why, when, and how?

PubMed

Rathore, Farooq A; Gosney, James E; Reinhardt, Jan D; Haig, Andrew J; Li, Jianan; DeLisa, Joel A

2012-10-01

Natural disasters can cause significant numbers of severe, disabling injuries, resulting in a public health emergency and requiring foreign assistance. However, since medical rehabilitation services are often poorly developed in disaster-affected regions and not highly prioritized by responding teams, physical and rehabilitation medicine (PRM) has historically been underemphasized in global disaster planning and response. Recent development of the specialties of "disaster medicine" and "disaster rehabilitation" has raised awareness of the critical importance of rehabilitation intervention during the immediate postdisaster emergency response. The World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine has authored this report to assess the role of emergency rehabilitation intervention after natural disasters based on current scientific evidence and subject matter expert accounts. Major disabling injury types are identified, and spinal cord injury, limb amputation, and traumatic brain injury are used as case studies to exemplify the challenges to effective management of disabling injuries after disasters. Evidence on the effectiveness of disaster rehabilitation interventions is presented. The authors then summarize the current state of disaster-related research, as well as lessons learned from PRM emergency rehabilitation response in recent disasters. Resulting recommendations for greater integration of PRM services into the immediate emergency disaster response are provided. This report aims to stimulate development of research and practice in the emerging discipline of disaster rehabilitation within organizations that provide medical rehabilitation services during the postdisaster emergency response. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The impact of patient's weight on post-stroke rehabilitation.

PubMed

Kalichman, Leonid; Alperovitch-Najenson, Deborah; Treger, Iuly

2016-08-01

Purpose To evaluate the influence of patient's weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission - FIM at discharge) were evaluated. The Kruskal-Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = -0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients' BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.

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

[Recommendations for the Stepwise Occupational Reintegration: Can the Characteristic of the Patients Explain the Differences Between the Rehabilitation Centers?].

PubMed

Schmid, L; Jankowiak, S; Kaluscha, R; Krischak, G

2016-06-01

The first step to initiate a stepwise occupational reintegration (SOR) is the recommendation of the rehabilitation centers. Therefore rehabilitation centers have a significant impact on the use of SOR. There is evidence that the recommendation rate between the rehabilitation centers differs clearly. The present survey therefore analyses in detail the differences of the recommendation rate and examines which patient-related factors could explain the differences. This study is based on analysis of routine data provided by the German pension insurance in Baden-Württemberg (Rehabilitationsstatistikdatenbasis 2013; RSD). In the analyses rehabilitation measures were included if they were conducted by employed patients (18-64 years) with a muscular-skeletal system disease or a disorder of the connective tissue. Logistic regression models were performed to explain the differences in the recommendation rate of the rehabilitation centers. The data of 134 853 rehabilitation measures out of 32 rehabilitation centers were available. The recommendation rate differed between the rehabilitation centers from 1.36-18.53%. The logistic regression analysis showed that the period of working incapacity 12 month before the rehabilitation and the working capacity on the current job were the most important predictors for the recommendation of a SOR by the rehabilitation centers. Also the rehabilitation centers themselves have an important influence. The results of this survey indicate that the characteristic of the patients is an important factor for the recommendation of SOR. Additionally the rehabilitation centers themselves have an influence on the recommendation of SOR. The results point to the fact that the rehabilitation centers use different criteria by making a recommendation. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

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

2010-07-01

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

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

PubMed

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

2017-02-01

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

The European physical and rehabilitation medicine journal network: historical notes on national journals.

PubMed

Negrini, S; Ilieva, E; Moslavac, S; Zampolini, M; Giustini, A

2010-06-01

In the last 40 years, physical and rehabilitation medicine (PRM) has made significant steps forward in Europe with the foundation of the European Federation of Physical Medicine and Rehabilitation (EFPMR) (1963) which gave rise to the European Society of Physical and Rehabilitation Medicine (ESPRM) (2004) the European Academy of Rehabilitation Medicine (1970), the PRM Section of the European Union of Medical Specialists (1974), and the European Board of PRM (1991). Our journal, formerly Europa Medico-physica (1964), the official journal of the EFPMR, now European Journal of Physical and Rehabilitation Medicine (EJPRM) and official journal of the ESPRM since 2008, is distinct for its steadfast European vocation, long-standing Mediter-ranean interests and connections with various national scientific societies. Jointly with the ESPRM, efforts are under way to set up the European Physical and Rehabilitation Medicine Journal Network (EPRMJN). The aim of this article is to present a profile of the national journals in the EPRMJN so as to give a better overview of how the scientific part of PRM in Europe has developed within a national perspective. A profile of the following national journals is presented: Annals of Physical and Rehabilitation Medicine (France), Fizikalna i rehabilitacijska medicina (Physical and Rehabilitation Medicine) (Croatia), Neurorehabilitation (Bulgaria), Physical and Rehabilitation Medicine Portuguese Society Journal (Portugal), Physical Medicine, Rehabilitaton, Health (Bulgaria), Physikalische Medizin - Rehabilitationsmedizin - Kurort-medizin/Journal of Physical and Rehabilitation Medicine (Germany and Austria) Prevention and Rehabilitation (Bulgaria), Rehabilitacija (Rehabilitation) (Slovenia), Rehabilitación (Madr) (Spain), Turkish Journal of Physical Medicine and Rehabilitation (Turkey). Some national journals in Europe have a very long history and tradition of research and education. Having a better knowledge of these realities, usually hidden to the international readership owing to the English language barrier, could promote science in our specialty.

Rehabilitation time before disability pension.

PubMed

Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Ose, Solveig Osborg; Bjørngaard, Johan Håkon

2012-10-30

The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

PubMed Central

Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

2017-01-01

Introduction Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Materials and methods Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. Results In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Conclusion Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD. PMID:28652722

Rehabilitation of drug abusers: the roles of perceptions, relationships and family supports.

PubMed

Adejoh, Samuel Ojima; Temilola, Olusegun M; Adejuwon, Funmilayo F

2018-05-14

The increase in the use, abuse and misuse of psychoactive substances is not just of concern to national government of different countries but poses a big problem to the international community as well as of a global public health challenge. The study explored the perceived influence of perceptions, relationships and family support on rehabilitation of drug abusers undergoing rehabilitation in a rehabilitation centre. The non-experimental study design was used. The study population was that of drug abuse patients undergoing rehabilitation in the Neuropsychiatric Hospital in Lagos. Purposive sampling technique was used to select the respondents. Forty drug abusers who were met the criteria of not being a psychotic, had undergone detoxification, in the last stages of rehabilitation and consented to voluntarily participate were interviewed using In-depth Interview Guide to collect qualitative data based on the objectives of the study. The data were manually content analysed. The drug abusers viewed their condition as a mental disorder, an illness, a bad and dangerous habit that can be treated. They viewed their relationship with their rehabilitation officers as professional and cordial, which is essential for the rehabilitation process. Financial, material and moral supports given by the family were identified as important catalysts for quick rehabilitation. Rehabilitation officers and policy makers should consider on improving on the role of professional relationships and family support in the rehabilitation process of drug abusers undergoing rehabilitation.

Rehabilitation time before disability pension

PubMed Central

2012-01-01

Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders. PMID:23110397

[Social inequality in medical rehabilitation].

PubMed

Deck, Ruth; Hofreuter-Gätgens, Kerstin

2016-02-01

The analysis of inequalities in health care provision in Germany is of high sociopolitical relevance. For medical rehabilitation, which is an essential part of health care provision, only a few studies exist. With the example of psychosomatic and orthopedic medical rehabilitation, the present article investigates how features of social inequality influence different aspects of medical rehabilitation. The database consists of a written survey on the quality assurance of medical rehabilitation in northern Germany that includes 687 patients aged between 21 and 87 years. Aspects of the access to rehabilitation (e.g., the motivation for application), the process (participation in therapies) and the outcomes (e.g., subjective health and occupational risk) of rehabilitation were investigated in relation to social inequality. Social inequality was measured by means of a social class index. For the analysis, Chi-squared tests, t tests and a repeated measures analysis of variance, adjusted for sex and age, were conducted. Initially, the analyses indicate that social inequality is of minor importance for access to rehabilitation and processes within rehabilitation. As subjective health is unequally distributed at the beginning of rehabilitation, however, equal treatment has to be discussed critically in terms of demand-driven treatment. In rehabilitation outcome distinct differences between social classes exist. To reduce these differences, rehabilitation aftercare close to the individual's living environment is necessary, which promotes the empowerment of vulnerable social groups in burdensome living conditions.

“It Is an Eye-Opener That There Is a Relationship between Rehabilitation and HIV”: Perspectives of Physiotherapists and Occupational Therapists in Kenya and Zambia on the Role of Rehabilitation with Adults and Children Living with HIV

PubMed Central

Cameron, Cathy; Mweshi, Margaret; Nkandu, Esther Munalula; Okidi, Carlius; Tattle, Stephen; Yates, Tammy

2016-01-01

Purpose: To present the perspectives of rehabilitation providers—physiotherapists and occupational therapists—in Kenya and Zambia on the role of rehabilitation in the care of adults and children living with HIV. Methods: This qualitative, interpretivist study was part of a broader project to adapt a Canadian e-module on HIV-related disability for rehabilitation providers in Sub-Saharan Africa (SSA). Focus groups, demographic questionnaires, and knowledge–attitude–belief surveys were conducted with rehabilitation providers in Kenya and Zambia. Focus group data were analyzed inductively using an iterative content analysis. Results: Sixty-three rehabilitation providers (52 physiotherapists, 11 occupational therapists) participated in 10 focus groups in Nyanza Province, Kenya, and Lusaka, Zambia. The participants described the role of rehabilitation in HIV care in terms of missed opportunities related to (1) HIV disclosure; (2) inter-professional and inter-sectoral collaboration; (3) community-based rehabilitation; (4) training for rehabilitation providers; (5) pediatric rehabilitation; and (6) the connections among disability, HIV, and poverty. Conclusions: The results point to the need for HIV policy and practice leaders to develop new models of care that recognize the crucial role of rehabilitation in the long-term management of HIV to address the shifting needs of the 25 million people living longer with HIV in SSA. PMID:27909379

38 CFR 21.294 - Selecting the training or rehabilitation facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under... the veteran's preference for a particular training or rehabilitation facility but VA has final...

Preparing Rehabilitation Counselors for Private Sector Practice within a CORE Accredited Generalist Educational Model

ERIC Educational Resources Information Center

Zanskas, Stephen; Leahy, Michael

2007-01-01

As private sector rehabilitation has matured as a field of practice, the issue of how rehabilitation counselor educators can effectively prepare rehabilitation counselors for practice in this setting remains. This article reviews the literature regarding the training needs of rehabilitation counselors entering private sector practice, and proposes…

Geriatric Rehabilitation ('Alters-Rehabilitation'): The New Challenge for Social Medicine and Science.

ERIC Educational Resources Information Center

Barolin, G. S.

1996-01-01

This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…

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…

Traumatic Brain Injury Rehabilitation in Hong Kong: A Review of Practice and Research.

PubMed

Yu, Junhong; Tam, Helena M K; Lee, Tatia M C

2015-01-01

The rising public health concern regarding traumatic brain injury (TBI) implies a growing need for rehabilitation services for patients surviving TBI. To this end, this paper reviews the practices and research on TBI rehabilitation in Hong Kong so as to inform future developments in this area. This paper begins by introducing the general situation of TBI patients in Hong Kong and the need for rehabilitation. Next, the trauma system in Hong Kong is introduced. Following that is a detailed description of the rehabilitation services for TBI patients in Hong Kong, as exemplified by a rehabilitation hospital in Hong Kong. This paper will also review intervention studies on rehabilitating brain-injured populations in Hong Kong with respect to various rehabilitation goals. Lastly, the implications of culture-related issues will be discussed in relation to TBI. The intervention studies conducted in Hong Kong are generally successful in achieving various rehabilitative outcomes. Additionally, certain cultural-related issues, such as the stigma associated with TBI, may impede the rehabilitative process and lead to various psychosocial problems.

Perceived motivational factors for female football players during rehabilitation after sports injury - a qualitative interview study.

PubMed

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-04-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players' motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation.

Mapping the literature of rehabilitation nursing

PubMed Central

Spasser, Mark A.; Weismantel, Arlene

2006-01-01

Objective: This paper describes a citation analysis of the literature of rehabilitation nursing, conducted as part of the Medical Library Association's Nursing and Allied Health Section's the “Mapping the Literature of Nursing Project.” Methods: One core journal, Rehabilitation Nursing, was selected, being both the official journal of the Association of Rehabilitation Nurses and the only journal devoted exclusively to rehabilitation nursing. Citations were analyzed according to format and date and stratified according to Bradford's Law of Scattering. Results: The nineteen journals that constitute Zone 1 contribute the same number of citations as the eighty-six journals that make up Zone 2. OCLC ArticleFirst, PubMed/MEDLINE, and CINAHL provide the most inclusive coverage of the rehabilitation literature. The source journal, Rehabilitation Nursing, is the most important journal in Zone 1 and thus the most influential rehabilitation nursing journal. Relative degrees of database coverage do not change between Zones 1 and 2. Conclusion: The journals in Zones 1 and 2 collectively represent most of the important subspecialties of rehabilitation nursing, such as the physiological, sociopsychological, and community reintegration issues involved in the long-term rehabilitation process. PMID:16710460

Mapping the literature of rehabilitation nursing.

PubMed

Spasser, Mark A; Weismantel, Arlene

2006-04-01

This paper describes a citation analysis of the literature of rehabilitation nursing, conducted as part of the Medical Library Association's Nursing and Allied Health Section's the "Mapping the Literature of Nursing Project." One core journal, Rehabilitation Nursing, was selected, being both the official journal of the Association of Rehabilitation Nurses and the only journal devoted exclusively to rehabilitation nursing. Citations were analyzed according to format and date and stratified according to Bradford's Law of Scattering. The nineteen journals that constitute Zone 1 contribute the same number of citations as the eighty-six journals that make up Zone 2. OCLC ArticleFirst, PubMed/MEDLINE, and CINAHL provide the most inclusive coverage of the rehabilitation literature. The source journal, Rehabilitation Nursing, is the most important journal in Zone 1 and thus the most influential rehabilitation nursing journal. Relative degrees of database coverage do not change between Zones 1 and 2. The journals in Zones 1 and 2 collectively represent most of the important subspecialties of rehabilitation nursing, such as the physiological, sociopsychological, and community reintegration issues involved in the long-term rehabilitation process.

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

PubMed

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Hyponatraemia in cancer patients on an inpatient rehabilitation unit.

PubMed

Nelson, M; Palmer, J L; Fu, J; Williams, J L; Yadav, R; Guo, Y

2014-05-01

This study identifies the incidence of hyponatraemia in cancer patients on an inpatient rehabilitation unit and examines the association between admission hyponatraemia and rehabilitation length of stay (LOS), functional outcome, and survival. After institutional review committee's approval, we retrospectively reviewed medical records of 295 consecutive patients who were admitted to this inpatient cancer rehabilitation unit between 27 January 2009 through 31 July 2010 in a tertiary cancer centre. The incidence of hyponatraemia in cancer patients admitted to our inpatient rehabilitation unit was 41.4%. Median rehabilitation LOS for patients with mild (Na 130-134 mEq/L) and moderate-severe (Na < 130 mEq/L) hyponatraemia was 11 and 15 days, respectively, which was significantly longer than patients with eunatraemia (10 days; P = 0.03). Functional Independence Measure gain for ambulation and transfers during inpatient rehabilitation stay was not significantly different between three different patient groups. We concluded that large portion of patients who require acute inpatient rehabilitation presented with hyponatraemia, which is associated with prolonged rehabilitation LOS. Whether aggressive management of hyponatraemia will shorten rehabilitation stay needs further study. © 2013 John Wiley & Sons Ltd.

Sex-Specific Predictors of Inpatient Rehabilitation Outcomes After Traumatic Brain Injury.

PubMed

Chan, Vincy; Mollayeva, Tatyana; Ottenbacher, Kenneth J; Colantonio, Angela

2016-05-01

To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population-based perspective. Retrospective cohort study. Inpatient rehabilitation. Patients in inpatient rehabilitation for a TBI within 1 year of acute care discharge between 2008/2009 and 2011/2012 (N=1730, 70% men, 30% women). None. Inpatient rehabilitation length of stay, total FIM score, and motor and cognitive FIM ratings at discharge. Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. Although many of the predictors examined were similar across men and women, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for men and women; mechanism of injury (P<.0001) was a significant predictor of functional outcome only among women, whereas comorbidities (P<.0001) was a significant predictor for men only. Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

PubMed

Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

2017-10-02

Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the first study to investigate expert perspectives on content related to postcolonialism and indigenous-settler inequities that should be included in the education of rehabilitation students in Canada. According to the participants in this study, rehabilitation educators in Canada should consider incorporating the following four themes into curricula to better address Indigenous-settler inequities in the context of rehabilitation: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for Indigenous Peoples in Canada; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to rise to the challenge of addressing health inequities with Indigenous Peoples in Canada. Postcolonialism is useful for rehabilitation providers because it is an approach that redirects the focus of problems from Indigenous People to the systems of oppression (specifically colonization and racialization) that cause ill health and disability.

Design and Dynamic Modeling of Flexible Rehabilitation Mechanical Glove

NASA Astrophysics Data System (ADS)

Lin, M. X.; Ma, G. Y.; Liu, F. Q.; Sun, Q. S.; Song, A. Q.

2018-03-01

Rehabilitation gloves are equipment that helps rehabilitation doctors perform finger rehabilitation training, which can greatly reduce the labour intensity of rehabilitation doctors and make more people receive finger rehabilitation training. In the light of the defects of the existing rehabilitation gloves such as complicated structure and stiff movement, a rehabilitation mechanical glove is designed, which provides driving force by using the air cylinder and adopts a rope-spring mechanism to ensure the flexibility of the movement. In order to fit the size of different hands, the bandage ring which can adjust size is used to make the mechanism fixed. In the interest of solve the complex problem of dynamic equation, dynamic simulation is carried out by using Adams to obtain the motion curve, which is easy to optimize the structure of ring position.

Satisfaction with rehabilitation in relation to self-perceived quality of life and function among patients with stroke - a 12 month follow-up.

PubMed

Hansson, Eva Ekvall; Beckman, Anders; Wihlborg, Anna; Persson, Sylvia; Troein, Margareta

2013-06-01

Stroke causes complex disability and function, and perceived quality of life has been shown to correlate with satisfaction with care as well as with life in general among stroke patients. The aim of this study was to study the relation of satisfaction with how rehabilitation was provided with self-perceived quality of life, self-perceived function and rehabilitation received, 12 months after the incidence. The subjects were assessed 12 months after the onset of stroke. The Barthel index was used to measure function, and the EuroQol-5D to measure quality of life. To measure satisfaction with how rehabilitation was provided, a questionnaire from the Swedish Stroke Register was used. Two hundred and eighty-three patients participated in the follow-up, 137 women and 146 men, aged between 42 and 95 years (mean age 75.2, SD 11.8). For the majority of patients rehabilitation was initiated at in-hospital care (directly after onset). One hundred and sixty-eight patients considered that rehabilitation was well provided for. Sixty-six regarded that the rehabilitation was only partly provided for and 35 that it was not provided for at all. High value on Barthel Index was associated with satisfaction with how rehabilitation was provided for (OR 2.81). Also, rehabilitation on three or more levels was negatively associated with satisfaction with rehabilitation provision (OR 0.24) and so was being male (OR 0.49). In this study, patients with higher values on Barthel Index were more satisfied with how rehabilitation was provided for. However, male patients and patients who received rehabilitation on three or more levels of care were less satisfied. Given the assumption that patients with more severe dysfunction after stroke are being rehabilitated on more levels, this might imply that it is not the amount of rehabilitation that gives satisfaction but the patients self-perceived function after rehabilitation. © 2012 Nordic College of Caring Science.

[Female patients with fibromyalgia syndrome in somatic and psychosomatic rehabilitation center - an exploratory study on access routes and differences in patient characteristics].

PubMed

Ullrich, A; Glattacker, M; Sibold, M; Egle, U T; Ehlebracht-König, I; Geigges, W; Köllner, V; Kruse, M; Jäckel, W H

2013-10-01

Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group. Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership. The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership. Our results provide initial evidence of how FMS patients access the German rehabilitation system and which of their characteristics are responsible for being assigned to a particular rehabilitation setting. © Georg Thieme Verlag KG Stuttgart · New York.

Publication trends of study protocols in rehabilitation.

PubMed

Jesus, Tiago S; Colquhoun, Heather L

2017-09-04

Growing evidence points for the need to publish study protocols in the health field. To observe whether the growing interest in publishing study protocols in the broader health field has been translated into increased publications of rehabilitation study protocols. Observational study using publication data and its indexation in PubMed. Not applicable. Not applicable. PubMed was searched with appropriate combinations of Medical Subject Headings up to December 2014. The effective presence of study protocols was manually screened. Regression models analyzed the yearly growth of publications. Two-sample Z-tests analyzed whether the proportion of Systematic Reviews (SRs) and Randomized Controlled Trials (RCTs) among study protocols differed from that of the same designs for the broader rehabilitation research. Up to December 2014, 746 publications of rehabilitation study protocols were identified, with an exponential growth since 2005 (r2=0.981; p<0.001). RCT protocols were the most common among rehabilitation study protocols (83%), while RCTs were significantly more prevalent among study protocols than among the broader rehabilitation research (83% vs. 35.8%; p<0.001). For SRs, the picture was reversed: significantly less common among study protocols (2.8% vs. 9.3%; p<0.001). Funding was more often reported by rehabilitation study protocols than the broader rehabilitation research (90% vs. 53.1%; p<0.001). Rehabilitation journals published a significantly lower share of rehabilitation study protocols than they did for the broader rehabilitation research (1.8% vs.16.7%; p<0.001). Identifying the reasons for these discrepancies and reverting unwarranted disparities (e.g. low rate of publication for rehabilitation SR protocols) are likely new avenues for rehabilitation research and its publication. SRs, particularly those aggregating RCT results, are considered the best standard of evidence to guide rehabilitation clinical practice; however, that standard can be improved in rigor and/or transparency if the publications of rehabilitation SRs protocols become more common.

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

PubMed

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

2017-01-01

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

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.

More daytime sleeping predicts less functional recovery among older people undergoing inpatient post-acute rehabilitation.

PubMed

Alessi, Cathy A; Martin, Jennifer L; Webber, Adam P; Alam, Tarannum; Littner, Michael R; Harker, Judith O; Josephson, Karen R

2008-09-01

To study the association between sleep/wake patterns among older adults during inpatient post-acute rehabilitation and their immediate and long-term functional recovery Prospective, observational cohort study. Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Older patients (aged > or = 65 years, N = 245) admitted for inpatient post-acute rehabilitation. None. Based on 7-day wrist actigraphy during the rehabilitation stay, mean nighttime percent sleep was only 52.2% and mean daytime percent sleep was 15.8% (16.3% based on structured behavioral observations). Using the Pittsburgh Sleep Quality Index (PSQI), participants reported their sleep was worse during rehabilitation compared to their premorbid sleep. Functional recovery between admission and discharge from rehabilitation (measured by the motor component of the Functional Independence Measure) was not significantly associated with reported sleep quality (PSQI scores) or actigraphically measured nighttime sleep. However, more daytime percent sleep (estimated by actigraphy and observations) during the rehabilitation stay was associated with less functional recovery from admission to discharge, even after adjusting for other significant predictors of functional recovery (mental status, hours of rehabilitation therapy received, rehospitalization, and reason for admission; adjusted R2= 0.267, P < 0.0001). More daytime sleeping during rehabilitation remained a significant predictor of less functional recovery in adjusted analyses at 3-month follow-up. Sleep disturbance is common among older people undergoing inpatient post-acute rehabilitation. These data suggest that more daytime sleeping during the rehabilitation stay is associated with less functional recovery for up to three months after admission for rehabilitation.

[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.

Impact of Rehabilitation on Outcomes in Patients With Ischemic Stroke: A Nationwide Retrospective Cohort Study in Japan.

PubMed

Yagi, Maiko; Yasunaga, Hideo; Matsui, Hiroki; Morita, Kojiro; Fushimi, Kiyohide; Fujimoto, Masashi; Koyama, Teruyuki; Fujitani, Junko

2017-03-01

We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke. Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admission. The average rehabilitation intensity per day was calculated as the total units of rehabilitation during hospitalization divided by the length of hospital stay. A multivariable logistic regression analysis with multiple imputation and an instrumental variable analysis were performed to examine the association of early and intensive rehabilitation with the proportion of improved ADL score. The proportion of improved ADL score was higher in the early and intensive rehabilitation group. The multivariable logistic regression analysis showed that significant improvements in ADL were observed for early rehabilitation (odds ratio: 1.08; 95% confidence interval: 1.04-1.13; P <0.01) and intensive rehabilitation of >5.0 U/d (odds ratio: 1.87; 95% confidence interval: 1.69-2.07; P <0.01). The instrumental variable analysis showed that an increased proportion of improved ADL was associated with early rehabilitation (risk difference: 2.8%; 95% confidence interval: 2.0-3.4%; P <0.001) and intensive rehabilitation (risk difference: 5.6%; 95% confidence interval: 4.6-6.6%; P <0.001). The present results suggested that early and intensive rehabilitation improved ADL during hospitalization in patients with ischemic stroke. © 2017 American Heart Association, Inc.

Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR): A Logic Model.

PubMed

Gill, Simone V; Khetani, Mary A; Yinusa-Nyahkoon, Leanne; McManus, Beth; Gardiner, Paula M; Tickle-Degnen, Linda

2017-07-01

In a patient-centered care era, rehabilitation can benefit from researcher-clinician collaboration to effectively and efficiently produce the interdisciplinary science that is needed to improve patient-centered outcomes. The authors propose the use of the Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR) logic model to provide guidance to rehabilitation scientists and clinicians who are committed to growing their involvement in interdisciplinary rehabilitation research. We describe the importance and key characteristics of the FAIRR model for conducting interdisciplinary rehabilitation research.

Implementation of Clinical Quality Management for Rehabilitation in Malaysia.

PubMed

Engkasan, Julia Patrick; Stucki, Gerold; Ali, Sadeeq; Yusof, Yusniza Mohd; Hussain, Hafez; Latif, Lydia Abdul

2018-04-18

In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

Understanding male cancer patients' barriers to participating in cancer rehabilitation.

PubMed

Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J

2015-11-01

The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. © 2015 John Wiley & Sons Ltd.

Vocational Rehabilitation of Young Adults with Psychological Disabilities.

PubMed

Tophoven, Silke; Reims, Nancy; Tisch, Anita

2018-05-10

Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a growing number of young people with psychological disabilities in vocational rehabilitation can be observed. The study at hand focuses on this group and examines their (un-)unemployment biographies before vocational rehabilitation, their access to vocational rehabilitation and identifies their individual challenges within the process of vocational rehabilitation. Methods Using a multi-methods approach, we analyze representative administrative data of the German Federal Employment Agency as well as biographical interviews conducted with young rehabilitants. We compare the population of young rehabilitants with psychological disorders to those with other disabilities in terms of vocational rehabilitation and initial labor market entry in order to get a representative picture about their school to work transitions. Since rehabilitants with psychological disabilities tend to be older than the remaining population, analyses are stratified by age groups. In addition, qualitative in-depth interviews provide an additional and deeper understanding of specific employment barriers youth with psychological disorders have to overcome. Furthermore, the individual perspective gives insight on how the crucial transition from school to work is perceived by the population under study. Results The pathway into vocational rehabilitation of youth with psychological disorders is often characterized by obstacles in their transition from school to work. During rehabilitation, it appears essential to provide psychological stabilization along with vocational training. Although their average level of education is higher than those of other rehabilitants, labor market transition after (often company-external) vocational training challenges many young people with psychological disabilities, leaving many of them with comparatively poor labor market prospects. Conclusions Young persons with psychological disabilities, who come from regular schools or dropped out from regular school or university, seem to find their way to vocational rehabilitation more indirectly. Furthermore, vocational rehabilitation itself is often prolonged for those with psychological disabilities possibly due to a corresponding stabilization process. However, vocational rehabilitation can be a core element within the stabilization process of a psychological disease.

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

ERIC Educational Resources Information Center

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

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

[Quality assurance of rehabilitation by the German pension insurance: an overview].

PubMed

Klosterhuis, H; Baumgarten, E; Beckmann, U; Erbstösser, S; Lindow, B; Naumann, B; Widera, T; Zander, J

2010-12-01

The German pension insurance has in recent years developed a comprehensive programme for quality assurance in rehabilitation, and has implemented the programme into routine practice. Different aspects of rehabilitation are evaluated with differentiated instruments. Issues dealt with inter alia include the quality of rehabilitative care in a narrower sense, the structure and organisation of the rehabilitation centres, as well as quality from the patients' perspective. On the whole, positive results predominate. Big differences in quality however have been found between the rehabilitation centres. The data collections and data evaluations carried out make a continuous process of quality assurance reporting possible for use by rehabilitation centres and pension insurance agencies. This will enable targeted initiatives for quality improvement. The methods and procedures of quality assurance are enhanced at regular intervals, and the scope of quality assurance is extended. Thus, rehab quality assurance is also expanded to cover ambulant rehabilitation or rehabilitation of children and young people. © Georg Thieme Verlag KG Stuttgart · New York.

[Research and Development of A Kinect Based Virtual System for Upper Limb Rehabilitation].

PubMed

Ding, Weili; Zheng, Yazhuo; Su, Yuping; Li, Xiaoli; Wei, Xiuli

2015-06-01

We developed a rehabilitation system by using the virtual reality technique and the Kinect in this paper. The system combines rehabilitation training with HMI and serious game organically, and provides a game and motion database to meet different patients' demands. Extended interface of game database is provided in two ways: personalized games can be developed by Virtools and Flash games which are suitable for patients' rehabilitation can be download from the Internet directly. In addition, the system provides patients with flexible interaction and easy control mode, and also presents real time data recording. An objective and subjective evaluation method is proposed to review the effectiveness of the rehabilitation training. According to the results of short questionnaires and the evaluation results of patients' rehabilitation training, the system compared with traditional rehabilitation can record and analyze the training data, which is useful to make rehabilitation plans. More entertainment and lower cost will increase patients' motivation, which helps to increase the rehabilitation effectiveness.

Computer Assisted REhabilitation (CARE) Lab: A novel approach towards Pediatric Rehabilitation 2.0.

PubMed

Olivieri, Ivana; Meriggi, Paolo; Fedeli, Cristina; Brazzoli, Elena; Castagna, Anna; Roidi, Marina Luisa Rodocanachi; Angelini, Lucia

2018-01-01

Pediatric Rehabilitation therapists have always worked using a variety of off-the-shelf or custom-made objects and devices, more recently including computer based systems. These Information and Communication Technology (ICT) solutions vary widely in complexity, from easy-to-use interactive videogame consoles originally intended for entertainment purposes to sophisticated systems specifically developed for rehabilitation.This paper describes the principles underlying an innovative "Pediatric Rehabilitation 2.0" approach, based on the combination of suitable ICT solutions and traditional rehabilitation, which has been progressively refined while building up and using a computer-assisted rehabilitation laboratory. These principles are thus summarized in the acronym EPIQ, to account for the terms Ecological, Personalized, Interactive and Quantitative. The paper also presents the laboratory, which has been designed to meet the children's rehabilitation needs and to empower therapists in their work. The laboratory is equipped with commercial hardware and specially developed software called VITAMIN: a virtual reality platform for motor and cognitive rehabilitation.

[The benefits of rehabilitation in people with low potential for recuperation].

PubMed

Bisson, Janick; Cantin, Johanne; Lambert, Johanne; Beauregard, Line

2007-12-01

This article presents the story of a young man who sustained severe limitations following a traumatic brain injury. Considering his very slow recovery rate and a virtual absence of contact with the environment, hopes for rehabilitation were deemed very low. He was nevertheless admitted to a rehabilitation institute for a trial period in November of 2000. This trial revealed potential for rehabilitation and daily treatments were undertaken. This young man left the rehabilitation centre two years later capable of new social participation, including attending an adapted school and even taking small trips. The mobilisation of the rehabilitation team, the financial support of the insurance company, the contribution of assistive devices, the support of those around him, collaborations with his community and above all his own motivation were all factors that played a major role in his rehabilitation. This rehabilitation experience brought the team to reflect on factors that determine rehabilitation potential, the notion of significant progress, as well as concepts of quality of life and social participation.

Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

PubMed

Księżopolska-Orłowska, Krystyna; Pacholec, Anna; Jędryka-Góral, Anna; Bugajska, Joanna; Sadura-Sieklucka, Teresa; Kowalik, Katarzyna; Pawłowska-Cyprysiak, Karolina; Łastowiecka-Moras, Elżbieta

2016-01-01

Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p < 0.001, p = 0.001, p = 0.007 and p < 0.001, respectively), as well as at the 3-month follow-up (p < 0.001, p < 0.001, p = 0.009 and p < 0.001, respectively). Rehabilitation using cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent traditional approach showed decreased disease activity following the initial 3-week period; however, this improvement did not sustain to the end of follow-up, 3 months later. Complex rehabilitation in RA has a positive effect on patients' clinical condition. The rehabilitation programme that includes cryotherapy overtops traditional rehabilitation, particularly as regards improvement in locomotor function, disease activity and sustaining willingness to continue working and exerts long-lasting effect. Rehabilitation using cryotherapy is more effective in improving locomotor function, decreasing disease activity and sustaining willingness to continue working compared to traditional rehabilitation. Rehabilitation using cryotherapy significantly reduces the intensity of pain experienced by patients with RA, and this positive effect is maintained at 3 months post-rehabilitation. Complex rehabilitation, particularly treatment using cryotherapy, improves patients' subjective assessment of their overall well-being and perception of their disease. Complex rehabilitation in rheumatoid arthritis has a positive effect on patients' clinical condition.

[Rehabilitation from the patient perspective--a qualitative analysis of the treatment beliefs of patients in inpatient orthopedic and psychosomatic rehabilitation].

PubMed

Heyduck, K; Glattacker, M; Meffert, C

2011-08-01

As the common sense self-regulation model (CSM) was further developed in the late 1990s, its focus was, along with subjective illness perceptions, the treatment representations of patients, in particular medication-related perceptions. However until now, only few studies have dealt with subjective concepts regarding non-medication treatment. The objective of this study was to explore the core content areas of the treatment concept of rehabilitation patients as a basis for developing a questionnaire to survey rehabilitation-related treatment beliefs. In 5 inpatient rehabilitation centres for psychosomatic and musculoskeletal diseases, guided focus groups were conducted with a total of n=25 rehabilitation patients. Some 56% of the participants were female; the average age was 52.8 years (SD=10.8). The interviews were transcribed and analyzed using the computer programme Atlas.ti based on the method recommended by Mayring in a multi-stage qualitative content analysis procedure. In the analysis of the discussion transcriptions, a total of 579 patient statements were categorized with 49 codes that were assigned to the areas (1) expectations and beliefs with respect to the rehabilitation process, (2) expectations of results, and (3) fears associated with rehabilitation. The process expectations were the most frequently discussed topic, constituting 58.2% of all patient statements. It was found that the patients associate not only numerous individual treatments with rehabilitation but also have concrete perceptions about the specific form rehabilitation should have, their own role in the rehabilitation process, and features of the overall rehabilitation concept. The outcome expectations are related to the areas activities of daily life and job, psyche, soma, and effectiveness of rehabilitation. Fears with respect to rehabilitation generally played only a subordinate role for those surveyed. The indication-specific analyses showed that the perceptions regarding the realization and form of rehabilitation differed among the various diagnosis groups, but the patients named similar categories for expectations of results and fears, with only some variation in importance. The focus groups allowed good insights into the patient perspectives of rehabilitation. Simultaneously, a good basis was created for generating contents of items for a questionnaire on the rehabilitative treatment concept, so that along with literature analyses, the qualitative method proved to be a suitable approach and good source for developing a questionnaire. © Georg Thieme Verlag KG Stuttgart · New York.

Commentary on Stiers and colleagues' guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

PubMed

Hatcher, Robert L

2015-05-01

Comments on the article, "Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training," by Stiers et al. (see record 2014-55195-001). Stiers and colleagues have provided a thorough and well-conceived set of guidelines that lay out the competencies expected for graduates of postdoctoral residencies in rehabilitation psychology, accompanied by a set of more specific, observable indicators of the residents' competence level. This work is an important aspect of the broader project of the Rehabilitation Psychology Specialty Council (APA Division 22, the American Board of Rehabilitation Psychology, the Foundation for Rehabilitation Psychology, the Academy of Rehabilitation Psychology, and the Council of Rehabilitation Psychology Postdocotral Training Programs) to develop overall guidelines for programs providing postdoctoral training in this field (Stiers et al., 2012). (c) 2015 APA, all rights reserved).

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

PubMed

2013-06-11

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

The World Health Organization "Rehabilitation 2030: a call for action".

PubMed

Gimigliano, Francesca; Negrini, Stefano

2017-04-01

February 6th-7th, 2017 might become a memorable date in the future of rehabilitation. On these two days, the World Health Organization (WHO) has summoned over 200 stakeholders in the Executive Board Room of the WHO Headquarters in Geneva, Switzerland. Their common aim was to a launch the "Rehabilitation 2030" call to action and to present the WHO Recommendations on rehabilitation in health systems. These initiatives are meant to draw attention to the increasing unmet need for rehabilitation in the world; to highlight the role of rehabilitation in achieving the Sustainable Development Goals proposed by the United Nations; to call for coordinated and concerted global action towards strengthening rehabilitation in health systems. The aim of this paper is to report on the scientific events of these 2 days, which will most likely mark the history of rehabilitation.

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.

The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study

PubMed Central

Yang, Yao-Hsu; Chang, Chia-Hao; Chen, Chih-Cheng; Chen, Pau-Chung

2016-01-01

Introduction Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce. Aim This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan. Methods Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0. Results Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P < 0.001) were the most important predictor of whether a patient with hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy) comprised the majority (71.2%) of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were <0.1% of the total annual medical costs. Conclusion Musculoskeletal or nervous system-related surgical procedures and increased use of clotting factor VIII concentrate affect the rehabilitation utilization of patients with hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A. PMID:27690229

Outpatient Rehabilitation for Medicaid-Insured Children Hospitalized With Traumatic Brain Injury

PubMed Central

Symons, Rebecca G.; Wang, Jin; Ebel, Beth H.; Vavilala, Monica S.; Buchwald, Dedra; Temkin, Nancy; Jaffe, Kenneth M.; Rivara, Frederick P.

2016-01-01

OBJECTIVES: To describe the prevalence of postdischarge outpatient rehabilitation among Medicaid-insured children hospitalized with a traumatic brain injury (TBI) and to identify factors associated with receipt of services. METHODS: Retrospective cohort of children <21 years, hospitalized for a TBI between 2007 and 2012, from a national Medicaid claims database. Outcome measures were receipt of outpatient rehabilitation (physical, occupational, or speech therapies or physician visits to a rehabilitation provider) 1 and 3 years after discharge. Multivariable regression analyses determined the association of demographic variables, injury severity, and receipt of inpatient services with receipt of outpatient rehabilitation at 1 and 3 years. The mean number of services was compared between racial/ethnic groups. RESULTS: Among 9361 children, only 29% received any type of outpatient rehabilitation therapy during the first year after injury, although 62% sustained a moderate to severe TBI. The proportion of children receiving outpatient therapies declined to 12% in the second and third years. The most important predictor of receipt of outpatient rehabilitation was receipt of inpatient therapies or consultation with a rehabilitation physician during acute care. Compared with children of other racial/ethnic groups, Hispanic children had lower rates of receipt of outpatient speech therapy. CONCLUSIONS: Hospitalized children who received inpatient assessment of rehabilitation needs were more likely to continue outpatient rehabilitation care. Hispanic children with TBI were less likely than non-Hispanics to receive speech therapy. Interventions to increase inpatient rehabilitation during acute care might increase outpatient rehabilitation and improve outcomes for all children. PMID:27244850

[Screening for rehabilitation needs of patients in care of family practitioners].

PubMed

Pullwitt, D H; Krause, O; Hildebrand, F; Fischer, G C

1997-11-01

Family doctors play an important role in promoting the access of patients to rehabilitation. On the one hand they are very often the first professionals to be contacted if patients want to take part in rehabilitation procedures whereas on the other hand there are also many patients whose need for rehabilitation remains undisclosed. No detailed estimates are available on how many of such patients exist in German GP-practices although it should be an important task of family doctors to discuss the pros and cons of rehabilitation particularly with their patients who are in need of it. We performed a non-representative pilot study in three GP offices during ten working days. patients older than 29 years were screened for their "rehabilitation status" with an instrument frequently used in German rehabilitation clinics. The patients were also asked whether or not they would like to participate in a rehabilitation procedure and what was the reason for their decision. Not knowing the patients' answers their doctors rated whether or not it would be appropriate for their patients to take part in rehabilitation. Additionally the doctors stated what kind of rehabilitation should be performed and what could be ist aims. In a sample of 181 patients about one-third was found to be in a severe "rehabilitation status", about one third in a state with higher than normal values--although not severe--and also approx. another third had a normal status. Family doctors stated that for one-third of their patients rehabilitation would be undoubtedly suitable at the time of the screening. In about two thirds of the cases the results of the questionnaire and the doctors' ratings corresponded. Some patients felt completely healthy although the results of the questionnaire and the doctors' statements rated them as being in need of rehabilitation. Other patients in need of rehabilitation rejected it for other than health-related reasons. The results of our study give evidence to the family doctors' key role for patients' access to rehabilitation. A representative study with a larger sample should be performed in the future because it could yield more detailed figures on the rehabilitation needs of family doctors' patients. Possibilities of standardised screening for rehabilitation needs in primary medical are should also be studied. The results of our pilot study also indicate the need for studies concerning non-medical causes of underutilised rehabilitation facilities. Family doctors should discuss these problems with their patients.

Perceived motivational factors for female football players during rehabilitation after sports injury – a qualitative interview study

PubMed Central

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-01-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete’s motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players’ motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation. PMID:29740552

Dysexecutive symptoms and carer strain following acquired brain injury: Changes measured before and after holistic neuropsychological rehabilitation.

PubMed

Goodwin, Rachel A; Lincoln, Nadina B; Bateman, Andrew

2016-06-18

Following acquired brain injury (ABI), deficits in executive functioning (EF) are common. As a result many brain-injured patients encounter problems in every-day functioning, and their families experience significant strain. Previous research has documented the benefits of cognitive rehabilitation for executive dysfunction, and rehabilitation programmes designed to ameliorate functional problems associated with ABI. This study primarily aims to evaluate whether a neuropsychological rehabilitation programme reduces reported symptoms of everyday dysexecutive behaviour and carer strain. In this study 66 ABI outpatients attended comprehensive holistic neuropsychological rehabilitation programme. A repeated-measures design was employed to determine the effect of rehabilitation on EF and carer strain, as part of a service evaluation. Outcome measures comprised the dysexecutive questionnaire (DEX/DEX-I) and carer strain index (CSI), applied pre- and post-rehabilitation. Results indicate rehabilitation benefited clients and carers in 5 of 6 DEX/DEX-I subscales, and 2 of 3 CSI subscales, (p < 0.05). An effect of aetiology on rehabilitation was found on the metacognitive scale of the DEX-I. Therefore, this study supports a comprehensive holistic neuropsychological rehabilitation programme as effective in reducing reported symptoms of dysexecutive behaviour and carer strain following ABI.

Impact of vocational rehabilitation on social functioning, cognitive functioning, and psychopathology in patients with chronic schizophrenia

PubMed Central

Suresh Kumar, P. N.

2008-01-01

Aim: To assess the impact of vocational rehabilitation on psychopathology, social functioning and cognitive functioning in schizophrenia Materials and Methods: 34 patients with DSM IV diagnosis of chronic schizophrenia were compared 40 patients with same diagnosis but not attending vocational rehabilitation using PANSS, SCARF social functioning Index and MMSE. Results and Discussion: Basic psycho-socio-demographic data were comparable in both groups except more hospitalization in the no rehabilitation group. Comparison of social functioning, cognitive functioning and psychopathology showed significant improvement in rehabilitated patients. Cognitive functioning had positive correlation with occupational role in the rehabilitated group and negative correlation in the rehabilitated group. Social functioning had negative correlation with positive and negative symptoms, general psychopathology and total PANSS score and cognitive symptoms in patients without rehabilitation. Conclusion: The present concludes that there is a definite limitation in the domains of social functioning, cognitive functioning and psychopathology in chronic schizophrenia patients who had no rehabilitation. However vocational rehabilitation significantly improves these limitations, which in turn help these patients to integrate into the society so as to function efficiently in their roles as parents, home makers and social beings. PMID:19823610

Exploring the bases for a mixed reality stroke rehabilitation system, Part I: A unified approach for representing action, quantitative evaluation, and interactive feedback

PubMed Central

2011-01-01

Background Although principles based in motor learning, rehabilitation, and human-computer interfaces can guide the design of effective interactive systems for rehabilitation, a unified approach that connects these key principles into an integrated design, and can form a methodology that can be generalized to interactive stroke rehabilitation, is presently unavailable. Results This paper integrates phenomenological approaches to interaction and embodied knowledge with rehabilitation practices and theories to achieve the basis for a methodology that can support effective adaptive, interactive rehabilitation. Our resulting methodology provides guidelines for the development of an action representation, quantification of action, and the design of interactive feedback. As Part I of a two-part series, this paper presents key principles of the unified approach. Part II then describes the application of this approach within the implementation of the Adaptive Mixed Reality Rehabilitation (AMRR) system for stroke rehabilitation. Conclusions The accompanying principles for composing novel mixed reality environments for stroke rehabilitation can advance the design and implementation of effective mixed reality systems for the clinical setting, and ultimately be adapted for home-based application. They furthermore can be applied to other rehabilitation needs beyond stroke. PMID:21875441

Modelling Drug Abuse Epidemics in the Presence of Limited Rehabilitation Capacity.

PubMed

Mushanyu, J; Nyabadza, F; Muchatibaya, G; Stewart, A G R

2016-12-01

The abuse of drugs is now an epidemic globally whose control has been mainly through rehabilitation. The demand for drug abuse rehabilitation has not been matched with the available capacity resulting in limited placement of addicts into rehabilitation. In this paper, we model limited rehabilitation through the Hill function incorporated into a system of nonlinear ordinary differential equations. Not every member of the community is equally likely to embark on drug use, risk structure is included to help differentiate those more likely (high risk) to abuse drugs and those less likely (low risk) to abuse drugs. It is shown that the model has multiple equilibria, and using the centre manifold theory, the model exhibits the phenomenon of backward bifurcation whose implications to rehabilitation are discussed. Sensitivity analysis and numerical simulations are performed. The results show that saturation in rehabilitation will in the long run lead to the escalation of drug abuse. This means that limited access to rehabilitation has negative implications in the fight against drug abuse where rehabilitation is the main form of control. This suggests that increased access to rehabilitation is likely to lower the drug abuse epidemic.

[Medical Rehabilitation as an Attractive Field of Work for Medical Doctors? - A Qualitative Survey].

PubMed

Lederle, Mareike; Kotzjan, Priscilla Simone; Niehues, Christiane; Brüggemann, Silke; Bitzer, Eva-Maria

2017-10-01

In the German Health system there is an increasing competition in the recruitment of specialised staff, especially for rehabilitation centres, which are deemed less attractive. Therefore, this study examines the attractiveness of the field of medical rehabilitation from the point of view of medical professionals. We conducted 16 semi-structured interviews with doctors from 7 rehabilitation centres with different medical specialisations. The interviews were digitized and transcribed. A structured content analysis was carried out using the software MAXQDA 11. 745 codes were identified and assigned to the categories "attractiveness", "unfavourable aspects" and "special features" of rehabilitation. Regarding medical rehabilitation, the interviewees appreciated especially the predictable, flexible working environment with little time pressure. Other than working with rehabilitative patients working as part of an interdisciplinary team was of high importance for the interviewees. Among the special features of rehabilitation in comparison with acute care were the higher relevance of the bio-psycho-social model of health and illness as well as the higher proportion of communication and organisation. Medical rehabilitation in Germany is an attractive field of work for medical doctors. This fact should be considered more with regards to rehabilitation's public image. © Georg Thieme Verlag KG Stuttgart · New York.

[Study on the center-driven multiple degrees of freedom upper limb rehabilitation training robot].

PubMed

Huang, Xiaohai; Yu, Hongliu; Wang, Jinchao; Dong, Qi; Zhang, Linling; Meng, Qiaoling; Li, Sujiao; Wang, Duojin

2018-03-01

With the aging of the society, the number of stroke patients has been increasing year by year. Compared with the traditional rehabilitation therapy, the application of upper limb rehabilitation robot has higher efficiency and better rehabilitation effect, and has become an important development direction in the field of rehabilitation. In view of the current development status and the deficiency of upper limb rehabilitation robot system, combined with the development trend of all kinds of products of the upper limb rehabilitation robot, this paper designed a center-driven upper limb rehabilitation training robot for cable transmission which can help the patients complete 6 degrees of freedom (3 are driven, 3 are underactuated) training. Combined the structure of robot with more joints rehabilitation training, the paper choosed a cubic polynomial trajectory planning method in the joint space planning to design two trajectories of eating and lifting arm. According to the trajectory equation, the movement trajectory of each joint of the robot was drawn in MATLAB. It laid a foundation for scientific and effective rehabilitation training. Finally, the experimental prototype is built, and the mechanical structure and design trajectories are verified.

Physiotherapy rehabilitation in the context of HIV and disability in KwaZulu-Natal, South Africa.

PubMed

Cobbing, Saul; Hanass-Hancock, Jill; Deane, Margaret

2014-01-01

The purpose of this study was to describe the experiences of people living with HIV (PLHIV) who had undergone a physiotherapy-led rehabilitation programme, with the aim of informing and improving future rehabilitation. The study population included patients living with HIV who were referred for physiotherapy rehabilitation at a public-funded KwaZulu-Natal hospital. Eight participants were considered for final analysis in the study. A qualitative research design was adopted using in-depth interviews to explore their experiences of their rehabilitation programme. Additionally all eligible participants were requested to complete the World Health Organisation Disability Assessment Schedule. Participants presented varying activity-related challenges with mobility, self-care and life activities being the most severely affected areas. Participants showed little understanding of their health conditions, prescribed medication and in some cases therapy. HIV and disability impacted their daily lives, adversely affecting work and domestic activities. Although participants reflected positively on the rehabilitation experience they faced a number of barriers to accessing continued rehabilitation. PLHIV who experience disability are affected in major life areas but the current model of delivering rehabilitation provides a number of barriers to patients. A more accessible approach of delivering HIV-care and rehabilitation needs to be developed. Implications for Rehabilitation Physiotherapists and other rehabilitation professionals, particularly those working in the South African public sector, need to consider developing and implementing home-based rehabilitation interventions for patients living with HIV and disability. This will counter some of the barriers these patients face in accessing hospital-based therapy. With the increasing incidence of HIV-related disabilities as PLHIV live longer lives, rehabilitation professionals working with this patient population should keep up to date with recent literature and practical training courses related to the disease and its management.

Time to rehabilitation in the burn population: incidence of zero onset days in the UDSMR national dataset.

PubMed

Schneider, Jeffrey C; Tan, Wei-Han; Goldstein, Richard; Mix, Jacqueline M; Niewczyk, Paulette; Divita, Margaret A; Ryan, Colleen M; Gerrard, Paul B; Kowalske, Karen; Zafonte, Ross

2013-01-01

A preliminary investigation of the burn rehabilitation population found a large variability of zero onset day frequency between facilities. Onset days is defined as the time from injury to inpatient rehabilitation admission; this variable has not been investigated in burn patients previously. This study explored if this finding was a facility-based phenomena or characteristic of burn inpatient rehabilitation patients. This study was a secondary analysis of Uniform Data System for Medical Rehabilitation (UDSmr) data from 2002 to 2007 examining inpatient rehabilitation characteristics among patients with burn injuries. Exclusion criteria were age less than 18 years and discharge against medical advice. Comparisons of demographic, medical and functional data were made between facilities with a high frequency of zero onset days versus facilities with a low frequency of zero onset days. A total of 4738 patients from 455 inpatient rehabilitation facilities were included. Twenty-three percent of the population exhibited zero onset days (n = 1103). Sixteen facilities contained zero onset patients; two facilities accounted for 97% of the zero onset subgroup. Facilities with a high frequency of zero onset day patients demonstrated significant differences in demographic, medical, and functional variables compared to the remainder of the study population. There were significantly more zero onset day admissions among burn patients (23%) than other diagnostic groups (0.5- 3.6%) in the Uniform Data System for Medical Rehabilitation database, but the majority (97%) came from two inpatient rehabilitation facilities. It is unexpected for patients with significant burn injury to be admitted to a rehabilitation facility on the day of injury. Future studies investigating burn rehabilitation outcomes using the Uniform Data System for Medical Rehabilitation database should exclude facilities with a high percentage of zero onset days, which are not representative of the burn inpatient rehabilitation population.

Provider perspectives on rehabilitation of patients with polytrauma.

PubMed

Friedemann-Sánchez, Greta; Sayer, Nina A; Pickett, Treven

2008-01-01

To describe, from the perspective of U.S. Department of Veterans Affairs (VA) polytrauma rehabilitation providers, (1) patients with combat-related polytrauma and their rehabilitation, (2) polytrauma patient family member involvement in rehabilitation, and (3) the impact on providers of providing polytrauma rehabilitation. Qualitative study based on rapid assessment process methodology, which included semistructured interviews, observation, and use of a field liaison. The 4 VA polytrauma rehabilitation centers (PRCs). Fifty-six purposefully selected PRC providers and providers from consulting services. Not applicable. Provider self-report of polytrauma patient characteristics, polytrauma patient family member involvement in rehabilitation, and the impact of polytrauma rehabilitation on providers themselves. According to PRC providers, polytrauma patients are younger than VA rehabilitation patients. Strong military identities affect rehabilitation needs and reactions to severe injury. The public and the media have particular interest in war-injured patients. Patients with blast-related polytrauma have unique constellations of visible (including amputations, craniectomies, and burns) and invisible (including traumatic brain injury, pain, and posttraumatic stress disorder) injuries. Providers have adjusted treatment strategies and involved services outside of rehabilitation because of this clinical complexity. Family members are intensely involved in rehabilitation and have service needs that may surpass those of families of rehabilitation patients without polytrauma. Sources of provider stress include new responsibilities, media attention, increased oversight, and emotional costs associated with treating severely injured young patients and their families. Providers also described the work as deeply rewarding. The VA should prioritize the identification or development and implementation of strategies to address family member needs and to monitor and ensure that PRC providers have access to appropriate resources. Future research should determine whether findings generalize to patients injured in other wars and to people who sustain polytraumatic injuries outside of a war zone, including victims of terrorist attacks.

Rehabilitation in the real-life environment of a shopping mall.

PubMed

Labbé, Delphine; Poldma, Tiiu; Fichten, Catherine; Havel, Alice; Kehayia, Eva; Mazer, Barbara; McKinley, Patricia; Rochette, Annie; Swaine, Bonnie

2018-04-01

The aim of this study was to explore how shopping malls could be used during rehabilitation and to identify the facilitators and barriers to their use. Two focus groups, conducted with 15 rehabilitation professionals from various disciplines and working with people with disabilities of all ages were structured around two topics: (i) The usage of malls for rehabilitation and (ii) Factors that facilitate or limit rehabilitation professionals' use of the mall as an environment for clinical assessment and/or intervention. The thematic analysis revealed that shopping malls were used to achieve several rehabilitation goals targeting physical and cognitive skills, psychological health and socialization. This real-life environment is motivating and helps foster independence and normalization. Factors affecting mall use during rehabilitation included personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). Shopping malls may be a relevant rehabilitation assessment and treatment environment that could contribute to optimizing community integration of people with disabilities. Implications for rehabilitation To ensure successful community reintegration, clients could be trained at some point during their rehabilitation, to perform activities in real-life settings, such as a shopping mall. Shopping malls appear to enable the attainment of rehabilitation goals targeting a variety of skills. This real-life environment appears to be motivating and helps foster independence and normalization. Factors felt to affect mall use during rehabilitation include personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). The shopping mall may be an untapped resource as it appears to be a relevant rehabilitation assessment and treatment environment that could contribute to optimizing community integration of people with disabilities.

Understanding Motivational Patterns--Early Identification Aids Rehabilitation

ERIC Educational Resources Information Center

Heijn, Cornelis; Granger, Carl V.

1974-01-01

Rehabilitation requires a well-motivated patient. Detection of "differential motivation" may give the rehabilitation team important clues to a physically handicapped patient's unresolved cognitive and emotional stresses that might negatively affect rehabilitation efforts. (Author/EA)

[Investigation of burn rehabilitation development of China in 2014].

PubMed

Ao, M; Wu, J; Chen, J

2017-05-20

Objective: To further study the development of burn rehabilitation in China, so as to promote the development of burn rehabilitation in China. Methods: The questionnaire about the development of burn rehabilitation treatment was started by Specialized Committee of Burn Treatment and Rehabilitation Science of Chinese Association of Rehabilitation Medicine (hereinafter referred to as Specialized Committee) in the end of 2014, and 65 affiliations of Specialized Committee members participated in. There was a total of 26 questions, mainly focusing on problems as below: (1) General information of the burn department of the units, including the number of authorized beds, annual admitted burn patients, annual admitted patients with extremely severe burn, doctors, nurses, rehabilitation therapists, and the condition of rehabilitation area and rehabilitation beds, etc. (2) Development of burn rehabilitation treatment, including the development of rehabilitation treatment, the intervention time of rehabilitation treatment, the rehabilitation treatment carried out in intensive care unit (ICU), the composition of rehabilitation treating personnel, and the professional title and background, educational background, and division of responsibilities of rehabilitation therapists, etc. (3) Major problems affecting the development of burn rehabilitation treatment of the units. The burn treatment units were grouped according to the number of annual admitted patients. The units' situation of authorized beds, admitted patients, allocation of medical personnel and rehabilitation, and the ratio of beds to doctors, beds to nurses, beds to full-time burn rehabilitation treating personnel were recorded. Data were processed with t test, one-way analysis of variance, and chi-square test. Results: (1) A total of 65 questionnaires were sent, and 45 questionnaires (69.2%) were retrieved. Among the 45 units that replied the questionnaires, 35 units were burn treatment units. (2) The 35 burn treatment units were divided into less than 500 cases group ( n =8), 501-1 000 cases group ( n =11), 1 001-1 500 cases group ( n =10), and more than 1 500 cases group ( n =6) according to the number of annual admitted patients. The number of authorized beds of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group ( t =4.563, P <0.05). The number of authorized beds of units in more than 1 500 cases group was significantly more than that in the other 3 groups, respectively (with t values from 1.859 to 3.743, P values below 0.05). The number of annual admitted patients of units in 501-1 000 cases group, 1 001-1 500 cases group, and more than 1 500 cases group was dramatically more than that in less than 500 cases group (with t values from 6.027 to 12.684, P values below 0.05). The number of annual admitted patients of units in 1 001-1 500 cases group and more than 1 500 cases group was significantly more than that in 501-1 000 cases group (with t values respectively 7.408 and 6.980, P values below 0.05). The number of annual admitted patients of units in more than 1 500 cases group was significantly more than that in 1 001-1 500 cases group ( t =4.239, P <0.05). The number of annual admitted patients with extremely severe burn and the condition of rehabilitation area and rehabilitation beds of units in the 4 groups was similar ( F =0.820, with χ (2) values respectively 5.266 and 2.848, P values above 0.05). The number of doctors of units in more than 1 500 cases group was significantly more than that in less than 500 cases group ( t =2.836, P <0.05). The number of nurses of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group ( t =2.837, P <0.05). The number of nurses and that of rehabilitation therapists of units in more than 1 500 cases group were significantly more than those in the other 3 groups (with t values from 1.762 to 4.789, P values below 0.05). (3) The 35 burn treatment units were able to provide at least one rehabilitation treatment for patients, among which body positioning, motion of joint exercise, infrared ray irradiation, hydrotherapy, function training, activities of daily life training, scar massage, and drug injection in scar were carried out well, while psychological therapy, music therapy, occupational rehabilitation, and social rehabilitation were mostly not carried out. (4) Only 9 (25.7%) burn treatment units started rehabilitation treatment for patients within 3 days after injury. (5) Twenty-seven (77.1%) burn treatment units could carry out body positioning in ICU. (6) Twenty-three burn treatment units had full-time rehabilitation treating personnel, and the units were divided into less than 500 cases group ( n =1), 501-1 000 cases group ( n =8), 1 001-1 500 cases group ( n =9), and more than 1 500 cases group ( n =5) according to the number of annual admitted patients. The ratio of beds to doctors of units in more than 1 500 cases group was significantly higher than that in 501-1 000 cases group ( t =2.810, P <0.05) and the ratios of beds to doctors of units in 501-1 000 cases group and 1 001-1 500 cases group were similar ( t =1.506, P >0.05). The ratios of beds to nurses and beds to full-time burn rehabilitation treating personnel in 4 groups were similar (with F values respectively 0.783 and 0.434, P values above 0.05). (7) Twenty burn treatment units had rehabilitation therapists with rehabilitation treatment related professional background (a total of 73 person, account for 76.0%), 80.8% (59/73) rehabilitation therapists with rehabilitation and therapeutic professions, 60.3% (44/73) with bachelor degree or above, and 87.7% (64/73) with primary and intermediate titles. Besides, 39.7% (29/73) rehabilitation therapists did physical therapy; 12.3% (9/73) rehabilitation therapists did occupational therapy; 38.4% (28/73) rehabilitation therapists did not have specific duties. (8) During the development of burn rehabilitation treatment of 35 burn treatment units, the common problems were reflected in the authorized strength and professional technology level of rehabilitation treatment relating personnel, and the area and equipment for rehabilitation. There were also many problems in cooperation between burn surgeons and rehabilitation therapists and fund. The supports from hospital and department leaders were good. Conclusions: Through the development of several years, the general condition and the development of rehabilitation treatment of burn treatment units in China are improved; the beginning time of burn rehabilitation treatment is advanced; the number of rehabilitation treatment personnel is increased with their speciality improved; the burn rehabilitation work get great support from hospitals and departments.

[Evaluation of outpatient rehabilitation: goals, conceptual framework and study design of a health and pension insurance joint research project].

PubMed

Haaf, H G; Badura, B; Bürger, W; Koch, U; Schliehe, F; Schott, T

2002-01-01

In Germany the statutory health and pension insurance schemes are the main providers of medical rehabilitation, the majority of rehabilitation measures being given in an inpatient setting. Over the last few years, the health and pension insurance schemes have strengthened the extension of outpatient rehabilitation, and have funded a comprehensive evaluation study in this context. In this evaluation study outpatient rehabilitation in centres with different conceptual backgrounds is compared with inpatient rehabilitation in rehab clinics, indications considered being cardiology and orthopaedics. Overall, 14 rehab centres and more than 2000 patients were included in the project. The patients were interviewed and medically examined before and after the measure. A follow-up was done after six and twelve months. In addition to the rehabilitants themselves, the rehab centre physicians as well as the office-practice physicians were interviewed about the outcome of the rehab measure. One year after rehabilitation, data were collected from the relevant health and pension insurance funds concerning the benefits the patients had received. Due to the study's non-experimental design, validity of the results is confined to rehabilitants participating on an outpatient basis and who had been found medically suited for this type of rehabilitation, were capable of travelling to the rehab centre on their own within less than 45 minutes and had voluntarily opted for the outpatient setting. The findings of the study show that outpatient rehabilitants' motivation and expectations differ from those found in inpatient rehabilitation. The health economics analysis performed is restricted to the costs involved in the rehabilitation measure as such as well as the health-related benefits provided to the rehabilitants in the twelve-month study period. The issue of whether increasing outpatient rehab measures will lead to decreasing costs in the rehab system as a whole had not been considered in the framework of this project.

Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

PubMed Central

O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

2014-01-01

Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these recommendations were derived was either low or very low, consisting primarily of narrative reviews or descriptive studies with small sample sizes. Recommendations addressed approaches to rehabilitation assessment and interventions, and contextual factors to consider for rehabilitation with older adults living with HIV. Conclusions These evidence-informed recommendations provide a guide for rehabilitation with older adults living with HIV. PMID:24833687

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study

PubMed Central

Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

2017-01-01

Objectives Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. Methods We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007–2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Results Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for ‘satisfaction with psychological care’ and 0.11 (99.5% CI 0.08 to 0.14) for ‘satisfaction with treatments during rehabilitation’. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Conclusions Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process. PMID:28801401

European initiative for the application of the International Classification of Functioning, Disability and Health: development of Clinical Assessment Schedules for specified rehabilitation services.

PubMed

Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold

2017-04-01

Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for improving data collection on people's functioning.

Connecting rehabilitation and everyday life--the lived experiences among women with stress-related ill health.

PubMed

Hellman, Therese; Jonsson, Hans; Johansson, Ulla; Tham, Kerstin

2013-10-01

The aim was to describe and understand how connecting rehabilitation experiences and everyday life was characterised in the lived experiences during the rehabilitation in women with stress-related ill health. Five women were interviewed on three occasions during a rehabilitation programme and once 3 months later. Data were analysed using the Empirical, Phenomenological and Psychological method. The participants experienced connections between their rehabilitation and their previous, present and future everyday life influencing both rehabilitation and everyday life in a back-and-forth process. These connections were experienced in mind or in doing, mostly targeting the private arena in everyday life. Connecting rehabilitation experiences to their working situations was more challenging and feelings of frustration and being left alone were experienced. Although the participants described constructive connections between rehabilitation experiences and the private arena in everyday life, they mostly failed to experience connections that facilitated a positive return to work. Recommended support in the return to work process in rehabilitation comprises the provision of practical work-related activities during rehabilitation; being supportive in a constructive dialogue between the participant and the workplace, and continuing this support in follow-ups after the actual rehabilitation period. Rehabilitation for persons with stress-related ill health needs to focus on the private arena as well as the work situation in everyday life. Creative activities may enable experiences that inspire connections in mind and connections targeting the private arena in everyday life. The work situation needs to be thoroughly discussed during rehabilitation for enabling the participants to experience a support in the return to work process. Rehabilitation including practical work-related activities, support in a constructive dialogue between the participant and the manager at the workplace, and continued support in follow-ups targeting the workplace might be beneficial for successfully return to work.

Organizing human functioning and rehabilitation research into distinct scientific fields. Part I: Developing a comprehensive structure from the cell to society.

PubMed

Stucki, Gerold; Grimby, Gunnar

2007-05-01

There is a need to organize rehabilitation and related research into distinct scientific fields in order to overcome the current limitations of rehabilitation research. Based on the general distinction in basic, applied and professional sciences applicable to research in general, and the rehabilitation relevant distinction between the comprehensive perspective based on WHO's integrative model of human functioning (ICF) and the partial perspective focusing on the biomedical aspects of functioning, it is possible to identify 5 distinct scientific fields of human functioning and rehabilitation research. These are the emerging human functioning sciences and integrative rehabilitation sciences from the comprehensive perspective, the established biosciences and biomedical rehabilitation sciences and engineering from the partial perspective, and the professional rehabilitation sciences at the cutting edge of research and practice. The human functioning sciences aim to understand human functioning and to identify targets for comprehensive interventions, with the goal of contributing to the minimization of the experience of disability in the population. The biosciences in rehabilitation aim to explain body injury and repair and to identify targets for biomedical interventions. The integrative rehabilitation sciences design and study comprehensive assessments and interventions that integrate biomedical, personal factor and environmental approaches suited to optimize people's performance. The biomedical rehabilitation sciences and engineering study diagnostic measures and interventions suitable to minimize impairment, including symptom control, and to optimize people's capacity. The professional rehabilitation sciences study how to provide best care with the goal of enabling people with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment. The organization of human functioning and rehabilitation research into the 5 distinct scientific fields facilitates the development of academic training programs and career building as well as the development of research structures dedicated to human functioning and rehabilitation research.

Predictors of Acute, Rehabilitation and Total Length of Stay in Acute Stroke: A Prospective Cohort Study.

PubMed

Ng, Yee Sien; Tan, Kristin Hx; Chen, Cynthia; Senolos, Gilmore C; Chew, Effie; Koh, Gerald Ch

2016-09-01

The poststroke acute and rehabilitation length of stay (LOS) are key markers of stroke care efficiency. This study aimed to describe the characteristics and identify the predictors of poststroke acute, rehabilitation and total LOS. This study also defined a subgroup of patients as "short" LOS and compared its complication rates and functional outcomes in rehabilitation with a "long" acute LOS group. A prospective cohort study (n = 1277) was conducted in a dedicated rehabilitation unit within a tertiary academic acute hospital over a 5-year period between 2004 and 2009. The functional independence measure (FIM) was the primary functional outcome measure in the rehabilitation phase. A group with an acute LOS of less than 7 days was defined as "short" acute LOS. Ischaemic strokes comprised 1019 (80%) of the cohort while the rest were haemorrhagic strokes. The mean acute and rehabilitation LOS were 9 ± 7 days and 18 ± 10 days, respectively. Haemorrhagic strokes and anterior circulation infarcts had significantly longer acute, rehabilitation and total LOS compared to posterior circulation and lacunar infarcts. The acute, rehabilitation and total LOS were significantly shorter for stroke admissions after 2007. There was poor correlation (r = 0.12) between the acute and rehabilitation LOS. In multivariate analyses, stroke type was strongly associated with acute LOS, while rehabilitation admission FIM scores were significantly associated with rehabilitation LOS. Patients in the short acute LOS group had fewer medical complications and similar FIM efficacies compared to the longer acute LOS group. Consideration for stroke type and initial functional status will facilitate programme planning that has a better estimation of the LOS duration, allowing for more equitable resource distribution across the inpatient stroke continuum. We advocate earlier transfers of appropriate patients to rehabilitation units as this ensures rehabilitation efficacy is maintained while the development of medical complications is potentially minimised.

Rehabilitation as "destination triage": a critical examination of discharge planning.

PubMed

Durocher, Evelyne; Gibson, Barbara E; Rappolt, Susan

2017-06-01

In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults' functional capabilities. Professionals' primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting "rehabilitation" stay was more akin to an extended process of "destination triage" biased towards the promotion of physical safety than optimizing functioning. The resulting reduction of rehabilitation into "destination triage" has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for Rehabilitation Current trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation. Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation. Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members.

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

Responding to the health and rehabilitation needs of people with disabilities post-Haiyan

PubMed Central

Kleinitz, Pauline; Calina, Liezel; Alcido, Ma Rowena; Gohy, Bérengère; Hall, Julie Lyn

2015-01-01

Introduction It is estimated that 15% of the world’s population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. Method A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Results Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Discussion Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters. PMID:26767137

State-of-the-Science on Postacute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy. An Introduction

PubMed Central

Heinemann, Allen W

2007-01-01

The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness, along with academic, professional, provider, accreditor, and other organizations, sponsored a 2-day State-of-the-Science of Postacute Rehabilitation Symposium in February 2007. The aim of this symposium was to serve as a catalyst for expanded research on postacute care (PAC) rehabilitation so that health policy is founded on a solid evidence base. The goals were to (a) describe the state of our knowledge regarding utilization, organization, and outcomes of postacute rehabilitation settings, (b) identify methodologic and measurement challenges to conducting research, (c) foster the exchange of ideas among researchers, policy makers, industry representatives, funding agency staff, consumers, and advocacy groups, and (d) identify critical questions related to setting, delivery, payment, and effectiveness of rehabilitation services. Plenary presentation and state-of-the-science summaries were organized around 4 themes: (a) the need for improved measurement of key rehabilitation variables and methods to collect and analyze this information, (b) factors that influence access to postacute rehabilitation care, (c) similarities and differences in quality and quantity of services across PAC settings, and (d) effectiveness of postacute rehabilitation services. The full set of symposium articles, including recommendations for future research, appear in Archives of Physical Medicine and Rehabilitation. PMID:18092560

Responding to the health and rehabilitation needs of people with disabilities post-Haiyan.

PubMed

Benigno, Mylene Rose; Kleinitz, Pauline; Calina, Liezel; Alcido, Ma Rowena; Gohy, Bérengère; Hall, Julie Lyn

2015-01-01

It is estimated that 15% of the world's population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters.

[Allocation decisions of health insurance rehabilitation managers--An explorative case study concerning stroke rehabilitation].

PubMed

Hasenbein, U; Wallesch, C-W

2003-12-01

We investigated processes of and subjective reasons for resource allocation in three out of four rehabilitation specialists of a regional office of a major health insurance. Decisions of health insurance personnel include approval of and duration of rehabilitation treatment and choice of clinical provider. Insurance specialists are mainly involved in documentation and coordination, whereas decisions mainly follow expert recommendations, mainly of the medical service. Allocation is based primarily on somatic impairment and disability, psychosocial function, motivation and rehabilitation potential are regarded as secondary. Goals and expected results of rehabilitation are neither individually defined nor their achievement evaluated. Decision processes are dominated by routines and agreements. Only exceptionally, defined rules and procedures are applied. Active case management is hampered by a highly specialized internal structure of the investigated insurance fund. The optimal fulfillment of individual requirements for a limited-time rehabilitation treatment is the central criterion for decision making. However, the specialists lack detailed information concerning appropriateness, quality and efficacy of rehabilitation providers, especially when taking patient-related variables into account. Instead, they trust that only high-quality institutions are contracted. Systematic control and feedback of rehabilitation results is not available. The surveyed rehabilitation managers do not include cost aspects in their decision-making. They would regard this as alien to a member- and patient-oriented policy. Improvement potentials with respect to rehabilitation case management are being reviewed.

[The Significance of Work Motivation for Rehabilitation Success].

PubMed

Kessemeier, Franziska; Stöckler, Christiane; Petermann, Franz; Bassler, Markus; Pfeiffer, Wolfgang; Kobelt, Axel

2017-11-28

Aim of this study Apart from the reduction of symptoms and the restoration of working ability, return to work is a long-term goal of medical rehabilitation. The aim of this study is to analyze the influence of work motivation on the outcome of rehabilitation. Methods The data basis consists of N=998 patients at the psychosomatic department of the Oberharz Rehabilitation Center as well as data from insurance accounts. Using multiple linear regression analysis the predictive power of work motivation on rehabilitation outcome as well as different facets of work motivation in their function as predictors are analyzed. Results Only minor statistical relations could be found between work motivation and rehabilitation success when also taking employment status of the previous year and subjective vocational disability into account. A small predictive power can be attributed to work motivation as a factor in rehabilitation success in the sense of a reduction of symptoms. Particular facets of work motivation are suitable to predict rehabilitation success. Patients with a work motivation risk profile differ from patients with a normal work motivation profile as regards their capacity to work in the year following rehabilitation treatment. Conclusion Work motivation represents a relevant construct in rehabilitation success but is strongly influenced by individual factors. During rehabilitation, individual problems which influence work motivation should be taken into account more strongly. © Georg Thieme Verlag KG Stuttgart · New York.

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...

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...

Virtual reality rehabilitation for stroke patients: Recent review and research issues

NASA Astrophysics Data System (ADS)

Arip, Eza Surya Mohd; Ismail, Waidah; Nordin, Md Jan; Radman, Abduljalil

2017-11-01

Stroke is one of the main causes of disability in the world. In order for stroke survivors to reduce their disability, they need to go through a rehabilitation process to regain back their independence and improve their quality of life. To guide patients in their rehabilitation process and improve their receptiveness in performing repetitive exercises, a new rehabilitation training program using Virtual Reality (VR) technology has been introduced. This has attracted many researchers to explore more on VR technology as a new tool for stroke patient's rehabilitation. This paper presents a review on existing VR systems that have been developed for stroke rehabilitation. First, recent VR systems utilized for rehabilitation after stroke are delineated and categorized. Each of these categories concludes with a discussion on limitations and any issues that arise from it. Finally, a concise summary with significant findings and future possibilities in VR rehabilitation research is presented in table format.

The need and its influence factors for community-based rehabilitation services for disabled persons in one district in Beijing.

PubMed

Dai, Hong; Xue, Hui; Yin, Zong-Jie; Xiao, Zhong-Xin

2006-12-01

To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Of the interviewees, 57.4% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost (P < 0.05), knowledge about rehabilitation medicine (P < 0.05); and the belief in the therapeutic benefit of the community-based rehabilitation service (P < 0.05). A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

Rehabilitation consumers' use and understanding of quality information: a health literacy perspective.

PubMed

Magasi, Susan; Durkin, Elizabeth; Wolf, Michael S; Deutsch, Anne

2009-02-01

To explore consumers' use and understanding of quality information about postacute rehabilitation facilities. Thematic, semistructured interviews. Two skilled nursing facilities and 2 inpatient rehabilitation facilities in a large Midwestern city. Rehabilitation inpatients (n=17) with stroke, hip fractures, and joint replacements and care partners (n=12) of rehabilitation inpatients. None. None. Health literacy imposed barriers to participants' understanding of quality information. Using the Institute of Medicine's Health Literacy Framework, we identified specific barriers that limited participants' abilities to (1) obtain quality information, (2) process and understand quality information, and (3) make appropriate decisions about the quality of a rehabilitation facility. Participants tended to rely on informal and nonquality information when choosing a rehabilitation facility. Given the barriers imposed by low health literacy, rehabilitation providers have a responsibility to present quality information in a way that consumers, especially those with low health literacy, can use and understand.

An advanced rehabilitation robotic system for augmenting healthcare.

PubMed

Hu, John; Lim, Yi-Je; Ding, Ye; Paluska, Daniel; Solochek, Aaron; Laffery, David; Bonato, Paolo; Marchessault, Ronald

2011-01-01

Emerging technologies such as rehabilitation robots (RehaBot) for retraining upper and lower limb functions have shown to carry tremendous potential to improve rehabilitation outcomes. Hstar Technologies is developing a revolutionary rehabilitation robot system enhancing healthcare quality for patients with neurological and muscular injuries or functional impairments. The design of RehaBot is a safe and robust system that can be run at a rehabilitation hospital under the direct monitoring and interactive supervision control and at a remote site via telepresence operation control. RehaBot has a wearable robotic structure design like exoskeleton, which employs a unique robotic actuation--Series Elastic Actuator. These electric actuators provide robotic structural compliance, safety, flexibility, and required strength for upper extremity dexterous manipulation rehabilitation training. RehaBot also features a novel non-treadmill paddle platform capable of haptics feedback locomotion rehabilitation training. In this paper, we concern mainly about the motor incomplete patient and rehabilitation applications.

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

PubMed

Sweetow, Robert W; Sabes, Jennifer Henderson

2007-06-01

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

Innovating With Rehabilitation Technology in the Real World: Promises, Potentials, and Perspectives.

PubMed

Chua, Karen Sui Geok; Kuah, Christopher Wee Keong

2017-10-01

In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies.

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

PubMed Central

Sweetow, Robert W.; Sabes, Jennifer Henderson

2007-01-01

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

Innovating With Rehabilitation Technology in the Real World

PubMed Central

Chua, Karen Sui Geok; Kuah, Christopher Wee Keong

2017-01-01

Abstract In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies. PMID:28708632

Planning for a medical surge incident: Is rehabilitation the missing link?

PubMed

Vonderschmidt, Kay

2017-01-01

This mixed methods study explored surge planning for patients who will need rehabilitative care after a mass casualty incident. Planning for a patient surge incident typically considers only prehospital and hospital care. However, in many cases, disaster patients need rehabilitation for which planning is often overlooked. The purpose of this study was to explore this hidden dimension of patient rehabilitation for surge planning and preparedness and ask: 1. To what extent can an analysis of standard patient acuity assessment tools [Simple Triage and Rapid Treatment and Injury Severity Score] be used to project future demand for admission to rehabilitative care? 2. What improvements to medical disaster planning are needed to address patient surge related to rehabilitation? This study found that standard patient benchmarks can be used to project demand for rehabilitation following a mass casualty incident, and argues that a reconceptualization of surge planning to include rehabilitation would improve medical disaster planning.

Proprietary Rehabilitation: A Better Understanding. Report from the Study Group of the Tenth Institute on Rehabilitation Issues, St. Louis, Missouri, June 1983.

ERIC Educational Resources Information Center

Corthell, David W.; de Groot, Jozef

This booklet presents the report of the Institute on Rehabilitation Issues, focusing on proprietary, or private for-profit rehabilitation. Following a list of the prime study group members, acknowledgements, and a brief preface, chapter I of the document presents an historical perspective on the rehabilitation movement in the United States,…

The Relationship between Degree Type, Certification Status, and Years of Employment and the Amount of Time Spent on Rehabilitation Counseling Tasks in State--Federal Vocational Rehabilitation

ERIC Educational Resources Information Center

Lustig, Dan C.; Strauser, David R.

2008-01-01

The purpose of this study is to examine the relationship between perceived percentage of time spent on particular rehabilitation counseling responsibilities, on one hand, and possession of an educational degree, certification as a rehabilitation counselor (CRC), and years worked for the state--federal vocational rehabilitation (VR) agency, on the…

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study.

PubMed

Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

2017-08-11

Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed

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

2016-08-17

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

Predicting participation in and successful outcome of a penile rehabilitation programme using a phosphodiesterase type 5 inhibitor with a vacuum erection device after radical prostatectomy.

PubMed

Kimura, Masaki; Caso, Jorge R; Bañez, Lionel L; Koontz, Bridget F; Gerber, Leah; Senocak, Cagri; Donatucci, Craig F; Vujaskovic, Zeljko; Moul, Judd W; Polascik, Thomas J

2012-12-01

Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? The role of the vacuum erection device (VED) has increased with its use in combined therapy with a phosphodiesterase type 5 inhibitor (PDE5i) for penile rehabilitation after radical prostatectomy (RP) and radiotherapy. The advantages of the VED are non-invasive, cost-effective, and a possibility of preventing shrinkage of penis length. Albeit current widespread use of penile rehabilitation programmes for post-RP erectile dysfunction, independent predictors for the rehabilitation participants, as well as for its treatment success have not been fully investigated. In the present study, we have added several new predictors for rehabilitation participation, e.g. African-Americans and higher preoperative sexual function. Conversely, higher preoperative PSA concentrations and the presence of positive surgical margins were predictors for avoidance of rehabilitation. Notably, there was a primary surgeon difference, which had a trend for predicting outcome of the rehabilitation among the participants, implying their surgical technique and follow-up might influence success of the rehabilitation. • To investigate baseline demographic and clinicopathological characteristics of men who participate in our penile rehabilitation programme after radical prostatectomy (RP). • To determine predictors for participation in rehabilitation, as well as successful rehabilitation outcome using multivariable logistic regression analyses. • We analysed data on 2345 consecutive patients who underwent RP between 2001 and 2009 in our institution. • The decision to participate in penile rehabilitation using phosphodiesterase type 5 inhibitor (PDE5i) with a vacuum erection device (VED) was based on the patient's choice after post-RP discussions. • Rehabilitation success was defined using the following criteria: (i) patients who continued the penile rehabilitation programme and did not switch treatment from PDE5i to other erectile aids, (ii) success was noted in men who had an Expanded Prostate Cancer Index Composite (EPIC) sexual function (SF) score of >75% of the patient's baseline EPIC score, and (iii) patients who answered that they achieved adequate erections with a PDE5i. • Logistic regression analysis was used to identify factors associated with treatment participation and its success. • Of 676 patients, 354 (53.2%) men participated in a penile rehabilitation programme. Among 329 rehabilitation participants with available data, 96 (29.2%) had treatment success. • In multivariable regression analysis, African-Americans (odds ratio [OR] 3.47, P < 0.001), and higher preoperative SF (OR 1.02, P < 0.001) were associated with participation in rehabilitation. • Higher preoperative PSA concentration (OR 0.50, P = 0.004) and presence of positive surgical margins (OR 0.68, P = 0.042) were found to be independent predictors for non-participation in the rehabilitation. • For rehabilitation outcomes, being older at surgery (OR 0.93, P = 0.001) and adjuvant therapy (OR 0.34, P = 0.047) had a negative association with successful outcome. • There was a trend in the relationship between primary surgeon and rehabilitation success (OR 1.05, P = 0.053) • Those patients who have risk factors, e.g. adverse prostate cancer features, need to be carefully counselled and encouraged to participate in the penile rehabilitation programme. • Clinicians could lead patients toward successful outcomes if appropriate surgical techniques and rehabilitation are provided. © 2012 BJU INTERNATIONAL.

Patient and Family Member Factors Influencing Outcomes of Poststroke Inpatient Rehabilitation.

PubMed

Fang, Yunhua; Tao, Qian; Zhou, Xiaoxuan; Chen, Shanjia; Huang, Jia; Jiang, Yingping; Wu, Yi; Chen, Lidian; Tao, Jing; Chan, Chetwyn C

2017-02-01

To investigate how family members' attitudes toward functional regain, and patients' knowledge and intention of independence influence poststroke rehabilitation. Cross-sectional study. Three rehabilitation inpatient settings. Younger (n=79) and older (n=84) poststroke patients, along with their family members (spouses, n=104; children, n=59). Not applicable. Custom-designed questionnaires were used to tap into the patients' knowledge about rehabilitation (Patient's Rehabilitation Questionnaire-Knowledge About Rehabilitation) and intention of independence (Patient's Rehabilitation Questionnaire-Intention of Independence), and family members' attitudes toward patients in performing basic activities of daily living (BADL) (Family Member Attitudes Questionnaire-BADL) and instrumental activities of daily living (Family Member Attitudes Questionnaire-instrumental activities of daily living). The rehabilitation outcomes included gains in motor, cognitive, and emotional functions, and self-care independence, measured with common clinical instruments. The Family Member Attitudes Questionnaire-BADL predicted cognitive outcome and the Patient's Rehabilitation Questionnaire-Intention of Independence predicted motor outcome for both groups. Differential age-related effects were revealed for the Patient's Rehabilitation Questionnaire-Intention of Independence in predicting emotional outcome only for the younger group, and self-care independence only for the older group. Patients' intention of independence positively affected motor recovery, while family members' positive attitudes promoted cognitive regain. The findings suggested plausible age-related differences in how patients' intentions affect emotion versus self-care independence outcomes. Future studies should explore strategies for promoting positive attitudes toward independence among patients and family members during poststroke rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Educational Preparation, Roles, and Competencies to Guide Career Development for Cardiac Rehabilitation Nurses.

PubMed

Lin, Stella H M; Neubeck, Lis; Gallagher, Robyn

Cardiac rehabilitation is one of the most widely recommended strategies to reduce the burden of cardiovascular disease. The multicomponent nature of cardiac rehabilitation programs requires a multidisciplinary team of healthcare professionals including nurses who are equipped with extensive knowledge and skills. However, there is a lack of a comprehensive, explicit career pathway that contains academic and clinical development to prepare nurses to become cardiac rehabilitation specialists. The aim of this study is to identify the 3 essential components for cardiac rehabilitation professionals: (1) educational preparation, (2) role/responsibility, and (3) competency to inform the framework of career development for cardiac rehabilitation nurses. Through scoping review, 4 stages from the methodological framework of scoping review by Arksey and O'Malley (Int J Soc Methodol. 2005;8:19-32) were used. Some attempts have been made in developing frameworks of career development for cardiac rehabilitation professionals with these 3 components through guidelines/standards and core curriculum development worldwide, among which the United States is the only country with a well-established system including guidelines for cardiac rehabilitation/secondary prevention programs, a position statement in terms of competencies, and certification examination for cardiac rehabilitation professionals. Nevertheless, further development and integration of these efforts, specifically for cardiac rehabilitation nurses, are required. It is vital to raise the awareness of the significant contribution that appropriately educated and trained nurses make in reducing the global burden of cardiovascular disease through cardiac rehabilitation. Therefore, action on establishing a system of comprehensive, clearly defined career development pathway for cardiac rehabilitation nurses worldwide is of immediate priority.

A qualitative study using the Theoretical Domains Framework to investigate why patients were or were not assessed for rehabilitation after stroke.

PubMed

Lynch, Elizabeth A; Luker, Julie A; Cadilhac, Dominique A; Fryer, Caroline E; Hillier, Susan L

2017-07-01

To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Eight acute stroke units in two states of Australia. Health professionals working in acute stroke units. Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain 'social and professional role'); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation ('belief about consequences'); the influence of the unit's relationships with other groups including rehabilitation teams ('social influences' domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices ('knowledge' domain). This study has identified that health professionals' perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.

Variations in Utilization of Inpatient Rehabilitation Services among Pediatric Trauma Patients.

PubMed

Nguyen, Huong T; Newton, Christopher; Pirrotta, Elizabeth A; Aguilar, Christine; Wang, N Ewen

2017-03-01

To assess clinical and nonclinical characteristics associated with the use of pediatric inpatient rehabilitation services among children with traumatic injuries. We hypothesized there would be no nonclinical variations in the use of pediatric inpatient rehabilitation services. Retrospective analysis of 1139 patients who were injured seriously (0-18 years of age) from our institutional trauma registry (2004-2014). Patients' nonclinical and clinical characteristics were analyzed. We used a full matching technique to compare characteristics between those admitted to rehabilitation (cases) to those discharged home (controls). We matched patients by age category, sex, maximum Abbreviated Injury Scale, and body region of maximum Abbreviated Injury Scale. We used survey-based multivariate logistic regression to identify characteristics associated with inpatient rehabilitation services, controlling for multiple injuries, distance from home to rehabilitation center, year of service, hospital length of stay, and clinically relevant interactions. Ninety-eight patients (8.6%) were admitted to inpatient rehabilitation and 968 (85.0%) were discharged home. Black and other minority patients had increased odds of receiving inpatient rehabilitation compared with white patients (OR, 7.6 [P< .001] and OR, 1.6 [P= .03], respectively). Patients with private compared with public insurance had increased odds of receiving inpatient rehabilitation (OR, 2.4; P< .001). Pediatric inpatient rehabilitation beds are a scarce resource that should be available to those with the greatest clinical need. The mechanism creating differences in the use of inpatient rehabilitation based on nonclinical characteristics such as race/ethnicity or insurance status must be understood to prevent disparities in access to inpatient rehabilitation services. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of rehabilitative voir dire on juror bias and decision making.

PubMed

Crocker, Caroline B; Kovera, Margaret Bull

2010-06-01

During voir dire, judges frequently attempt to "rehabilitate" venirepersons who express an inability to be impartial. Venirepersons who agree to ignore their biases and base their verdict on the evidence and the law are eligible for jury service. In Experiment 1, biased and unbiased mock jurors participated in either a standard or rehabilitative voir dire conducted by a judge and watched a trial video. Rehabilitation influenced insanity defense attitudes and perceptions of the defendant's mental state, and decreased scaled guilt judgments compared to standard questioning. Although rehabilitation is intended to correct for partiality among biased jurors, rehabilitation similarly influenced biased and unbiased jurors. Experiment 2 found that watching rehabilitation did not influence jurors' perceptions of the judge's personal beliefs about the case.

Prediction of Membership in Rehabilitation Counseling Professional Associations

ERIC Educational Resources Information Center

Phillips, Brian N.; Leahy, Michael J.

2012-01-01

Declining membership is a concerning yet poorly understood issue affecting professional associations across disciplines (Bauman, 2008). Rehabilitation counseling association membership is in decline even while number of certified rehabilitation counselors continues to increase (Leahy, 2009). Factors influencing rehabilitation counseling…

Implementing Computer Technology in the Rehabilitation Process.

ERIC Educational Resources Information Center

McCollum, Paul S., Ed.; Chan, Fong, Ed.

1985-01-01

This special issue contains seven articles, addressing rehabilitation in the information age, computer-assisted rehabilitation services, computer technology in rehabilitation counseling, computer-assisted career exploration and vocational decision making, computer-assisted assessment, computer enhanced employment opportunities for persons with…

Cost-effective river rehabilitation planning: optimizing for morphological benefits at large spatial scales.

PubMed

Langhans, Simone D; Hermoso, Virgilio; Linke, Simon; Bunn, Stuart E; Possingham, Hugh P

2014-01-01

River rehabilitation aims to protect biodiversity or restore key ecosystem services but the success rate is often low. This is seldom because of insufficient funding for rehabilitation works but because trade-offs between costs and ecological benefits of management actions are rarely incorporated in the planning, and because monitoring is often inadequate for managers to learn by doing. In this study, we demonstrate a new approach to plan cost-effective river rehabilitation at large scales. The framework is based on the use of cost functions (relationship between costs of rehabilitation and the expected ecological benefit) to optimize the spatial allocation of rehabilitation actions needed to achieve given rehabilitation goals (in our case established by the Swiss water act). To demonstrate the approach with a simple example, we link costs of the three types of management actions that are most commonly used in Switzerland (culvert removal, widening of one riverside buffer and widening of both riversides) to the improvement in riparian zone quality. We then use Marxan, a widely applied conservation planning software, to identify priority areas to implement these rehabilitation measures in two neighbouring Swiss cantons (Aargau, AG and Zürich, ZH). The best rehabilitation plans identified for the two cantons met all the targets (i.e. restoring different types of morphological deficits with different actions) rehabilitating 80,786 m (AG) and 106,036 m (ZH) of the river network at a total cost of 106.1 Million CHF (AG) and 129.3 Million CH (ZH). The best rehabilitation plan for the canton of AG consisted of more and better connected sub-catchments that were generally less expensive, compared to its neighbouring canton. The framework developed in this study can be used to inform river managers how and where best to spend their rehabilitation budget for a given set of actions, ensures the cost-effective achievement of desired rehabilitation outcomes, and helps towards estimating total costs of long-term rehabilitation activities. Rehabilitation plans ready to be implemented may be based on additional aspects to the ones considered here, e.g., specific cost functions for rural and urban areas and/or for large and small rivers, which can simply be added to our approach. Optimizing investments in this way will ultimately increase the likelihood of on-ground success of rehabilitation activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Wienert, Julian; Schwarz, Betje; Bethge, Matthias

2016-07-27

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

How can the rehabilitation planning process at the workplace be improved? A qualitative study from employers' perspective.

PubMed

Larsson, Agneta; Gard, Gunvor

2003-09-01

Employers in Sweden are by law responsible for planning and controlling the working environment situation in their companies and for ensuring that any need for rehabilitation is noted as soon as possible and that action is taken. This includes developing a plan for rehabilitation. The aim of this study is to describe employers' experiences of the work rehabilitation planning process at the workplace, and how it can be improved with a focus on quality and cost-effectiveness. Qualitative interviews were performed with 10 employers of employee/s that had participated in vocational rehabilitation at a rehabilitation center in the North of Sweden. The results showed that employers were interested in detecting work rehabilitation needs and in taking action early. Rehabilitation at the workplace could be improved by development of routines, improved work relations and work technique, and environment in-service training at the workplace. Prevention was perceived as a prerequisite for a good result of rehabilitation. Attention to social and geographic conditions is needed. Organizational and financial limitations exist.

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.

Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort.

PubMed

Chiung-Jui Su, Daniel; Yuan, Kuo-Shu; Weng, Shih-Feng; Hong, Rong-Bin; Wu, Ming-Ping; Wu, Hing-Man; Chou, Willy

2015-01-01

To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA) complications, adverse events, and medical expenses within one postoperative year. We retrospectively retrieve data from Taiwan's National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab) and delayed rehabilitation (Delayed Rehab). Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p < 0.001) higher medical and rehabilitation expenses and more outpatient department (OPD) visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR): 3.152; 95% confidence interval (CI): 1.211-8.203; p < 0.05) than the Early Rehab group. Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA.

Health Services Research in Rehabilitation and Disability-The Time is Now.

PubMed

Graham, James E; Middleton, Addie; Roberts, Pamela; Mallinson, Trudy; Prvu-Bettger, Janet

2018-01-01

Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the "Triple Aim" of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Benefit of Modified Rehabilitation and Minimally Invasive Techniques in Total Hip Replacement

PubMed Central

Lilikakis, Anastasios K; Gillespie, Beryl; Villar, Richard N

2008-01-01

INTRODUCTION We wished to assess if an intensive rehabilitation regimen alone, or one combined with modified anaesthetic and surgical techniques, can change the speed of rehabilitation or the length of hospital stay after total hip replacement. PATIENTS AND METHODS We compared 44 patients who had followed a traditional care pathway, with 38 patients who had rehabilitated under a new rehabilitation protocol, with 40 patients who had also received modified, minimally invasive techniques. The speed of rehabilitation was measured in terms of three specific milestones accomplished on the day after surgery. RESULTS We found a statistically significant improvement in the day after surgery each activity was possible. The length of hospital stay was reduced from 6.5 days to 5.4 days to 4.1 days, a difference which was also statistically significant. CONCLUSIONS The data support the view that a new rehabilitation protocol alone can reduce the length of hospital stay and hasten rehabilitation. The combination of modified anaesthetic and minimally invasive surgical techniques with the new rehabilitation regimen can further improve short-term outcome after total hip replacement. PMID:18634739

Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges.

PubMed

Cowen, T D; Meythaler, J M; DeVivo, M J; Ivie, C S; Lebow, J; Novack, T A

1995-09-01

To determine the relationship between early variables (initial Glasgow Coma Scale [GCS] scores, computed tomography [CT] findings, presence of skeletal trauma, age, length of acute hospitalization) and outcome variables (Functional Independence Measure [FIM] scores, rehabilitation length of stay [LOS], rehabilitation charges) in traumatic brain injury (TBI). Inception cohort. University tertiary care rehabilitation center. 91 patients with TBI. Inpatient rehabilitation. FIM, rehabilitation LOS, and rehabilitation charges. Patients in the severely impaired (GCS = 3 to 7) group showed significantly lower (p = .01) mean admission and discharge motor scores (21.26, 39.83) than patients in the mildly impaired (GCS = 13 to 15) group (38.86, 55.29). Cognitive scores were also significantly lower (p < .01) in the severely impaired group on admission (26.73 vs 54.14) and discharge (42.28 vs 66.48). These findings continued to be statistically significant (p < .01) after regression analysis accounted for the other early variables previously listed. Regression analysis also illustrated that longer acute hospitalization LOS was independently associated with significantly lower admission motor (p < .01) and cognitive (p = .05) scores, and significantly higher (p = .01) rehabilitation charges. Patients with CT findings of intracranial bleed with skull fracture had longer total LOS (70.88 vs 43.08 days; p < .05), rehabilitation LOS (30.01 vs 19.68 days; p < .10), and higher rehabilitation charges ($43,346 vs $25,780; p < .05). Paradoxically, those patients in a motor vehicle crash with an extremity bone fracture had significantly higher (p = .002; p = .04 after regression analysis) FIM cognitive scores on admission (48.30 vs 27.28) and discharge (64.74 vs 45.78) than those without a fracture. Finally, data available on rehabilitation admission were used to predict discharge outcomes. The percentage of explained variance for each outcome variable is as follows: discharge FIM motor score, 69.5%; discharge FIM cognitive score, 71.2%; rehabilitation LOS, 54.1%; rehabilitation charges, 61.1%. The most powerful predictor of LOS and charges was the admission FIM motor score (p < .001), followed by CT findings (p = .02) and age (p = .04). Information readily available on rehabilitation admission, particularly the FIM motor score, may be useful in predicting discharge FIM scores as well as utilization of medical rehabilitation resources. Earlier transfer to rehabilitation may result in higher functional status and lower rehabilitation charges, as well as lower acute hospitalization charges. The presence of extremity fractures encountered during a motor vehicle crash is associated with a more favorable outcome in TBI as evidenced by higher discharge FIM cognitive scores.

Qualitative research in rehabilitation science: opportunities, challenges, and future directions.

PubMed

VanderKaay, Sandra; Moll, Sandra E; Gewurtz, Rebecca E; Jindal, Pranay; Loyola-Sanchez, Adalberto; Packham, Tara L; Lim, Chun Y

2018-03-01

Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field. Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions. Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research. Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential. Implications for Rehabilitation Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner-client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting patients that are utilizing these services. Changes over time in how qualitative research is conceptualized, conducted, and utilized to advance rehabilitation science have resulted in a number of unique opportunities and challenges in using qualitative research that must be considered within this field. Advances in methodology and increased expectations for evaluation must be considered to ensure quality and credibility of qualitative rehabilitation research within rehabilitation. Improved quality and credibility may increase likelihood of research dissemination and use by clinicians intervening within the rehabilitation process in order to improve clinical practice. In order to maximize opportunities and mitigate challenges there are two principal future directions for rehabilitation scientists to consider: (1) advancing training in qualitative methods to adequately prepare future rehabilitation scientists and (2) engaging qualitative communities of research.

75 FR 27327 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Centers (RRTCs)-- Effective Vocational Rehabilitation (VR) Service Delivery Practices Catalog of Federal... priority for an RRTC on Effective Vocational Rehabilitation (VR) Service Delivery Practices. The Assistant... priority. Effective Vocational Rehabilitation (VR) Service Delivery Practices Background: The...

78 FR 76599 - Rehabilitation Research Advisory Council; Request for Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... DEPARTMENT OF EDUCATION Rehabilitation Research Advisory Council; Request for Nominations AGENCY...: Request for nominations--Rehabilitation Research Advisory Council. SUMMARY: The Secretary of the U.S. Department of Education announces the agency's intention to establish a Rehabilitation Research Advisory...

75 FR 36237 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... outcomes for underserved populations; (4) identify research gaps; (5) identify mechanisms of integrating... Part IV Department of Education National Institute on Disability and Rehabilitation Research (NIDRR)-- Disability and Rehabilitation Research Projects and Centers Program-- Rehabilitation Research...

76 FR 2944 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... equipment. Rehabilitate airfield guidance signs. Rehabilitate runway 16/34 (design only). Rehabilitate parallel and connecting taxiways (design only). Rehabilitate terminal building. Conduct wildlife hazard assessment. Terminal building expansion (design only). PFC administrative costs. Reconstruct west aircraft...

77 FR 49852 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... of Projects Approved for Collection and Use: Runway 11/29 pavement rehabilitation. Taxiway B pavement rehabilitation. Runway 15/33 pavement rehabilitation. Aircraft rescue and firefighting equipment acquisition. Security enhancements. Rehabilitate concrete commercial apron. General aviation apron pavement...

78 FR 57675 - Notice of Passenger Facility Charge Approvals and Disapprovals

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

... carrier and general aviation apron rehabilitation--design. Air carrier and general aviation apron rehabilitation--design reimbursement. Air carrier and general aviation apron rehabilitation--construction. Rehabilitate and expand auto parking lot--design. Airfield lighting control--design. Aircraft rescue and...

75 FR 27544 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... science in research on employment for individuals with disabilities. Washington, DC: The Urban Institute... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Disability Rehabilitation Research...

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…

Vocational Rehabilitation: An Employment Program. Hearing on Examining the Vocational Rehabilitation System and the Rehabilitation Act, Focusing Slightly and Explore Some of the Issues, Including Linkage, the VR System Faces in Ohio, (Columbus, OH) 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 examining the vocational rehabilitation system and the Vocational Rehabilitation Act and exploring some of the issues, including linkage, faced by the vocational rehabilitation system in Ohio. Statements were provided by a U.S. senator (Mike DeWine, Ohio) and representatives of the following agencies…

National Institutes of Health Research Plan on Rehabilitation

PubMed Central

O’Mara, Ann; Rowland, Julia H.; Greenwell, Thomas N.; Wiggs, Cheri L.; Fleg, Jerome; Joseph, Lyndon; McGowan, Joan; Panagis, James S.; Washabaugh, Charles; Peng, Grace C. Y.; Bray, Rosalina; Cernich, Alison N.; Cruz, Theresa H.; Marden, Sue; Michel, Mary Ellen; Nitkin, Ralph; Quatrano, Louis; Spong, Catherine Y.; Shekim, Lana; Jones, Teresa L. Z.; Juliano-Bult, Denise; Panchinson, David M.; Chen, Daofen; Jakeman, Lyn; Knebel, Ann; Tully, Lois A.; Chan, Leighton; Damiano, Diane; Tian, Biao; McInnes, Pamela; Khalsa, Partap; Reider, Eve; Shurtleff, David; Elwood, William; Ballard, Rachel; Ershow, Abby G.; Begg, Lisa

2017-01-01

Abstract One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation. This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: NIH Medical Rehabilitation Coordinating Committee. Am J Phys Med Rehabil. 2017;97(4):404—407. PMID:28499003

Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

PubMed

Stelmack, Joan

2005-05-01

A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

Responding to the World Health Organization Gobal Disability Action Plan in Ukraine: Developing a National Disability, Health and Rehabilitation Plan.

PubMed

Gutenbrunner, Christoph; Tederko, Piotr; Grabljevec, Klemen; Nugraha, Boya

2018-04-18

In order to support the development of a National Disability, Health and Rehabilitation Plan (NDHRP) for Ukraine, a technical consultation was carried out by a Rehabilitation Advisory Team (RAT) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in 2015. The consultation was based on assessment of the situation of persons with disabilities and the rehabilitation system in Ukraine. Recommendations for activities and projects to improve rehabilitation services within the healthcare system were developed and proposed. In order to reach consensus on the recommendations, dialogues were held with different stakeholders, including the Ministry of Public Health. The recommendations included: coordination of disability and rehabilitation policies within the Ministry of Public Health and among other involved ministries; translation and adaptation of international definitions of functioning, disability, and assessment tools into Ukrainian; data collection on the epidemiology of disability and the need for rehabilitation; implementation of health-related rehabilitation services; and implementation of international definitions and curricula of rehabilitation professions. The mission was regarded as successful and one year later a few changes had been adopted by the Ukrainian government. Further action based on this research is necessary. It will be important to track the changes and evaluate the results after an appropriate period of time.

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

PubMed

Liu, Yali; Ji, Linhong

2018-02-01

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

A systematic literature review of the use and effectiveness of the Computer Assisted Rehabilitation Environment for research and rehabilitation as it relates to the wounded warrior.

PubMed

Collins, John-David; Markham, Amanda; Service, Kathrine; Reini, Seth; Wolf, Erik; Sessoms, Pinata

2015-01-01

Several U.S. military treatment and research facilities employ a Computer Assisted Rehabilitation Environment (CAREN) [Motek Medical BV, Amsterdam, The Netherlands] for research and rehabilitation of complex injuries exhibited by Wounded Warriors. There has been little scientific evidence of the effectiveness of this type of system for rehabilitation. A systematic review of the literature was completed to determine what type of work has been performed on the CAREN and report findings of clinical significance. Specific terms were searched on electronic databases to include journal articles, abstracts, and peer-reviewed conference proceedings related to the CAREN. Twenty-six publications were elicited that met our criteria. These were divided by their primary focus: rehabilitation, clinical research, and technical reports. Results from published articles have determined that the system is a capable tool for both assessment and rehabilitation, but little has currently been published, particularly on patient populations. More research needs to be performed to evaluate its effectiveness as a rehabilitation tool compared to other rehabilitation methods. It is expected that a system, such as the CAREN, will challenge patients multifactorially (e.g. physically and cognitively) and provide biofeedback while decreasing rehabilitation time and increasing effectiveness of treatment.

[Effect of "Xingnao Kaiqiao Zhenfa" (Acupuncture Technique for Restoring Consciousness) Combined with Rehabilitation Training on Nerve Repair and Expression of Growth-associated Protein-43 of Peri-ischemic Cortex in Ischemic Stroke Rats].

PubMed

Xu, Lei; Yan, Xing-Zhou; Li, Zhen-Yu; Cao, Xiao-Fang; Wang, Min

2017-06-25

To observe the effect of "Xingnao Kaiqiao Zhenfa" (acupuncture technique for restoring consciousness) combined with enriched rehabilitation training on motor function and expression of growth-associated protein-43 (GAP-43) of peri-ischemic cortex in ischemic stroke rats, so as to investigate its mechanism underlying improvement of ischemic stroke. SD rats were randomly divided into sham operation, model, rehabilitation and comprehensive rehabilitation groups, which were further divided into 3 time-points:7, 14 and 21 d ( n =6 in each). Cerebral ischemia(CI) model was established by occlusion of the middle cerebral artery with heat-coagulation. The rehabilitation group was treated by enriched rehabilitation training, once a day. The comprehensive rehabilitation group was treated by acupuncture combined with enriched rehabilitation training. Acupuncture was applied to bilateral "Neiguan"(PC 6) and "Shuigou"(GV 26) for 30 min, once a day. The neurological function score, balance-beam walking test and rotating-rod walking test were evaluated at the end of the corresponding treatment time. The expression of GAP-43 in peri-ischemic cortex was detected by immunohistochemistry. In comparison with the sham operation group, the scores of neurological function, beam walking test and rotating-rod walking test were significantly higher in the model group ( P <0.01). There were no significant changes in the scores of balance-beam walking and rotating-rod walking tests in the rehabilitation group compared with the model group on day 7 ( P >0.05). Compared with the model group at the other time points, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in the rehabilitation and comprehensive rehabilitation groups ( P <0.05). Compared with the rehabilitation group, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in the comprehensive rehabilitation group ( P <0.05). In comparison with the sham operation group, the number of GAP-43 positive cells of peri-ischemic cortex was significantly higher in the model group ( P <0.01). Compared with the model group, the numbers of GAP-43 positive cells of peri-ischemic cortex were significantly increased in the rehabilitation and comprehensive rehabilitation groups ( P <0.01). The number of GAP-43 positive cells of peri-ischemic cortex in the comprehensive rehabilitation group was significantly higher than that in the rehabilitation group ( P <0.01). "Xingnao Kaiqiao Zhenfa" combined with enriched rehabilitation training can promote the recovery of nerve function in ischemic stroke rats, which may be associated with its effect in up-regulating the expression of GAP-43 in the peri-ischemic cortex.

Survivors of chronic stroke - participant evaluations of commercial gaming for rehabilitation.

PubMed

Paquin, Kate; Crawley, Jamie; Harris, Jocelyn E; Horton, Sean

2016-10-01

There has been an increase in research on the effect that virtual reality (VR) can have on physical rehabilitation following stroke. However, research exploring participant perceptions of VR for post-stroke rehabilitation has been limited. Semi-structured interviews were conducted with 10 chronic stroke participants (10 males, mean age = 72.1, mean time since injury = 38.6 mos.) who had recently completed an upper extremity VR stroke rehabilitation programme. Four main themes emerged: 'the VR experience,' 'functional outcomes,' 'instruction,' and the 'future of VR in stroke rehabilitation,' along with nine sub-themes. Participants illustrated the positive impact that VR training had on their functional abilities as well as their confidence towards completing activities of daily living (ADL). Participants also expressed the need for increased rehabilitation opportunities within the community. Overall, participants were optimistic about their experience with VR training and all reported that they had perceived functional gain. VR is an enjoyable rehabilitation tool that can increase a stroke survivor's confidence towards completing ADL. Implications for Rehabilitation Although there is an increase in rehabilitation programmes geared towards those with chronic stroke, we must also consider the participants' perception of those programmes. Incorporating participant feedback may increase enjoyment and adherence to the rehabilitation programmes. The VR experience, as well as provision of feedback and instruction, are important aspects to consider when developing a VR programme for stroke survivors. VR for rehabilitation may be a feasible tool for increasing the survivors' confidence in completing ADL post-stroke.

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

PubMed

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

2017-03-06

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

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis.

PubMed

Fitzgerald, G K; Hinman, R S; Zeni, J; Risberg, M A; Snyder-Mackler, L; Bennell, K L

2015-05-01

A Task Force of the Osteoarthritis Research Society International (OARSI) has previously published a set of guidelines for the conduct of clinical trials in osteoarthritis (OA) of the hip and knee. Limited material available on clinical trials of rehabilitation in people with OA has prompted OARSI to establish a separate Task Force to elaborate guidelines encompassing special issues relating to rehabilitation of OA. The Task Force identified three main categories of rehabilitation clinical trials. The categories included non-operative rehabilitation trials, post-operative rehabilitation trials, and trials examining the effectiveness of devices (e.g., assistive devices, bracing, physical agents, electrical stimulation, etc.) that are used in rehabilitation of people with OA. In addition, the Task Force identified two main categories of outcomes in rehabilitation clinical trials, which include outcomes related to symptoms and function, and outcomes related to disease modification. The guidelines for rehabilitation clinical trials provided in this report encompass these main categories. The report provides guidelines for conducting and reporting on randomized clinical trials. The topics include considerations for entering patients into trials, issues related to conducting trials, considerations for selecting outcome measures, and recommendations for statistical analyses and reporting of results. The focus of the report is on rehabilitation trials for hip, knee and hand OA, however, we believe the content is broad enough that it could be applied to rehabilitation trials for other regions as well. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

[Digital Information on Rehabilitation and Retirement for Physicians - A Practical Test].

PubMed

Deck, Ruth; Waschkau, Alexander; Götz, Katja; Schwill, Simon; Flum, Elisabeth; Steinhäuser, Jost

2018-06-14

About 1.6 million rehabilitation applications are submitted to the German pension insurance annually. Physicians working in ambulatory care play an important role in the application process. Studies show that there is too little knowledge about medical rehabilitation in these groups of physicians, the detection of rehabilitation needs and the process of application for rehabilitation. Against this background, a website Information for Doctors on Rehabilitation & Retirement was developed which addresses especially these needs. The aim of the study was to evaluate the website within a practical test. The practical test was performed with a mixed Methods Approach: 1) Quantitative survey with respect to increased knowledge after using the homepage, 2) assessment of cases with regard to rehabilitation indication and 3) evaluation of the user friendliness of the homepage by participating doctors by means of think-aloud technique. A total of 79 postgraduate General Practice trainees participated. They had high information needs regarding different aspects of rehabilitation, which were partly satisfied by the use of the homepage. The correct assessment of rehabilitation cases improved with the aid of the website for general practitioners with experience with application for rehabilitation only. The homepage was evaluated as clear and helpful, but the texts were judged as too extensive. The homepage can support physicians working in ambulatory care with respect to rehabilitation. Some impulses for optimization of the content have been identified and can help to further increase the usefulness of the website. © Georg Thieme Verlag KG Stuttgart · New York.

A comparison of stroke rehabilitation; data from two national cohorts.

PubMed

Bērziņa, G; Vētra, A; Sunnerhagen, K S

2016-10-01

Inpatient rehabilitation is a commonly used complex intervention to improve a person's independence after stroke. Evaluation and comparison of the effects of routine clinical practice could provide a contribution towards optimization of stroke care. The aim of this study is to describe results of inpatient rehabilitation as a complex intervention for persons after stroke and explore possible differences between two countries. Data from 1055 Latvian and 1748 Swedish adult patients after stroke receiving inpatient rehabilitation, during 2011-2013, were used for this retrospective cohort study. Qualitative description of systems, as well as information on basic medical and sociodemographic information, and organizational aspects were reported. Change in the Functional Independence Measure during rehabilitation was investigated. In six domains of the instrument, the shifts for three levels of dependence were analysed using ordinal regression analysis. The components of stroke care seem to be similar in Latvia and Sweden. However, the median time since stroke onset until the start of rehabilitation was 13 weeks in Latvia and 2 weeks in Sweden. The median length of rehabilitation was 12 and 49 days, respectively. The level of dependency at start, time since stroke onset and length of the period had an impact on the results of the rehabilitation. Although components of the rehabilitation are reported as being the same, characteristics and the outcome of the inpatient rehabilitation are different. Therefore, comparison of stroke rehabilitation between countries requires caution. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

PubMed

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

2015-01-01

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

Incorporating Feminism into Rehabilitation Counselor Education

ERIC Educational Resources Information Center

Jeon, Mookyong

2015-01-01

Purpose: The author describes how rehabilitation counselor educators can incorporate the feminist perspective in teaching rehabilitation counselors-in-training by exploring history, core values, and training methods of feminism. Method: Based on a literature review, the author compares philosophy and concepts of rehabilitation counseling and…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

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

Introduction to Positive Psychology in Rehabilitation

ERIC Educational Resources Information Center

Chou, Chih-Chin; Chan, Fong; Phillips, Brian; Chan, Jacob Yui Chung

2013-01-01

Positive psychology has received increasing attention in rehabilitation counseling research and practice. The rehabilitation counseling philosophy shares a similar emphasis of personal assets and strengths, which provides a solid foundation for the integration of positive psychology into the professional practice of rehabilitation counseling. In…

76 FR 339 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... making statistical and other methodological consultation available for research projects that use the TBI... Information; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Disability and Rehabilitation Research Projects (DRRPs...

76 FR 344 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... making statistical and other methodological consultation available for research projects that use the SCI... Information; National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Disability and Rehabilitation Research Projects (DRRPs...

78 FR 7419 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... underserved populations; (4) identify research gaps; (5) identify mechanisms for integrating research and... Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Minority-Serving Institution Advanced Rehabilitation Research Training Projects AGENCY: Office of Special Education and...

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...

34 CFR 361.45 - Development of the individualized plan for employment.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM State Plan and Other Requirements for Vocational Rehabilitation Services... determined to be eligible for vocational rehabilitation services or, if the designated State unit is...

34 CFR 361.42 - Assessment for determining eligibility and priority for services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE VOCATIONAL REHABILITATION SERVICES PROGRAM State Plan and Other Requirements for Vocational Rehabilitation Services.... In order to determine whether an individual is eligible for vocational rehabilitation services and...

20 CFR 702.508 - Vocational rehabilitation; confidentiality of information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Vocational rehabilitation; confidentiality of... PROCEDURE Vocational Rehabilitation § 702.508 Vocational rehabilitation; confidentiality of information. The... which it is provided; (b) Interested persons and agencies have been advised that any information...

75 FR 39779 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-12

... Part III Department of Education National Institute on Disability and Rehabilitation Research (NIDRR)-- Disability and Rehabilitation Research Projects and Centers Program-- Disability Rehabilitation Research Project (DRRP)--Center on Knowledge Translation (KT) for Employment Research (Center); Notices #0...

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...

Innovations in Vocational Rehabilitation and Mental Retardation.

ERIC Educational Resources Information Center

Ayers, George E., Ed.

Conference proceedings of the Vocational Rehabilitation Subdivision Meetings held at the American Association on Mental Deficiency contain discussions of innovative aspects of vocational rehabilitation and mental retardation. In the area of training rehabilitation counselors, George Baroff describes the Mental Retardation Training Institute in…

78 FR 22783 - Final 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--Disability Rehabilitation Research Project AGENCY: Office of Special Education and... Research Project (DRRP) on Knowledge Translation for Technology Transfer under the Disability and...

[Education, advanced and further training in the field "psychology in rehabilitation"].

PubMed

Bengel, J; Gall, H; Grande, G; Küch, D; Mittag, O; Schmucker, D; Spijkers, W; Arling, V; Jahed, J; Lutze, B; Morfeld, M

2014-04-01

The commission for vocational training, training and further education of the German Society of Rehabilitation Science tends to discuss and to give recommendations for various professions in rehabilitation. The working group, which is led by J. Bengel/Freiburg and M. Morfeld/Magdeburg-Stendal created an inventory of Rehabilitation Psychology. The training programs for Rehabilitation Psychology at universities and universities of applied science in Germany are based on a job profile of psychologists in medical and vocational rehabilitation. The different universities have diverse priorities focusing on Rehabilitation Psychology. The offer changes because of the adaption of requirements and implementation of Bologna Reform. The training and further education offers are specific and available for large indication areas. Finally outstanding issues and problems are pointed out. © Georg Thieme Verlag KG Stuttgart · New York.

Pediatric rehabilitation psychology: Rehabilitating a moving target.

PubMed

Kaufman, Jacqueline N; Lahey, Sarah; Slomine, Beth S

2017-08-01

The current special section includes manuscripts focusing on four aspects of pediatric rehabilitation psychology that are unique to this practice area. The first domain addressed is natural developmental progression in the context of a disability (i.e., habilitation). The next domain addressed in this special section is pediatric rehabilitation; pediatric rehabilitation psychology addresses the reacquisition of previously attained skills and abilities within the context of the natural developmental milieu. This special section also highlights the inherently interdisciplinary and transdisciplinary nature of pediatric rehabilitation psychology given the complex environment in which children exist. Finally, the special section includes illustrations of the crucial role pediatric rehabilitation psychologists play in facilitating transitions through major milestones, particularly from pediatrics to adulthood when living with a disability. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Working with 'hands-off' support: a qualitative study of multidisciplinary teams' experiences of home rehabilitation for older people.

PubMed

Randström, Kerstin Björkman; Wengler, Yvonne; Asplund, Kenneth; Svedlund, Marianne

2014-03-01

There is a move towards the provision of rehabilitation for older people in their homes. It is essential to ensure that rehabilitation services promote independence of older people. The aim of the study was to explore multidisciplinary teams' experiences of home rehabilitation for older people. Five focus groups were conducted with multidisciplinary teams based in a municipality in Sweden, covering seven different professions. In total, 28 participants volunteered to participate in these interviews. Interviews were transcribed verbatim and analysed according to content analysis. Two main categories, as well as four subcategories, emerged. The first main category, having a rehabilitative approach in everyday life, consisted of the subcategories: 'giving 'hands-off' support' and 'being in a home environment'. The second main category, working across professional boundaries, consisted of the subcategories: 'coordinating resources' and 'learning from each other'. Common goals, communication skills and role understanding contributed to facilitating the teams' performances of rehabilitation. A potential benefit of home rehabilitation, because the older person is in a familiar environment, is to work a rehabilitative approach into each individual's activity in their everyday life in order to meet their specific needs. At an organisational level, there is a need for developing services to further support older people's psychosocial needs during rehabilitation. Team performance towards an individual's rehabilitation should come from an emerged whole and not only from the performance of a specific professional approach depending on the traditional role of each profession. A rehabilitative approach is based on 'hands-off' support in order to incorporate an individual's everyday activities as a part of their rehabilitation. © 2012 Blackwell Publishing Ltd.

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

PubMed Central

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

2016-01-01

Objective To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. Design Prospective, multicenter, longitudinal cohort study. Setting Acute TBI rehabilitation programs. Participants Patients (N=1946) receiving 138,555 therapy sessions. Interventions Not applicable. Main Outcome Measures Effort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS). Results The Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (P<.001). For patients who completed 2, 3, or 4 weeks of rehabilitation, differences in effort ratings (P<.001) were observed between 5 subgroups stratified by admission FIM cognitive scores and over time. In linear mixed-effects modeling, age and Comprehensive Severity Index brain injury severity score at admission, days from injury to rehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (P<.0001). Conclusions Patients' level of effort can be observed and reliably rated in the TBI inpatient rehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies. PMID:26212400

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.

Seniors, risk and rehabilitation: broadening our thinking.

PubMed

Egan, Mary Y; Laliberte Rudman, Debbie; Ceci, Christine; Kessler, Dorothy; McGrath, Colleen; Gardner, Paula; King, Judy; Lanoix, Monique; Malhotra, Ravi

2017-06-01

Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations. Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life. Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary. This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an explicit focus on person-centered definitions of risk and a satisfying life are recommended.

A qualitative study on cross-cultural communication in post-accident in-patient rehabilitation of migrant and ethnic minority patients in Austria.

PubMed

Dressler, Dominique; Pils, Peter

2009-01-01

The objective of this study was to examine how the staff of a post-accident in-patient rehabilitation centre in Austria perceived cross-cultural communication between the staff and migrant and ethnic minority patients. A qualitative study was conducted with 28 semi-structured expert interviews with staff members in a post-accident in-patient rehabilitation centre in Austria. The interviews were conducted along the pathway of rehabilitation. Migrant and ethnic minority patients constitute about one-third of the patients, and often speak little or no German. Staff members (apart from those with migrant/ethnic minority origin) do not speak the languages of the majority of migrant and ethnic minority patients. The language barriers affect the whole rehabilitation process. The staff is unsure whether patients understand; it is difficult to explain the aim of therapies or rehabilitation, and therapies therefore hampered or impossible. To overcome these barriers, non-trained persons are used as interpreters, but the resulting communication is often perceived as unsatisfactory. External professional interpreters are used rarely because they are costly and difficult to organise. Cultural aspects also affect cross-cultural communication. Aspects mostly relating to daily life are dealt with in a pragmatic way. However, cultural aspects directly impacting rehabilitation, and particularly pain behaviour, are seen as more difficult to deal with. Effective and intensive communication between the individual patient and the rehabilitation team is essential for the outcome of rehabilitation, as patients must undertake their own rehabilitation and the rehabilitation team must be able to investigate the objectives, views and dreams of the individual patient to establish rehabilitation objectives in keeping with the patient's wishes.

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.

[Acupuncture combined with rehabilitation training for foot drop after stroke].

PubMed

Qi, Yujun; Shen, Juan

2016-07-12

To compare the clinical efficacy difference between acupuncture combined with rehabilitation and simple rehabilitation for foot drop after stroke. Ninety-eight patients were randomly divided into a combination group and a rehabilitation group, 49 cases in each one. Acupuncture and rehabilitation were used in the combination group. The acupoints were Yanglingquan (GB 34), Zusanli (ST 36), Guangming (GB 37), Xuanzhong (GB 39), Sanyinjiao (SP 6), etc., while rehabilitation included training for musculi hippicus strength and musculi triceps surae. Only the same rehabilitation was applied in the rehabilitation group. The treatment was given six times a week for continuous six weeks. Musculi hippicus force, shank triceps spasticity, toe flexion improvement and the maximum integral EMG (iEMG) of the musculi tibialis anterior and caput laterale musculi gastrocnemii were compared between the two groups,and the effects were evaluated. After treatment, the musculi hippicus force, iEMG of musculi tibialis anterior and caput laterale musculi gastrocnemii, the function scores of the lower limbs by Fugl-Meyer of the two groups were better than those before treatment (all P <0.05), with the better effect in the combination group (all P <0.05). And the scores of shank triceps tension were decreased in the two groups (both P <0.05), more apparently for the combination therapy ( P <0.05). The improvement rate of toe flexion of the combination group was 87.76% (43/49), which was obviously higher than 69.39% (34/49) of the rehabilitation group ( P <0.05). The cured rate of the combination group was 48.98%(24/49), and it was better than 28.57% (14/49) of the rehabilitation group ( P <0.05). Acupuncture combined with rehabilitation achieves better effect than simple rehabilitation for foot drop after stroke.

Characteristics of Inpatient Care and Rehabilitation for Acute First-Ever Stroke Patients

PubMed Central

Chang, Won Hyuk; Shin, Yong-Il; Lee, Sam-Gyu; Oh, Gyung-Jae; Lim, Young Shil

2015-01-01

Purpose The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients. Materials and Methods This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge. Results A total of 2159 patients were reviewed. The mean age was 61.5±14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management. Conclusion Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke. PMID:25510773

Rehabilitation for Survivors of the 1994 Genocide in Rwanda: What Are the Lessons Learned?

PubMed

Uwamaliya, Philomène; Smith, Grahame

2017-04-01

Rehabilitation remains a significant concern among survivors of the 1994 genocide in Rwanda. Rehabilitation falls under tertiary prevention, which is a core function of public health. Despite efforts to introduce various rehabilitation programmes for genocide survivors in Rwanda, these initiatives have often proved inadequate in meeting their long-term needs. The failure of the Rwandan Government, international community, United Nations, and other Non-Government Organisations (NGOs) calls into serious question their commitment to international human rights laws. Rehabilitation should be regarded as a free-standing human right for genocide survivors and a human rights-based approach to the rehabilitative process should incorporate measurable outcomes based on an agreed ethical framework. The author calls upon the international community to reiterate its concerns about genocide survivors and reaffirm its commitments to human rights. The main issues discussed in this article are: the long-term needs of survivors of the 1994 genocide; what is already provided, and the gaps; how Stucki's Rehabilitation Cycle framework (a problem-solving tool) can help improve current provision; the role of the international community, NGOs, and genocide survivors' organisations in advancing rehabilitation; and the need for a human rights-based approach to rehabilitation. A strong recognition of the right to rehabilitation is crucial. An ethical framework related to the human rights-based approach should also assist in setting outcomes that can be measured against agreed standards, ensuring: rights that have been violated are identified; the accountability of each service provider in promoting rehabilitation; rehabilitation which is inclusive and non-discriminatory; participation by encouraging collaboration with survivors rather than doing things for them; and empowerment by enabling survivors to understand their rights and have the confidence to challenge or question when their rights have been violated.

Cardiac rehabilitation after percutaneous coronary intervention: Results from a nationwide survey.

PubMed

Olsen, Siv Js; Schirmer, Henrik; Bønaa, Kaare H; Hanssen, Tove A

2018-03-01

The purpose of this study was to estimate the proportion of Norwegian coronary heart disease patients participating in cardiac rehabilitation programmes after percutaneous coronary intervention, and to determine predictors of cardiac rehabilitation participation. Participants were patients enrolled in the Norwegian Coronary Stent Trial. We assessed cardiac rehabilitation participation in 9013 of these patients who had undergone their first percutaneous coronary intervention during 2008-2011. Of these, 7068 patients (82%) completed a self-administered questionnaire on cardiac rehabilitation participation within three years after their percutaneous coronary intervention. Twenty-eight per cent of the participants reported engaging in cardiac rehabilitation. Participation rate differed among the four regional health authorities in Norway, varying from 20%-31%. Patients undergoing percutaneous coronary intervention for an acute coronary syndrome were more likely to participate in cardiac rehabilitation than patients with stable angina (odds ratio 3.2; 95% confidence interval 2.74-3.76). A multivariate statistical model revealed that men had a 28% lower probability ( p<0.001) of participating in cardiac rehabilitation, and the odds of attending cardiac rehabilitation decreased with increasing age ( p<0.001). Contributors to higher odds of cardiac rehabilitation participation were educational level >12 years (odds ratio 1.50; 95% confidence interval 1.32-1.71) and body mass index>25 (odds ratio 1.19; 95% confidence interval 1.05-1.36). Prior coronary artery bypass graft was associated with lower odds of cardiac rehabilitation participation (odds ratio 0.47; 95% confidence interval 0.32-0.70) Conclusion: The estimated cardiac rehabilitation participation rate among patients undergoing first-time percutaneous coronary intervention is low in Norway. The typical participant is young, overweight, well-educated, and had an acute coronary event. These results varied by geographical region.

Association Between Facility Type During Pediatric Inpatient Rehabilitation and Functional Outcomes

PubMed Central

Fuentes, Molly M.; Apkon, Susan; Jimenez, Nathalia; Rivara, Frederick P.

2017-01-01

Objective To compare functional outcomes between children receiving inpatient rehabilitation at children’s hospitals and those at other facilities. Design Retrospective cohort study. Setting Inpatient rehabilitation facilities. Participants Children (N=28,793) aged 6 months to 18 years who received initial inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Total, cognitive, and motor developmental functional quotients (DFQs; which is the WeeFIM score divided by age-adjusted norms and multiplied by 100) at discharge from inpatient rehabilitation and WeeFIM efficiency (the change in WeeFIM score from admission to discharge divided by the length of the rehabilitation stay), adjusting for age, sex, race, insurance, region, admission function, impairment type, discharge year, and length of stay. Results A total of 12,732 children received rehabilitation at 25 children’s hospitals and 16,061 at 36 other facilities (general hospitals or freestanding rehabilitation hospitals). Adjusting for clustering by facility, patients at children’s hospitals had a lower cognitive DFQ at admission (difference between children’s hospitals and other facility types, −3.8; 95% confidence interval [CI], −7.7 to −0.1), a shorter length of stay (median, 16d vs 22d; P<.001), and a higher WeeFIM efficiency (difference, 0.63; 95% CI, 0.25–1.00) than did children at other facility types. Rehabilitation in a children’s hospital was independently associated with a higher discharge cognitive DFQ (regression coefficient, 2.3; 95% CI, 0.3–4.2) and more efficient rehabilitation admissions (regression coefficient, 0.3; 95% CI, 0.1–0.6). Conclusions Children who receive inpatient rehabilitation at children’s hospitals have more efficient inpatient rehabilitation admissions, a shorter median length of stay, and a slight improvement in cognitive function than do children at other facility types. PMID:27026580

[Problems of occupational rehabilitation in the shipbuilding industry. II. Rehabilitation in a group of ship welders].

PubMed

Sygit, M; Wecławik, Z

1987-01-01

The causes of rehabilitation of welders employed in the Maritime Shipyard in Szczecin have been analysed for the period 1979-1984. The main causes were found to be diseases of the musculo-osseous system (18.9%) and respiratory tract (14.8%). Temporary rehabilitation covered 67.3% of welders (2/3 for respiratory tract diseases), whereas permanent rehabilitation--23.5% (2/3 for musculo-osseous diseases).

Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review.

PubMed

Corbetta, Davide; Imeri, Federico; Gatti, Roberto

2015-07-01

In people after stroke, does virtual reality based rehabilitation (VRBR) improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Systematic review with meta-analysis of randomised trials. Adults with a clinical diagnosis of stroke. Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Walking speed, balance, mobility and adverse events. In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19), balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5) and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4). When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1), but insufficient evidence was found to comment about walking speed (one trial) and balance (high heterogeneity). Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

The PQRS-Montreal: a measure of patients' perceptions of the quality of rehabilitation services for persons with a traumatic brain injury.

PubMed

Swaine, Bonnie; Dassa, Clément; Koné, Anna; Dutil, Élisabeth; Demers, Louise; Trempe, Claire

2017-01-01

Purpose To determine the factorial validity, internal consistency, criterion-related and concurrent validity of the Perception of Quality of Rehabilitation Services - Montreal (PQRS-Montreal) questionnaire for persons receiving traumatic brain injury (TBI) rehabilitation services. Design Cross-sectional study. Setting Seventeen facilities providing acute care and intensive inpatient and outpatient TBI adult rehabilitation. Participants Five-hundred thirty adults (GCS  =  3-15; mean age  =  41.5 ± 16.9 years) who received rehabilitation were administered the questionnaire during an interview near time of discharge. Subjects responded to the 61 PQRS-Montreal items (five-point scale of agreement) and to the Client Satisfaction Question (CSQ8). Results Exploratory and confirmatory factor analyses identified three potential subscales (one- and two-factor solutions) explaining 26.1-41% of the variance (ecological approach, quality of team, service organization). The subscales' internal structures were interpretable and their internal consistency varied from 0.51 to 0.90 (Cronbach's α). Rehabilitation phase significantly and positively impacted factor scores and all factor scores were significantly and moderately correlated with CSQ8 scores. Conclusions The PQRS-Montreal possesses adequate psychometric properties supporting its use as a valid tool to measure patients' perception of the quality of TBI rehabilitation services. This tool could help guide the development and monitoring of TBI rehabilitation service delivery. Implications for Rehabilitation The importance of measuring and monitoring quality of care is increasingly important in rehabilitation. Using the experiences and perceptions of care of service users is a valid way of assessing the quality of rehabilitation services. The PQRS-Montreal has adequate psychometric properties supporting its use as a valid tool to measure patients' perception of the quality of TBI rehabilitation services. This tool could help guide the development and monitoring of TBI rehabilitation service delivery.

Can warmwater streams be rehabilitated using watershed-scale standard erosion control measures alone?

PubMed

Shields, F Douglas; Knight, Scott S; Cooper, Charles M

2007-07-01

Degradation of warmwater streams in agricultural landscapes is a pervasive problem, and reports of restoration effectiveness based on monitoring data are rare. Described is the outcome of rehabilitation of two deeply incised, unstable sand-and-gravel-bed streams. Channel networks of both watersheds were treated using standard erosion control measures, and aquatic habitats within 1-km-long reaches of each stream were further treated by addition of instream structures and planting woody vegetation on banks ("habitat rehabilitation"). Fish and their habitats were sampled semiannually during 1-2 years before rehabilitation, 3-4 years after rehabilitation, and 10-11 years after rehabilitation. Reaches with only erosion control measures located upstream from the habitat measure reaches and in similar streams in adjacent watersheds were sampled concurrently. Sediment concentrations declined steeply throughout both watersheds, with means > or = 40% lower during the post-rehabilitation period than before. Physical effects of habitat rehabilitation were persistent through time, with pool habitat availability much higher in rehabilitated reaches than elsewhere. Fish community structure responded with major shifts in relative species abundance: as pool habitats increased after rehabilitation, small-bodied generalists and opportunists declined as certain piscivores and larger-bodied species such as centrarchids and catostomids increased. Reaches without habitat rehabilitation were significantly shallower, and fish populations there were similar to the rehabilitated reaches prior to treatment. These findings are applicable to incised, warmwater streams draining agricultural watersheds similar to those we studied. Rehabilitation of warmwater stream ecosystems is possible with current knowledge, but a major shift in stream corridor management strategies will be needed to reverse ongoing degradation trends. Apparently, conventional channel erosion controls without instream habitat measures are ineffective tools for ecosystem restoration in incised, warmwater streams of the Southeastern U.S., even if applied at the watershed scale and accompanied by significant reductions in suspended sediment concentration.

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.

The effects of the Norwegian Coordination Reform on the use of rehabilitation services: panel data analyses of service use, 2010 to 2013.

PubMed

Monkerud, Lars C; Tjerbo, Trond

2016-08-05

In 2012 the Norwegian Coordination Reform was implemented. The main motivation was to encourage municipalities to expand local, primary health care services. From 2012 to 2014, under the Municipal Co-Financing regime, municipalities were obliged to cover 20 % of the costs of health services provided at the specialist (hospital) level. Importantly, use of rehabilitation services in private institutions was not part of the cost-sharing mechanism of Municipal Co-Financing. Rehabilitation services may be seen as quite similar in nature whether they be provided by municipalities, hospitals or private institutions. Thus, with rehabilitation patients readily "transferrable" between levels, the question is whether the reform brought with it a sought after shift towards more municipal rehabilitation and less specialist rehabilitation. Data from the Norwegian Patient Register and from Statistics Norway/KOSTRA were utilized to gauge annual expenditures and inputs in specialist, municipal and private institution rehabilitation services respectively. Fixed effects and first difference regression analyses for the period 2010-2013 were carried out to account for certain time-invariant traits of municipalities and/or hospital regions, and results were adjusted for contemporaneous trends in local needs. Expenditures in specialist rehabilitation services declined sharply (typically by 8-10 %) from 2011 (pre-reform) to 2012 (post-reform), while expenditures in private rehabilitation services rose markedly in the same period (typically by 42-44 %). The results do not suggest any general expansion of municipal rehabilitation services. The results of the analyses suggest that municipalities shift away from the use of specialist rehabilitation services and towards the use of rehabilitation services in private institutions since the latter becomes relatively cheaper (free-of charge) than both municipal and specialist services in post-reform periods (as specialist services come at a cost to municipalities post-reform). While the main goal of the reform has not materialized the results nevertheless suggest that incentives (of cost-shifting) do play a significant role in rehabilitation service use.

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

Problematising risk in stroke rehabilitation.

PubMed

Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

2016-11-01

Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or more severe stroke. Viewing individuals affected by stroke as possessing a range of independence and diverse personally valued activities that exist within a network of relations offers wider possibilities for action in rehabilitation.

23 CFR 650.407 - Application for bridge replacement or rehabilitation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Application for bridge replacement or rehabilitation... ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Highway Bridge Replacement and Rehabilitation Program § 650.407 Application for bridge replacement or rehabilitation. (a) Agencies participate...

23 CFR 650.411 - Procedures for bridge replacement and rehabilitation projects.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Procedures for bridge replacement and rehabilitation... ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Highway Bridge Replacement and Rehabilitation Program § 650.411 Procedures for bridge replacement and rehabilitation projects. (a) Consideration...

Evidence-Based Rehabilitation Counseling Practice: A Pedagogical Imperative

ERIC Educational Resources Information Center

Kosciulek, John F.

2010-01-01

This article describes how rehabilitation educators can aid students and practitioners in learning about and engaging in evidence-based rehabilitation counseling practice (EBRCP). Information describing (a) the definition and rationale for EBRCP, (b) controversies surrounding EBRCP, (c) facilitating rehabilitation counselor enthusiasm for EBRCP,…

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...

Using Attribution Theory to Examine Community Rehabilitation Provider Stigma

ERIC Educational Resources Information Center

Strauser, David R.; Ciftci, Ayse; O'Sullivan, Deirdre

2009-01-01

This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences…

Issues in International Rehabilitation.

ERIC Educational Resources Information Center

Nathanson, Jeanne H., Ed.

1991-01-01

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

[Rehabilitation after anterior cruciate ligament suturing].

PubMed

Andrtová, M; Chlupatá, I

1994-01-01

The authors discuss problems of rehabilitation after suture of the anterior cruciate ligament where frequently errors are committed and where inadequate rehabilitation may cause damage to the patient. Different periods of rehabilitation after LCA sutures are discussed and suitable methods of exercise for different periods are recommended.

78 FR 9869 - Proposed Priorities-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... and rehabilitation research; (2) foster an exchange of expertise, information, and training methods to... observational findings, and creating other sources of research-based information. This research stage may....133B-6.] Proposed Priorities--National Institute on Disability and Rehabilitation Research...

76 FR 33734 - Applications for New Awards; Spinal Cord Injury Model Systems (SCIMS) Centers and SCIMS Multi...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... Institute on Disability and Rehabilitation Research (NIDRR)-- Disability and Rehabilitation Research Projects and Centers Program-- Disability and Rehabilitation Research Projects (DRRPs) and Special Projects... Research Projects. General Disability and Rehabilitation Research Projects (DRRP) Requirements priority...

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...

24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

24 CFR 1003.202 - Eligible rehabilitation and preservation activities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... heating and cooling equipment, including the use of solar energy equipment; (5) Improvements to increase...) Improvements to increase the efficient use of energy in structures through such means as installation of storm... rehabilitation; (9) Rehabilitation services, such as rehabilitation counseling, energy auditing, preparation of...

76 FR 60133 - Proposed Information Collection (Request for Supplies (Chapter 31-Vocational Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... (Request for Supplies (Chapter 31--Vocational Rehabilitation)); Comment Request AGENCY: Veterans Benefits... to determine whether supplies requested for a veteran's rehabilitation program are necessary. DATES.... Title: Request for Supplies (Chapter 31--Vocational Rehabilitation), VA Form 28-1905m. OMB Control...

76 FR 19753 - Applications for New Awards; Vocational Rehabilitation Services Projects for American Indians...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... DEPARTMENT OF EDUCATION Applications for New Awards; Vocational Rehabilitation Services Projects..., Department of Education. ACTION: Notice. Overview Information Vocational Rehabilitation Services Projects for... vocational rehabilitation (VR) services to American Indians with disabilities who reside on or near Federal...

78 FR 36667 - Final Priority; National Institute on Disability and Rehabilitation Research-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... 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 Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and...

75 FR 18185 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... state-of-the-science conference on its designated priority research area in the fourth year of the... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research...

24 CFR 401.472 - Rehabilitation funding.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Rehabilitation funding. 401.472... (MARK-TO-MARKET) Restructuring Plan § 401.472 Rehabilitation funding. (a) Sources of funds—(1) Project accounts. The Restructuring Plan for funding rehabilitation must include funds from the project's residual...

Professional Associations and Memberships in Rehabilitation Counseling.

ERIC Educational Resources Information Center

Sussman, Marvin B.; And Others

As part of a study of the career contingencies of the rehabilitation counselor, an examination was made of the role, membership patterns, and goals of three professional associations--the National Rehabilitation Counseling Association (NRCA), the American Rehabilitation Counseling Association (ARCA), and the American Psychological Association…

23 CFR 650.411 - Procedures for bridge replacement and rehabilitation projects.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Procedures for bridge replacement and rehabilitation... ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Highway Bridge Replacement and Rehabilitation Program § 650.411 Procedures for bridge replacement and rehabilitation projects. (a) Consideration...

23 CFR 650.407 - Application for bridge replacement or rehabilitation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Application for bridge replacement or rehabilitation... ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Highway Bridge Replacement and Rehabilitation Program § 650.407 Application for bridge replacement or rehabilitation. (a) Agencies participate...

Aspects of physical medicine and rehabilitation in geriatrics.

PubMed

Pils, Katharina

2016-02-01

Specialists in physical medicine and rehabilitation are important partners during the ageing process: health promotion and prevention for fit elderly people, training and rehabilitation for prefrail people and support for frail people focusing on usage of what is left and dignity in the latest period of life. The main focus is the relationship between IC diagnoses and functioning in everyday life based on the International Classification of Functioning (ICF). The diseases lead to possible treatments; functioning shows the importance of rehabilitative strategies in a team approach. Physiatrists are experts on this complex issue.The main goal of rehabilitative strategies during life course is to maintain function, improve quality of life and delay dependency and need of care.Three settings are chosen to show the different aspects of physical medicine and rehabilitation: health promotion and prevention, rehabilitation and palliative-rehabilitative procedures in long-term care. The non-pharmaceutical treatment of pain, the geriatric assessment, knowledge in discharge management and team communications are important skills.

General patterns of managerial approaches to work motivation: Implications for rehabilitation professionals involved in occupational rehabilitation.

PubMed

Murphy, G C; Foreman, P

1993-03-01

Calls for rehabilitation counselors to learn more about the world of work have been recently repeated. The validity of these calls is suggested by a group of studies which indicate that the rehabilitation counseling literature has an established emphasis on matters of counseling and adjustment rather than on matters related to behavior in organizations. A survey of rehabilitation counsellors' beliefs about key topics in organizational behavior indicates that their beliefs are often discrepant with those of practicing managers and supervisors. A summary of dominant models of work motivation adopted by managerial workers is presented and some implications for occupational rehabilitation practice identified. Finally, some contemporary literature relevant to managerial approaches to employee motivation are identified and it is suggested that familiarity with this literature could assist rehabilitation practitioners move from a more narrow occupational rehabilitation role to a broader involvement in organizational life via the expansion of the disability management approach in work organizations.

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

PubMed

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

2017-03-06

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

The association between neighborhood residential rehabilitation and injection drug use in Baltimore, Maryland, 2000-2011

PubMed Central

Linton, Sabriya L.; Jennings, Jacky M.; Latkin, Carl A.; Kirk, Gregory D.; Mehta, Shruti H.

2014-01-01

This study utilized multilevel cross-classified models to longitudinally assess the association between neighborhood residential rehabilitation and injection drug use. We also assessed whether relocating between neighborhoods of varying levels of residential rehabilitation was associated with injection drug use. Residential rehabilitation was categorized into three groups (e.g. low, moderate, high), and lagged one visit to ensure temporality. After adjusting for neighborhood and individual-level factors, residence in a neighborhood with moderate residential rehabilitation was associated with a 23% reduction in injection drug use [AOR=0.77; 95% CI (0.67,0.87)]; residence in a neighborhood with high residential rehabilitation was associated with a 26% reduction in injection drug use [AOR=0.74; 95% CI (0.61,0.91)]. Continuous residence within neighborhoods with moderate/high rehabilitation, and relocating to neighborhoods with moderate/high rehabilitation, were associated with a lower likelihood of injection drug use. Additional studies are needed to understand the mechanisms behind these relationships. PMID:24840154

[Psychosocial rehabilitation at the dawn of the 21st century: II: Therapeutic or rehabilitative modalities and institutional disposition].

PubMed

Gasset, François; Orita, Alina; Spagnoli, Dany; Pomini, Valentino; Rabia, Sophie; Ducret, Michel; Veillon, Henri; Cucchia, Anne-Therèse

2004-04-01

The main goal of psychosocial rehabilitation is to compensate the vulnerability underlying psychiatric disorders through intermediate institutions when the persistence and recurrence of these disorders have led to social and professional exclusion. Intermediate institutions refer to services which allow transition between the state of dependence on the hospital to the state of relative autonomy in social community. Psychosocial rehabilitation is a comprehensive approach which link the type of interventions: treatment, rehabilitation and support integrated in multimodal and individualized programs. A study of the out-patients followed by the rehabilitation unit of the psychiatric department in Lausanne has shown that provision of services is divided into 60% for rehabilitation, 20% for treatment and 20% for support independently of the psychiatric disorders. The implementation of these programs necessitates institutional support from psychiatric hospital to outpatient clinics through different types of facilities in order to offer a medical and psychosocial device of rehabilitation into the community.

[Goals, goal attainment, and patient satisfaction in psychosomatic rehabilitation].

PubMed

Richter, Matthias; Schmid-Ott, Gerhard; Muthny, Fritz A

2011-01-01

The study assesses patient satisfaction and investigates the correlation between patient satisfaction and the setting and attainment of goals. Cross-sectional questionnaire-based assessment data were provided anonymously by 276 patients at the end of their inpatient stay in psychosomatic rehabilitation. Patient satisfaction as well as sociodemographic, disease-related, and outcome parameters including rehabilitation goals were assessed at the beginning of rehabilitation and their attainment at the end of rehabilitation. Goal-attainment scales based on factor analysis showed a high degree of goal-attainment with respect to "lifestyle and priorities" and "psychotherapeutic goals." Patient satisfaction correlated most significantly with the goal-attainment level at the end of rehabilitation (r=.62) and the subscale "attainment of psychotherapeutic goals" (r=.57). Nonattainment of goals (r=-.55) was more closely related with patient satisfaction than the attainment (r=.40). The results confirm the central role of goal-setting and goal-attainment in rehabilitation, and reveal the necessity of goal-setting assessment of goal-attainment in the process of rehabilitation.

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.

Spinal cord injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional independence

PubMed Central

Mahmoud, Husam; Qannam, Hazem; Mortenson, Ben

2017-01-01

Objectives 1) To describe functional status, length of stay (LOS), and time to rehabilitation admission trends. 2) To identify independent predictors of motor function following rehabilitation for traumatic and nontraumatic spinal cord injury (SCI). Participants Adult patients with SCI discharged from inpatient rehabilitation between 2009–2014. Design Retrospective cohort study. Setting Spinal injury rehabilitation unit at the King Fahad Medical City, Riyadh, Saudi Arabia. Methods From retrospective chart reviews of 312 traumatic and 106 nontraumatic SCI, we extracted information on time from injury to rehabilitation admission, rehabilitation LOS, and Functional Independence Measure (FIM) score (admission and discharge). Additionally we collected information on SCI patients’ demographics and injury characteristics. Hierarchical regression was employed to investigate variables associated with FIM motor score at discharge for traumatic SCI and nontraumatic SCI. Outcome measures FIM motor score measured at discharge. Results Mean and median days from injury to rehabilitation admission were not significantly different for traumatic SCI (377±855, 150) and nontraumatic SCI (288±403, 176). Mean and median days for rehabilitation LOS were significantly longer for traumatic SCI (85±60, 70) compared to nontraumatic SCI (64±59, 49) (p=…..). FIM scores improved significantly from admission to discharge in both groups. For individuals with traumatic SCI, after accounting for admission FIM motor score, tetraplegia and time from injury to rehabilitation, admission had a significant but small negative association with discharge FIM motor score. For individuals with nontraumatic SCI, increasing age and AIS score of A or B had a significant negative association with discharge FIM motor score. LOS in rehabilitation was not a significant contributor for either model. Conclusions Decreasing the time from injury to rehabilitation admission may improve outcomes for those with traumatic SCI. Since time spent in rehabilitation was shorter than most other countries, a change in practice in this area may be warranted. Developing new strategies to improve outcomes for older patients with nontraumatic SCI would also be beneficial. PMID:28139661

Enhanced Medical Rehabilitation increases therapy intensity and engagement and improves functional outcomes in post-acute rehabilitation of older adults: a randomized controlled trial

PubMed Central

Lenze, Eric J.; Host, Helen H.; Hildebrand, Mary W.; Morrow-Howell, Nancy; Carpenter, Brian; Freedland, Kenneth E.; Baum, Carolyn A.; Dixon, David; Doré, Peter; Wendleton, Leah; Binder, Ellen F.

2012-01-01

Objectives For millions of disabled older adults each year, post-acute care in skilled nursing facilities (SNFs) is a brief window of opportunity to regain enough function to return home and live independently. Too often this goal is not achieved, possibly due to therapy that is inadequately intense or engaging. This study tested Enhanced Medical Rehabilitation, an intervention designed to increase patient engagement in, and intensity of, daily physical and occupational therapy sessions in post-acute care rehabilitation. Design Randomized controlled trial of Enhanced Medical Rehabilitation versus standard-of-care rehabilitation. Setting Post-acute care unit of a skilled nursing facility in St Louis, MO. Participants 26 older adults admitted from a hospital for post-acute rehabilitation. Intervention Based on models of motivation and behavior change, Enhanced Medical Rehabilitation is a set of behavioral skills for physical and occupational therapists (PT/OT) that increase patient engagement and intensity, with the goal of improving functional outcome, through: (1) a patient-directed, interactive approach, (2) increased rehabilitation intensity, and (3) frequent feedback to patients on their effort and progress. Measurements Therapy intensity: assessment of patient active time in therapy sessions. Therapy engagement: Rehabilitation Participation Scale. Functional and performance outcomes: Barthel Index, gait speed, and six-minute walk. Results Participants randomized to Enhanced Medical Rehabilitation had higher intensity therapy and were more engaged in their rehabilitation sessions; they had more improvement in gait speed (improving from 0.08 to 0.38 meter/sec vs. 0.08 to 0.22 in standard of care,p=0.003) and six-minute walk (from 73 to 266 feet vs. 40 to 94 feet in standard of care, p=0.026), with a trend for better improvement of Barthel Index (+43 points vs. 26 points in standard of care, p=0.087), compared to participants randomized to standard-of-care rehabilitation. Conclusion Higher intensity and patient engagement in the post-acute rehabilitation setting is achievable, with resultant better functional outcomes for older adults. Findings should be confirmed in a larger randomized controlled trial. PMID:22863663

Nursing staffs self-perceived outcome from a rehabilitation 24/7 educational programme - a mixed-methods study in stroke care.

PubMed

Loft, M I; Esbensen, B A; Kirk, K; Pedersen, L; Martinsen, B; Iversen, H; Mathiesen, L L; Poulsen, I

2018-01-01

During the past two decades, attempts have been made to describe nurses' contributions to the rehabilitation of inpatients following stroke. There is currently a lack of interventions that integrate the diversity of nurses' role and functions in stroke rehabilitation and explore their effect on patient outcomes. Using a systematic evidence- and theory-based design, we developed an educational programme, Rehabilitation 24/7, for nursing staff working in stroke rehabilitation aiming at two target behaviours; working systematically with a rehabilitative approach in all aspects of patient care and working deliberately and systematically with patients' goals. The aim of this study was to assess nursing staff members' self-perceived outcome related to their capability, opportunity and motivation to work with a rehabilitative approach after participating in the stroke Rehabilitation 24/7 educational programme. A convergent mixed-method design was applied consisting of a survey and semi-structured interviews. Data collection was undertaken between February and June 2016. Data from the questionnaires ( N  = 33) distributed before and after the intervention were analysed using descriptive statistics and Wilcoxon sign rank test. The interviews ( N  = 10) were analysed using deductive content analysis. After analysing questionnaires and interviews separately, the results were merged in a side by side comparison presented in the discussion. The results from both the quantitative and qualitative analyses indicate that the educational programme shaped the target behaviours that we aimed to change by addressing the nursing staff's capability, opportunity and motivation and hence could strengthen the nursing staff's contribution to inpatient stroke rehabilitation. A number of behaviours changed significantly, and the qualitative results indicated that the staff experienced increased focus on their role and functions in rehabilitation practice. Our study provides an understanding of the outcome of the Rehabilitation 24/7 educational programme on nursing staff's behaviours. A mixed-methods approach provided extended knowledge of the changes in the nursing staff members' self-percived behaviours after the intervention. These changes suggest that educating the nursing staff on rehabilitation using the Rehabilitation 24/7 programme strengthened their knowledge and beliefs about rehabilitation, goal-setting as well as their role and functions .

[Rehabilitation of the patients following the endoprosthetic replacement of the joints of the lower extremities].

PubMed

Rud, I M; Melnikova, E A; Rassulova, M A; Razumov, A N; Gorelikov, A E

2017-12-28

The present article is the analytical review of the literature pertaining to the problem of rehabilitation of the patients following the endoprosthetic replacement of joints of the lower extremities. The relevance of the problem of interest for medical rehabilitation is beyond any doubt. The traditional methods for the rehabilitation of the patients do not always lead to the desired results. The authors discuss in detail the need for and the contemporary approaches to the rehabilitation of the patients who had undergone reconstructive surgery and arthroplasty of the joints of the lower extremities. The pathogenetically-based three-stage algorithm for medical rehabilitation is proposed.

A Game System for Cognitive Rehabilitation

PubMed Central

Shapi'i, Azrulhizam; Mat Zin, Nor Azan; Elaklouk, Ahmed Mohammed

2015-01-01

Brain injury such as traumatic brain injury (TBI) and stroke is the major cause of long-term disabilities in many countries. The increasing rate of brain damaged victims and the heterogeneity of impairments decrease rehabilitation effectiveness and competence resulting in higher cost of rehabilitation treatment. On the other hand, traditional rehabilitation exercises are boring, thus leading patients to neglect the prescribed exercises required for recovery. Therefore, we propose game-based approach to address these problems. This paper presents a rehabilitation gaming system (RGS) for cognitive rehabilitation. The RGS is developed based on a proposed conceptual framework which has also been presented in this paper. PMID:25815320

[Rehabilitation potential of disabled persons with consequences of cerebral stroke and effects of factors of the organization of rehabilitation assistance].

PubMed

Voskresenskaia, O N; Klemesheva, Iu N; Akimova, T N

2012-01-01

The authors demonstrated the possibility for the practical use of the index "Rehabilitation Potential" in the evaluation of the degree of restoration of neurological deficit developed due to cerebral stroke. The most significant factors characterizing the organization and implementation of rehabilitation measures in different periods of stroke and the effect of these factors on the level of rehabilitation potential of disabled persons with consequences of stroke are specified. It has been shown that the perfect organization of restorative treatment has a positive effect on the level of rehabilitation potential of disabled persons.

Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences.

PubMed

Flick, C L

1999-05-01

This self-directed learning module highlights recent research in assessment of stroke outcomes and management of the psychosocial consequences of stroke. It is a part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses predictive factors for mortality and functional recovery; proposed case mix adjustment and prospective payment systems for stroke rehabilitation; continuum of care and utilization of acute, nursing home, outpatient and home health rehabilitation programs; reintegration and socialization after stroke; vocational rehabilitation of stroke patients; and management of the psychosocial effects of stroke on patients and families.

[The development of the rehabilitation medicine concept in Israel (1948-1974)].

PubMed

Paran, Geula; Rozenberg-Friedman, Lilach; Ohry, Avi

2015-07-01

The field of physical medicine and rehabilitation in Israel was developed in different ways. Some services were developed as a part of comprehensive rehabilitation centers like the Loewenstein Hospital and others were developed as a part of specific disciplines, like the Polio-Rehabilitation Center at Assaf Harofeh hospital. Moreover, the various fields of rehabilitation medicine were developed at different rates. The origin of each stemmed from different circumstances. Sometimes they were developed with a direct connection to a national event and sometimes separately. Occasionally, the field was developed as a result of one person's initiation and others as a result of the establishment's recognition of the value and the essentiality of the field. This essay will focus, in a chronological manner, on the development of the medical rehabilitation fields, that took place in the two leading rehabilitation centers in Israel, the Loewenstein Hospital and at Tel Hashomer. These rehabilitation centers were established in Israel close to the establishment of the State of Israel and their activity will be discussed until 1974, the year in which the Israeli society had to deal with the results of the Yom Kippur war, which had drastic implications on rehabilitation medicine.

The state of rehabilitation research: art or science?

PubMed

Tate, Denise G

2006-02-01

Rehabilitation research has been criticized as not standing up enough to the rigors of scientific method to be called "science." The field has been portrayed as slow to promote its scientific achievements and to include them under the rubric of evidence-based rehabilitation. Following in the footsteps of psychology, rehabilitation as a broad-based discipline has faced many similar obstacles in achieving scientific status. Controversy exists about what exactly constitutes rehabilitation science versus its art and its respective multidisciplinary domains. The conception of these domains is directly related to current methods available to assess the state of the discipline and its research accomplishments. I used quantitative methods, such as randomized clinical and/or controlled trials (RCTs) and systematic reviews, to assess the status of rehabilitation research. Findings suggest that, as a field, rehabilitation makes significant contributions to science, measurable by the number and quality of RCTs and systematic reviews conducted so far on topics of critical importance for clinical care. In "artful" complement, qualitative approaches can be used as research tools to aid investigators in seeking knowledge beyond that obtained by quantitative methods, assessing many complexities associated with the various contexts of rehabilitation research. Other requirements to develop a common vision of rehabilitation science are also discussed.

[The formation and developmental outlook of medical rehabilitation in the Armed Forces of the Russian Federation].

PubMed

Chizh, I M; Ivanov, V N; Golov, Iu S; Shchegol'kov, A M

2000-01-01

In medical service system of AF RF rehabilitation means combination of medical, military and professional, social and economic and pedagogical measures directed to recovery of health, fighting efficiency (ability to work) which were disturbed or lost by servicemen because of disease or trauma. In the article the main landmarks of rehabilitation development in Russian military medicine are pointed out, today's state of system on the whole and stages in particular is analyzed, perspectives of development are determined. The authors have noted considerable contribution made by Central Military Clinical Hospital N 6 to development of medical rehabilitation. Arsenal of modern rehabilitation and restorative measures is indicated. Methodological principles of rehabilitation conduction are shown. The main ways in further improvement of medical rehabilitation are development of its specialization, rise in economic and social efficiency of rehabilitation measures at the expense of significant unloading of hospital urgent beds and decrease in periods of patient return to military service who will be ready to perform their duties in whole volume. Introduction of modern methodological and organizational principles of medical rehabilitation into the practice of medical support of the Armed Forces' personnel will contribute to achievement of success in this area.

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

PubMed

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

2018-05-08

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

75 FR 39216 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

...)-- Effective Vocational Rehabilitation (VR) Service Delivery Practices; Notice Inviting Applications for New... in the Federal Register on February 1, 2008 (73 FR 6132). The Effective Vocational Rehabilitation (VR... Centers (RRTC) Requirements and Effective Vocational Rehabilitation (VR) Service Delivery Practices. Note...

75 FR 47801 - Office of Special Education and Rehabilitative Services; Overview Information; Special...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... Receiving Social Security Disability Insurance (SSDI) Served by State Vocational Rehabilitation (VR...) Served by State Vocational Rehabilitation (VR) Agencies. Program Authority: 29 U.S.C. 773(b). Applicable... Security Disability Insurance (SSDI) Served by State Vocational Rehabilitation (VR) Agencies--CFDA Number...

76 FR 42167 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... subcommittees of the Board will meet to evaluate merit review applications: August 9--Rehabilitation Engineering... Rehabilitation. August 16--Rehabilitation Engineering and Prosthetics/Orthotics. August 16-17--Psychological Health and Social Reintegration; Sensory Systems/Communication; Spinal Cord Injury; and Career...

78 FR 14483 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... DEPARTMENT OF EDUCATION 34 CFR Chapter III [CFDA Number: 84.133B-10.] Proposed Priority--National...: Office of Special Education and Rehabilitative Services, Department of Education. ACTION: Proposed priority. SUMMARY: The Assistant Secretary for Special Education and Rehabilitative Services proposes a...

36 CFR 72.53 - Preapplication process for Rehabilitation and Innovation grants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Rehabilitation and Innovation grants. 72.53 Section 72.53 Parks, Forests, and Public Property NATIONAL PARK..., Approval and Administration § 72.53 Preapplication process for Rehabilitation and Innovation grants. To... to submission and approval of Rehabilitation and Innovation proposals. (1) Preapplications shall be...

36 CFR 72.53 - Preapplication process for Rehabilitation and Innovation grants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Rehabilitation and Innovation grants. 72.53 Section 72.53 Parks, Forests, and Public Property NATIONAL PARK..., Approval and Administration § 72.53 Preapplication process for Rehabilitation and Innovation grants. To... to submission and approval of Rehabilitation and Innovation proposals. (1) Preapplications shall be...

36 CFR 72.53 - Preapplication process for Rehabilitation and Innovation grants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Rehabilitation and Innovation grants. 72.53 Section 72.53 Parks, Forests, and Public Property NATIONAL PARK..., Approval and Administration § 72.53 Preapplication process for Rehabilitation and Innovation grants. To... to submission and approval of Rehabilitation and Innovation proposals. (1) Preapplications shall be...

36 CFR 72.53 - Preapplication process for Rehabilitation and Innovation grants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Rehabilitation and Innovation grants. 72.53 Section 72.53 Parks, Forests, and Public Property NATIONAL PARK..., Approval and Administration § 72.53 Preapplication process for Rehabilitation and Innovation grants. To... to submission and approval of Rehabilitation and Innovation proposals. (1) Preapplications shall be...

36 CFR 72.53 - Preapplication process for Rehabilitation and Innovation grants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Rehabilitation and Innovation grants. 72.53 Section 72.53 Parks, Forests, and Public Property NATIONAL PARK..., Approval and Administration § 72.53 Preapplication process for Rehabilitation and Innovation grants. To... to submission and approval of Rehabilitation and Innovation proposals. (1) Preapplications shall be...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

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

78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... observational research or research toward the development of diagnostic or outcome assessment tools. The... observational findings, and creating other sources of research-based information. This research stage may....133B-6] Final Priorities; National Institute on Disability and Rehabilitation Research--Rehabilitation...

78 FR 20069 - Proposed Priority-National Institute on Disability and Rehabilitation Research (NIDRR...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... contribute to this outcome by emphasizing the principles of universal design in its product research and... Rehabilitation Research (NIDRR)--Rehabilitation Engineering Research Centers (RERCs)--Technologies To Support... priority for the Disability and Rehabilitation Research Projects and Centers Program administered by NIDRR...

75 FR 81253 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... Information; National Institute on Disability and Rehabilitation Research (NIDRR)--Research Fellowships... disabilities, to conduct research on the rehabilitation of individuals with disabilities. Note: This program is... integrates many issues relating to disability and rehabilitation research topics. The Plan, which was...

75 FR 25845 - Office of Special Education and Rehabilitative Services (OSERS); Overview Information; Centers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services (OSERS); Overview... from the Office of Special Education and Rehabilitative Services. The pre-application meeting will be.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-11007...

75 FR 77629 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-13

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Secretary for Special Education and Rehabilitative Services may change the maximum amount through a notice... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

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

Can Psychiatric Rehabilitation Be Core to CORE?

ERIC Educational Resources Information Center

Olney, Marjorie F.; Gill, Kenneth J.

2016-01-01

Purpose: In this article, we seek to determine whether psychiatric rehabilitation principles and practices have been more fully incorporated into the Council on Rehabilitation Education (CORE) standards, the extent to which they are covered in four rehabilitation counseling "foundations" textbooks, and how they are reflected in the…

77 FR 13578 - Disability and Rehabilitation Research Project; Traumatic Brain Injury Model Systems Centers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... DEPARTMENT OF EDUCATION Disability and Rehabilitation Research Project; Traumatic Brain Injury... Rehabilitation Research Project--Traumatic Brain Injury Model Systems Centers. CFDA Number: 84.133A-5. SUMMARY... for Disability and Rehabilitation Research Projects (DRRPs) to serve as Traumatic Brain Injury Model...

38 CFR 21.268 - Employment adjustment allowance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C... who completes a period of rehabilitation and reaches the point of employability will be paid an... rehabilitation to the point of employability. (Authority: 38 U.S.C. 3108(f)) (c) Special programs. An employment...

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,…

[Comparison of Psychosomatic Rehabilitation for German and Foreign Patients].

PubMed

Zollmann, P; Pimmer, V; Rose, A D; Erbstößer, S

2016-12-01

Aim: This study aims to comprehensively analyse the course of psychosomatic rehabilitation - from access to quantifiable rehabilitation outcomes. A comparison is made between 3 groups of patients: German citizens, patients of Turkish nationality or patients of foreign or unknown nationality. Methods: The data set used comprises routine data of the German Pension Insurance regarding psychosomatic rehabilitation from the so called Reha-Statistik-Database (RSD, database for rehabilitation statistics) over a period from 2007 to 2014. We included 128,165 compulsorily insured persons who underwent psychosomatic rehabilitation in 2012. Results: Among the patients in psychosomatic rehabilitation in 2012 5.8 % were of foreign nationality. Turkish patients were with 2.0 % the largest group, patients with another or unknown nationality or stateless patients constitute the additional group. The most common diagnoses for all groups were affective disorders and neurotic, somatoform and stress disorders. Differences between the groups can be demonstrated with regard to sociodemographics and employment status prior to rehabilitation: Patients of foreign nationality, and here especially Turkish patients, are on average younger, more often married and have less advanced vocational training than German patients. Accordingly, they work more often in less qualified jobs with lower wages. The health status prior rehabilitation, measured as days of sick leave, is also worse compared to German patients. In contrast to other indications there is no disadvantage regarding access to psychosomatic rehabilitation. On the contrary: the age-standardised uptake ratios of Turkish patients, especially of women, are markedly higher than in Germans. Treatment during psychosomatic rehabilitation is more or less identical. With regards to outcome of rehabilitation, reintegration into working life or transition into disability pension Turkish patients are less successful. As important influential variables for return to work (RTW) the following factors were identified: Employment duration in the last 12 months before the start of rehabilitation, the medically tested ability to work for the last employment, age and wage in the last year before the start of rehabilitation. Even after the inclusion of these variables in the logistic regression model, a direct influence of the Turkish citizenship has remained. Conclusion: In this study Turkish patients are a special group. This is especially true for Turkish women. They start from a lower baseline in comparison with their male compatriots, they have higher access to psychosomatic rehabilitation and the results of rehabilitation are less favourable. These findings may be attributable to the markedly worse health and employment status of the female Turkish patient group. Nevertheless, nationality itself remains to be a significant influencing factor. © Georg Thieme Verlag KG Stuttgart · New York.

An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation.

PubMed

Spruit, Martijn A; Singh, Sally J; Garvey, Chris; ZuWallack, Richard; Nici, Linda; Rochester, Carolyn; Hill, Kylie; Holland, Anne E; Lareau, Suzanne C; Man, William D-C; Pitta, Fabio; Sewell, Louise; Raskin, Jonathan; Bourbeau, Jean; Crouch, Rebecca; Franssen, Frits M E; Casaburi, Richard; Vercoulen, Jan H; Vogiatzis, Ioannis; Gosselink, Rik; Clini, Enrico M; Effing, Tanja W; Maltais, François; van der Palen, Job; Troosters, Thierry; Janssen, Daisy J A; Collins, Eileen; Garcia-Aymerich, Judith; Brooks, Dina; Fahy, Bonnie F; Puhan, Milo A; Hoogendoorn, Martine; Garrod, Rachel; Schols, Annemie M W J; Carlin, Brian; Benzo, Roberto; Meek, Paula; Morgan, Mike; Rutten-van Mölken, Maureen P M H; Ries, Andrew L; Make, Barry; Goldstein, Roger S; Dowson, Claire A; Brozek, Jan L; Donner, Claudio F; Wouters, Emiel F M

2013-10-15

Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our knowledge of its efficacy and scope. The purpose of this Statement is to update the 2006 document, including a new definition of pulmonary rehabilitation and highlighting key concepts and major advances in the field. A multidisciplinary committee of experts representing the ATS Pulmonary Rehabilitation Assembly and the ERS Scientific Group 01.02, "Rehabilitation and Chronic Care," determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant clinical and scientific expertise. The final content of this Statement was agreed on by all members. An updated definition of pulmonary rehabilitation is proposed. New data are presented on the science and application of pulmonary rehabilitation, including its effectiveness in acutely ill individuals with chronic obstructive pulmonary disease, and in individuals with other chronic respiratory diseases. The important role of pulmonary rehabilitation in chronic disease management is highlighted. In addition, the role of health behavior change in optimizing and maintaining benefits is discussed. The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.

The importance of 'global meaning' for people rehabilitating from spinal cord injury.

PubMed

Littooij, E; Leget, C J W; Stolwijk-Swüste, J M; Doodeman, S; Widdershoven, G A M; Dekker, J

2016-11-01

Qualitative study. To explore whether aspects of global meaning (that is, fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) are associated with processes and outcomes in rehabilitation, as experienced by people with spinal cord injury (SCI). People living in the community receiving outpatient rehabilitation in a Dutch rehabilitation center. In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed using qualitative research methods: structural and provisional coding. Core values, relationships, worldview, identity and inner posture (that is, the way in which people relate to the facts of life) were associated with various processes and outcomes of rehabilitation. Elements of the rehabilitation process included motivation, regulation of emotion, making decisions and handling stress. Elements of the outcome of rehabilitation included physical functioning, emotional functioning, social functioning and subjective sense of meaning. The influence was positive, with the exception of one case in which worldview and inner posture were negatively associated with motivation. Besides that, respondents emphasized the importance of rehabilitation professionals attuning to their global meaning. All aspects of global meaning were positively associated with various processes and outcomes of rehabilitation. It is recommended that rehabilitation professionals are aware of the importance of global meaning to people with SCI and that they take people's fundamental beliefs and life goals into account.

Understanding consumer and clinician preferences and decision making for rehabilitation following arthroplasty in the private sector.

PubMed

Buhagiar, Mark A; Naylor, Justine M; Simpson, Grahame; Harris, Ian A; Kohler, Friedbert

2017-06-19

To understand private consumer and clinician preferences towards different rehabilitation modes following knee or hip arthroplasty, and identify factors which influence the chosen rehabilitation pathway. Mixed methods cross-sectional study involving 95 semi-structured interviews of consumers (patients and carers) and clinicians (arthroplasty surgeons, physiotherapists and rehabilitation physicians) in Sydney, Australia, during 2014-2015. Participants were asked about the acceptability of different modes of rehabilitation provision, and factors influencing their chosen rehabilitation pathway. Interviews were in person or via the telephone. Qualitative analysis software was used to electronically manage qualitative data. An analytical approach guided data analysis. Pre-operative preferences strongly influenced the type of rehabilitation chosen by consumers. Key factors that influenced this were both intrinsic and extrinsic, including; the previous experience of self or known others, the perceived benefits of the chosen mode, a sense of entitlement, the role of orthopaedic surgeons and influence of patient preference, a patient's clinical status post-surgery, the private hospital business model and insurance provider involvement. The acceptability of rehabilitation modes varied between clinician groups. No one rehabilitation mode provided following arthroplasty is singularly preferred by stakeholders. Factors other than the belief that a particular mode was more effective than another appear to dominate the pathway followed by private arthroplasty consumers, indicating evidence-based policies around rehabilitation provision may have limited appeal in the private sector.

Rehabilitation Research at the National Institutes of Health:

PubMed Central

Bean, Jonathan F.; Damiano, Diane; Ehrlich-Jones, Linda; Fried-Oken, Melanie; Jette, Alan; Jung, Ranu; Lieber, Rick L.; Malec, James F.; Mueller, Michael J.; Ottenbacher, Kenneth J.; Tansey, Keith E.; Thompson, Aiko

2017-01-01

Abstract Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the American With Disabilities Act, the NIH established the National Center for Medical Rehabilitation Research with the goal of developing and implementing a rehabilitation research agenda. Currently, a total of 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Dr Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference under the title “Rehabilitation Research at NIH: Moving the Field Forward.” This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future. This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: Frontera WR, Bean JF, Damiano D, et al. Am J Phys Med Rehabil. 2017;97(4):393–403. PMID:28499004

Reviewing the Evidence: In Pursuit of a Framework for Parkinson Disease Rehabilitation with Games.

PubMed

Tece Bayrak, Aslihan; Wünsche, Burkhard; Lutteroth, Christof

2016-01-01

Exercise gaming has been receiving a significant interest from both consumers and researchers. Be it for the purposes of weight loss, physical fitness or even just enjoyment, the potential of games to support rehabilitation has also been under investigation for a while. Due to our aging society, game based therapies could be a solution for optimizing resources and reducing rehabilitation costs. This paper aims to discuss the potential capacity of games as systems to enhance the relation of physical exercise and cognition for the rehabilitation of Parkinson Disease. Our investigation demonstrates that there is no established methodology for games in rehabilitation of Parkinson's addressing how games can encapsulate physical exercise strategies while providing safety, continuous monitoring and cognitive development exercises in facilitation of rehabilitation. Since rehabilitation with games is trending, yet to be developed rehabilitation strategies would benefit from new insights into the relationship between game worlds, physical exercise and motor-cognitive training. Therefore, it is useful to do further research into realizing (1) a relational model that demonstrates the relation between game world (composed of game features including formal game elements, audio-visual features, mechanics and dynamics), motor skills, cognition and physical exercise for both generic and specific rehabilitation purposes, (2) a structured task creation approach for game features that reconciles specific rehabilitation outcomes, correct level of engagement, task difficulty and safety requirements for target demographic.

Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

PubMed

Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

2016-01-01

This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

A characterization of clinical questions asked by rehabilitation therapists.

PubMed

Kloda, Lorie Andrea; Bartlett, Joan C

2014-04-01

This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.

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.

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.

[Efficiency of rehabilitation methods in the treatment of arm lymphedema after breast cancer surgery].

PubMed

Petruseviciene, Daiva; Krisciūnas, Aleksandras; Sameniene, Jūrate

2002-01-01

In this article we analyze influence of rehabilitation methods in treatment of arm lymphedema. In Kaunas oncological hospital were examined 60 women after surgery for breast cancer. The work objective was to evaluate efficiency of rehabilitation methods in treatment of arm lymphedema and in evaluate movement amplitude of shoulder joint. Two groups of women depending on rehabilitation start were evaluated. The same methods of rehabilitation were applied to both groups: physical therapy, electrostimulation, massage, lymphodrainage with apparate. Our study indicated that women, who were treated at early period of rehabilitation (3 months), showed statistically significantly (p < 0.01) better results in increase of movement amplitude of shoulder joint. However, results of treatment of arm lymphedema, comparing with women who started rehabilitation after 12 months, were equally successful--results were not statistically significantly better (p > 0.05).

Quality of life of individuals submitted to vestibular rehabilitation.

PubMed

Patatas, Olívia Helena Gomes; Ganança, Cristina Freitas; Ganança, Fernando Freitas

2009-01-01

Balance disorders affect social, family and professional activities. Vestibular rehabilitation can reduce the impact of these disorders on the quality of life of individuals with vertigo. to study the influence of vestibular rehabilitation on the quality of life of individuals, correlating it with gender, age, results from computerized vectoelectronystagmography and vertigo. Retrospective. Twenty-two individuals were submitted to customized vestibular rehabilitation and the Brazilian Dizziness Handicap Inventory - DHI before and after vestibular rehabilitation. Results from this questionnaire were correlated with gender, age, vestibular assessment and the presence of vertigo. all the DHI scores reduced significantly after vestibular rehabilitation. There were no differences among genders; adults and elderly patients; irritative peripheral vestibular syndromes; deficiency syndromes and normal exams; the presence or absence of vertigo. all the individuals had improvements in their quality of life after customized vestibular rehabilitation.

Measurement of participation in rehabilitation research.

PubMed

Heinemann, Allen W

2010-09-01

The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness sponsored a 2-day International Symposium on Measurement of Participation in Rehabilitation Research in October 2008 as a preconference to the annual meeting of the American Congress of Rehabilitation Medicine and the American Society of Neurorehabilitation. The aims of the symposium were to highlight the state of the art in the measurement of participation and discuss its utility as an outcome measure for persons with disabilities by examining the construct of participation and its measurement. Plenary presentations and group discussions were organized around 4 key issues: (1) conceptualization, (2) operationalization, (3) environmental influences, and (4) personal characteristics. The full set of symposium articles, including recommendations for future research, appears in this supplement to Archives of Physical Medicine and Rehabilitation. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors.

PubMed

Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther; Thorne, Sally; Lomborg, Kirsten

The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may be compromised by HCP attitudes and conduct. These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.

Rethinking the continuum of stroke rehabilitation.

PubMed

Teasell, Robert W; Murie Fernandez, Manuel; McIntyre, Amanda; Mehta, Swati

2014-04-01

Suffering a stroke can be a devastating and life-changing event. Although there is a large evidence base for stroke rehabilitation in the acute and subacute stages, it has been long accepted that patients with stroke reach a plateau in their rehabilitation recovery relatively early. We have recently published the results of a systematic review designed to identify all randomized controlled trials (RCTs) where a rehabilitation intervention was initiated more than 6 months after the onset of the stroke. Of the trials identified, 339 RCTs met inclusion criteria, demonstrating an evidence base for stroke rehabilitation in the chronic phase as well. This seems at odds with the assumption that further recovery is unlikely and the subsequent lack of resources devoted to chronic stroke rehabilitation and management. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rehabilitation and education are underutilized for mild stroke and TIA sufferers.

PubMed

Faux, Steven G; Arora, Pooja; Shiner, Christine T; Thompson-Butel, Angelica G; Klein, Linda A

2018-06-01

Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, delivering education and rehabilitation to this population can be complex and challenging. Via synthesis of a narrative review and clinical experience, we explore the unique and inherent complexities of rehabilitation management and education provision for patients following mild stroke and TIA. A considerable proportion of TIA/mild stroke survivors have ongoing rehabilitation needs that are poorly addressed. The need for rehabilitation in these patients is often overlooked, and available assessment tools lack the sensitivity to identify common subtle impairments in cognition, mood, language and fatigue. Active and accessible education interventions need to be initiated early after the event, and integrated with ongoing rehabilitation management. Priority areas in need of future development in this field are highlighted and discussed. Implications for rehabilitation Survivors of mild stroke and TIA have ongoing unmet rehabilitation needs and require a unique approach to rehabilitation and education. Rehabilitation needs are difficult to assess and poorly addressed in this cohort, where available assessment tools lack the sensitivity required to identify subtle impairments. Education needs to be initiated early after the event and involve active engagement of the patient in order to improve stroke knowledge, mood and motivate adherence to lifestyle modifications and secondary prevention. Rehabilitation physicians are currently an underutilized resource, who should be more involved in the management of all patients following TIA or mild stroke.

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.

Quality of care indicators for the structure and organization of inpatient rehabilitation care of children with traumatic brain injury.

PubMed

Zumsteg, Jennifer M; Ennis, Stephanie K; Jaffe, Kenneth M; Mangione-Smith, Rita; MacKenzie, Ellen J; Rivara, Frederick P

2012-03-01

To develop evidence-based and expert-driven quality indicators for measuring variations in the structure and organization of acute inpatient rehabilitation for children after traumatic brain injury (TBI) and to survey centers across the United States to determine the degree of variation in care. Quality indicators were developed using the RAND/UCLA modified Delphi method. Adherence to these indicators was determined from a survey of rehabilitation facilities. Inpatient rehabilitation units in the United States. A sample of rehabilitation programs identified using data from the National Association of Children's Hospitals and Related Institutions, Uniform Data System for Medical Rehabilitation, and the Commission on Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating children with TBI. Survey respondents comprised 31 pediatric and 28 all age units. Not applicable. Variations in structure and organization of care among institutions providing acute inpatient rehabilitation for children with TBI. Twelve indicators were developed. Pediatric inpatient rehabilitation units and units with higher volumes of children with TBI were more likely to have: a census of at least 1 child admitted with a TBI for at least 90% of the time; adequate specialized equipment; a classroom; a pediatric subspecialty trained medical director; and more than 75% of therapists with pediatric training. There were clinically and statistically significant variations in the structure and organization of acute pediatric rehabilitation based on the pediatric focus of the unit and volume of children with TBI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation.

PubMed

New, Peter Wayne; Marshall, Ruth; Stubblefield, Michael D; Scivoletto, Giorgio

2017-03-01

People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes.

Attitudes of rehabilitation medicine doctors toward medical ethics in Malaysia.

PubMed

Mazlina, M; Julia, P E

2011-06-01

Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care. We surveyed 74 rehabilitation physicians and residents in Malaysia using a self-administered descriptive questionnaire. The questions covered medical ethics issues on allocation of resources, patient confidentiality, discharge planning, goal-setting, reimbursement documentation, decision-making capacity and withdrawal of life support. The overall response rate was 69 percent. More than 80 percent of respondents would disclose confidential information to their team members if it would affect the rehabilitation process. More than two-thirds of respondents would not allocate scarce rehabilitation resources if the functional outcome is marginally positive. Issues involving patients' autonomy in decision-making, both in life-threatening and non-life-threatening situations, showed mix responses. The least common response was on the issue of discharge planning, where 51 percent of respondents would send a patient back to a nursing home with suboptimal care if there were no other alternatives. The attitude of Malaysian rehabilitation doctors toward ethical issues is reflective of the level of maturity of rehabilitation medicine in Malaysia. Issues on allocation of resources, discharge planning and decision-making capacity are significantly influenced by limited rehabilitation facilities in parts of the country. The lack of influence from external factors, such as a developed health insurance system, contributes to the difference in attitude between rehabilitation doctors in Malaysia and those in developed countries.

Employee and work-related predictors for entering rehabilitation: a cohort study of civil servants.

PubMed

Lamminpää, Anne; Kuoppala, Jaana; Väänänen-Tomppo, Irma; Hinkka, Katariina

2012-07-01

The aim of this study was to determine how employee well-being, psychosocial factors at work, leadership and perceived occupational health services predict entering rehabilitation as modelled in the Job Well-being Pyramid. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. A total of 147 employees entered rehabilitation during the median follow-up time of 7 years. Permanent employment, large organizations, feedback from supervisors, client violence and physically monotonous work were associated with an increased rate of entering rehabilitation, whereas physical jobs, clear aims, high appreciation, job satisfaction and job enjoyment were associated with a decreased rate of entering rehabilitation. Employee well-being in general was also associated with entering rehabilitation, and this was decreased by good work ability, good health, mental well-being and physical fitness and increased by constant musculoskeletal symptoms. On the other hand, support from supervisors, job control, work pressure, team climate at work, communication, bullying and discrimination, physical work environment, and sense of coherence appeared to have no association. Various psychosocial factors at work and job well-being predict entering rehabilitation. The association between employee health and entering rehabilitation refers to the fact that the selection process for rehabilitation works reasonably well and those in need of rehabilitation are also granted it. In general, these findings coincide well with the Job Well-being Pyramid model. Improving job conditions and well-being at work is likely to decrease the need for rehabilitation.

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

PubMed Central

Marshall, Ruth; Stubblefield, Michael D.; Scivoletto, Giorgio

2017-01-01

Background People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Design Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Setting Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Participants Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Outcomes Measures Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Results Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. Conclusions A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes. PMID:27088581

Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India.

PubMed

Kamalakannan, Sureshkumar; Gudlavalleti Venkata, Murthy; Prost, Audrey; Natarajan, Subbulakshmy; Pant, Hira; Chitalurri, Naveen; Goenka, Shifalika; Kuper, Hannah

2016-09-01

To assess the rehabilitation needs of stroke survivors in Chennai, India, after discharge from the hospital. Mixed-methods research design. Home-based. Stroke survivors (n=50; mean age ± SD, 58.9±10.5y) and primary caregivers of these stroke survivors (n=50; mean age ± SD, 43.1±11.8y) took part in the quantitative survey. A subsample of stroke survivors (n=12), primary caregivers (n=10), and health care professionals (n=8) took part in the qualitative in-depth interviews. Not applicable. Rehabilitation needs after hospital discharge. About 82% of the needs expressed by stroke survivors and 92% of the needs expressed by caregivers indicated that they had a substantial need for information. The proportion of financial needs reported by the stroke survivors and the caregivers was 70% and 75%, respectively. The qualitative data revealed major gaps in access to stroke rehabilitation services. Service providers identified availability and affordability of services as key problems. Stroke survivors and their caregivers identified lack of information about stroke as major barriers to accessibility of stroke rehabilitation services. Caregivers expressed a tremendous need for support to manage family dynamics. The study highlights a considerable unmet need for poststroke rehabilitation services. Given the lack of rehabilitation resources in India, developing an accessible, innovative, patient-centered, culturally sensitive rehabilitation intervention is of public health importance. It is crucial for low- and middle-income countries like India to develop technology-driven stroke rehabilitation strategies to meet the growing rehabilitation needs of stroke survivors. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Acquisition and rehabilitation of eligible properties; rehabilitation standards. 572.100 Section 572.100 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY...

What We Can Learn from Developing Countries: The Community Based Rehabilitation Model.

ERIC Educational Resources Information Center

Zambone, Alana M.; Suarez, Stephanie Cox

1996-01-01

The community-based rehabilitation model has successfully trained community members in rural areas of Asia, Africa, and Latin America to deliver educational and rehabilitation services to disabled individuals and their families. Practices applicable to improving educational and rehabilitation services in the United States involve staff…

Rehabilitation Services for Rural Blind Persons in Malaysia.

ERIC Educational Resources Information Center

Ooi, G.

1990-01-01

The article traces the experiences of the Malaysian Association for the Blind in developing rehabilitation services for rural blind persons. It explains the rationale for a community-based approach to rehabilitation and concludes that center-based and community-based approaches to rehabilitation complement each other in bringing services to rural…

Factors Considered by Vocational Rehabilitation Professionals in Employability and Earning Capacity Assessment

ERIC Educational Resources Information Center

Williams, John M.; Dunn, Patrick L.; Bast, Steve; Giesen, Judy

2006-01-01

The purpose of this study was to identify the factors that contributed to vocational rehabilitation assessment of earning capacity. Rehabilitation professionals who attended a national forensic rehabilitation conference were asked to rate the importance of 26 variables in development of opinions of earning capacity. Exploratory factor analysis…

38 CFR 21.84 - Individualized written rehabilitation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C...) Identify goals and objectives to be achieved by the veteran during the period of rehabilitation services... the veteran to achieve the goals and objectives of the plan. (Authority: 38 U.S.C. 3107) (b) Elements...

Facilities of Early Rehabilitation after Stroke in Poland 2010

ERIC Educational Resources Information Center

Opara, Jozef A.; Langhorne, Peter; Larsen, Torben; Mehlich, Krzysztof; Szczygiel, Jaroslaw

2012-01-01

The aim of this work was to survey the contemporary facilities for early post-stroke rehabilitation in Poland. The main research questions were as follows: what is the availability of inpatient rehabilitation for post-stroke patients in neurological departments and in rehabilitation departments? The growing costs of healthcare are encouraging…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

78 FR 26626 - Applications for New Awards; National Institute on Disability and Rehabilitation Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... Rehabilitation Research--Disability and Rehabilitation Research Projects--Inclusive Cloud and Web Computing... Rehabilitation Research Projects (DRRPs)--Inclusive Cloud and Web Computing Notice inviting applications for new...#DRRP . Priorities: Priority 1--DRRP on Inclusive Cloud and Web Computing-- is from the notice of final...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Code of Federal Regulations, 2010 CFR

2010-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

7 CFR 457.164 - Nursery rehabilitation endorsement.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Rehabilitation costs covered by this endorsement are limited to expenditures for labor and materials for pruning...., broken limbs from high winds, trees uprooted by hurricane, etc.); (ii) The extent of damage (e.g., twenty... practical to rehabilitate the damaged plants (It is not practical if the costs of rehabilitation are greater...

7 CFR 457.164 - Nursery rehabilitation endorsement.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Rehabilitation costs covered by this endorsement are limited to expenditures for labor and materials for pruning...., broken limbs from high winds, trees uprooted by hurricane, etc.); (ii) The extent of damage (e.g., twenty... practical to rehabilitate the damaged plants (It is not practical if the costs of rehabilitation are greater...

7 CFR 457.164 - Nursery rehabilitation endorsement.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Rehabilitation costs covered by this endorsement are limited to expenditures for labor and materials for pruning...., broken limbs from high winds, trees uprooted by hurricane, etc.); (ii) The extent of damage (e.g., twenty... practical to rehabilitate the damaged plants (It is not practical if the costs of rehabilitation are greater...

7 CFR 457.164 - Nursery rehabilitation endorsement.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Rehabilitation costs covered by this endorsement are limited to expenditures for labor and materials for pruning...., broken limbs from high winds, trees uprooted by hurricane, etc.); (ii) The extent of damage (e.g., twenty... practical to rehabilitate the damaged plants (It is not practical if the costs of rehabilitation are greater...

7 CFR 457.164 - Nursery rehabilitation endorsement.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Rehabilitation costs covered by this endorsement are limited to expenditures for labor and materials for pruning...., broken limbs from high winds, trees uprooted by hurricane, etc.); (ii) The extent of damage (e.g., twenty... practical to rehabilitate the damaged plants (It is not practical if the costs of rehabilitation are greater...

Research Plan for the National Center for Medical Rehabilitation Research.

ERIC Educational Resources Information Center

National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

This research plan describes a framework for defining and developing the field of rehabilitation sciences and research opportunities for the National Center for Medical Rehabilitation Research (NCMRR) and other agencies funding medical rehabilitation research. The plan addresses the needs of both persons who are involved in habilitation and in…

Surviving Traumatic Brain Injury: A Study of Post Acute Rehabilitation Services.

ERIC Educational Resources Information Center

Schuyler, Suellen

The problems facing a rehabilitation counselor in successfully working with survivors of brain trauma are myriad. This review examined evaluation techniques, rehabilitation therapies, and existing services that have proven effective with traumatic brain injury (TBI) clients. There is a gap in rehabilitation services that results in the TBI…

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...

Rehabilitation Counselor Education and the New Code of Ethics

ERIC Educational Resources Information Center

Glosoff, Harriet L.; Cottone, R. Rocco

2010-01-01

The purpose of this article is to discuss recent changes in the Commission on Rehabilitation Counselor Certification "Code of Professional Ethics for Rehabilitation Counselors", effective January 1, 2010, that are most relevant to rehabilitation counselor educators. The authors provide a brief overview of these key changes along with implications…

42 CFR 412.604 - Conditions for payment under the prospective payment system for inpatient rehabilitation facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... payment system for inpatient rehabilitation facilities. 412.604 Section 412.604 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment for Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.604 Conditions for payment under the prospective payment system for inpatient...

36 CFR 72.54 - Rehabilitation and Innovation grants-full application process.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Rehabilitation and Innovation..., Approval and Administration § 72.54 Rehabilitation and Innovation grants—full application process. Once a Rehabilitation or Innovation proposal has received a tentative grant offer, applicants will be responsible for...

36 CFR 72.54 - Rehabilitation and Innovation grants-full application process.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Rehabilitation and Innovation..., Approval and Administration § 72.54 Rehabilitation and Innovation grants—full application process. Once a Rehabilitation or Innovation proposal has received a tentative grant offer, applicants will be responsible for...

36 CFR 72.54 - Rehabilitation and Innovation grants-full application process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Rehabilitation and Innovation..., Approval and Administration § 72.54 Rehabilitation and Innovation grants—full application process. Once a Rehabilitation or Innovation proposal has received a tentative grant offer, applicants will be responsible for...

36 CFR 72.54 - Rehabilitation and Innovation grants-full application process.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Rehabilitation and Innovation..., Approval and Administration § 72.54 Rehabilitation and Innovation grants—full application process. Once a Rehabilitation or Innovation proposal has received a tentative grant offer, applicants will be responsible for...

36 CFR 72.54 - Rehabilitation and Innovation grants-full application process.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Rehabilitation and Innovation..., Approval and Administration § 72.54 Rehabilitation and Innovation grants—full application process. Once a Rehabilitation or Innovation proposal has received a tentative grant offer, applicants will be responsible for...

Assessing Infusion of Social Justice in Rehabilitation Counselor Education Curriculum

ERIC Educational Resources Information Center

Dong, Shengli; Ethridge, Glacia; Rodgers-Bonaccorsy, Roe; Oire, Spalatin N.

2015-01-01

Purpose: To examine the extent to which rehabilitation counselor educators understand and are committed to infusing social justice in the rehabilitation counseling curricula. Method: The authors used a quantitative descriptive research design to examine the level and extent of integrating social justice into rehabilitation counseling curricular.…

34 CFR 350.34 - Which Rehabilitation Engineering Research Centers must have an advisory committee?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Which Rehabilitation Engineering Research Centers must... Engineering Research Centers Does the Secretary Assist? § 350.34 Which Rehabilitation Engineering Research Centers must have an advisory committee? A Rehabilitation Engineering Research Center conducting research...

34 CFR 350.34 - Which Rehabilitation Engineering Research Centers must have an advisory committee?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Which Rehabilitation Engineering Research Centers must... Engineering Research Centers Does the Secretary Assist? § 350.34 Which Rehabilitation Engineering Research Centers must have an advisory committee? A Rehabilitation Engineering Research Center conducting research...

34 CFR 350.34 - Which Rehabilitation Engineering Research Centers must have an advisory committee?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Which Rehabilitation Engineering Research Centers must... Engineering Research Centers Does the Secretary Assist? § 350.34 Which Rehabilitation Engineering Research Centers must have an advisory committee? A Rehabilitation Engineering Research Center conducting research...

34 CFR 350.34 - Which Rehabilitation Engineering Research Centers must have an advisory committee?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Which Rehabilitation Engineering Research Centers must... Engineering Research Centers Does the Secretary Assist? § 350.34 Which Rehabilitation Engineering Research Centers must have an advisory committee? A Rehabilitation Engineering Research Center conducting research...

34 CFR 350.34 - Which Rehabilitation Engineering Research Centers must have an advisory committee?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Which Rehabilitation Engineering Research Centers must... Engineering Research Centers Does the Secretary Assist? § 350.34 Which Rehabilitation Engineering Research Centers must have an advisory committee? A Rehabilitation Engineering Research Center conducting research...

Rehabilitation Counseling Professional Associations: Membership, Membership Intentions, and Levels of Commitment among Rehabilitation Counseling Professionals

ERIC Educational Resources Information Center

Phillips, Brian N.

2011-01-01

Declining membership is a concerning, yet poorly understood issue affecting professional associations across many disciplines (Bauman, 2008). The discipline of rehabilitation counseling is experiencing membership decline even as the number of certified rehabilitation counselors continues to increase (Leahy, 2009). Little empirical research…

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... workshop or rehabilitation facility may be authorized when the training offered is a sound method of... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief... in a sheltered workshop or rehabilitation facility. (a) General. A vocational course in a sheltered...

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... workshop or rehabilitation facility may be authorized when the training offered is a sound method of... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief... in a sheltered workshop or rehabilitation facility. (a) General. A vocational course in a sheltered...

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... workshop or rehabilitation facility may be authorized when the training offered is a sound method of... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief... in a sheltered workshop or rehabilitation facility. (a) General. A vocational course in a sheltered...

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... workshop or rehabilitation facility may be authorized when the training offered is a sound method of... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief... in a sheltered workshop or rehabilitation facility. (a) General. A vocational course in a sheltered...

75 FR 27318 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-11607 Filed 5-13-10; 8:45 am...) The Education Department General Administrative Regulations (EDGAR) in 34 CFR parts 74, 75, 77, 79, 80...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Code of Federal Regulations, 2012 CFR

2012-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Code of Federal Regulations, 2011 CFR

2011-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Code of Federal Regulations, 2014 CFR

2014-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Code of Federal Regulations, 2013 CFR

2013-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

23 CFR 650.407 - Application for bridge replacement or rehabilitation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Application for bridge replacement or rehabilitation... Rehabilitation Program § 650.407 Application for bridge replacement or rehabilitation. (a) Agencies participate... agency for review and processing. The State is responsible for submitting the six computer card format or...

23 CFR 650.407 - Application for bridge replacement or rehabilitation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Application for bridge replacement or rehabilitation... Rehabilitation Program § 650.407 Application for bridge replacement or rehabilitation. (a) Agencies participate... agency for review and processing. The State is responsible for submitting the six computer card format or...

23 CFR 650.407 - Application for bridge replacement or rehabilitation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Application for bridge replacement or rehabilitation... Rehabilitation Program § 650.407 Application for bridge replacement or rehabilitation. (a) Agencies participate... agency for review and processing. The State is responsible for submitting the six computer card format or...

Rehabilitation Counselor Narratives on Factors Affecting Vocational Goal Acquisition of Female Immigrant Clients: Incorporating Policy

ERIC Educational Resources Information Center

Akande, Abigail O.

2014-01-01

This dissertation examines factors affecting the service outcomes of immigrant women with disabilities who received vocational rehabilitation services, from the perspectives of their rehabilitation counselors. The participants were eight rehabilitation counselors who had received their Master's degrees from programs accredited by the Council on…

Rehabilitation of the Ankle after Acute Sprain or Chronic Instability.

ERIC Educational Resources Information Center

Mattacola, Carl G.; Dwyer, Maureen K.

2002-01-01

Outlines rehabilitation concepts applicable to acute and chronic ankle injury, providing evidence for current techniques used in ankle rehabilitation and describing a functional rehabilitation program that progresses from basic to advanced, while taking into account empirical data from the literature and clinical practice. The article notes that…

Manual for Training Leprosy Rehabilitation Workers.

ERIC Educational Resources Information Center

Itoh, Masayoshi; Eason, Alice L.

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

Critical Thinking Skills for Rehabilitation Professionals in the 21st Century

ERIC Educational Resources Information Center

Lewis, Allen N.; King, Eric S.; Pitt, Jenelle S.; Getachew, Almaz; Shamburger, Aisha

2010-01-01

Critical thinking (CT) is an essential tool for rehabilitation professionals in the 21st century. Well developed CT skills are indicated for rehabilitation professionals in the new century to promote continuous quality improvement of the service delivery system. Such improvement will occur as rehabilitation professionals learn to routinely…

42 CFR 409.33 - Examples of skilled nursing and rehabilitation services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Examples of skilled nursing and rehabilitation... Posthospital SNF Care § 409.33 Examples of skilled nursing and rehabilitation services. (a) Services that could qualify as either skilled nursing or skilled rehabilitation services—(1) Overall management and evaluation...

42 CFR 409.33 - Examples of skilled nursing and rehabilitation services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Examples of skilled nursing and rehabilitation... Posthospital SNF Care § 409.33 Examples of skilled nursing and rehabilitation services. (a) Services that could qualify as either skilled nursing or skilled rehabilitation services—(1) Overall management and evaluation...

42 CFR 409.33 - Examples of skilled nursing and rehabilitation services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Examples of skilled nursing and rehabilitation... Posthospital SNF Care § 409.33 Examples of skilled nursing and rehabilitation services. (a) Services that could qualify as either skilled nursing or skilled rehabilitation services—(1) Overall management and evaluation...

Methods and Forms of Rehabilitation of Visually Impaired Persons.

ERIC Educational Resources Information Center

Bell, S.

1990-01-01

The paper describes rehabilitation services provided by the Royal National Institute for the Blind (United Kingdom), focusing specifically on its Employment Rehabilitation Centers. Current vocational rehabilitation policy of the Institute is described, and a study in progress to determine the Institute's role in future programs is discussed.…

Perspectives on National Health Insurance and Rehabilitation. Emerging Issues in Rehabilitation.

ERIC Educational Resources Information Center

Dorken, Herbert; LaRocca, Joseph

Major research findings are synthesized and innovations of current concern to vocational rehabilitation professionals are reported in this paper on national health insurance (NHI) and rehabilitation. Discussion covers the following topics: the concept of insurance, forms of health insurance, issues arising from hearings on NHI, perspectives of…

Regenerative Rehabilitation: Applied Biophysics Meets Stem Cell Therapeutics.

PubMed

Rando, Thomas A; Ambrosio, Fabrisia

2018-03-01

The emerging field of regenerative rehabilitation integrates biological and bioengineering advances in regenerative medicine with rehabilitative sciences. Here we highlight recent stem cell-based examples of the regenerative rehabilitation paradigm to promote tissue repair and regeneration, and we discuss remaining challenges and future directions for the field. Published by Elsevier Inc.

A new era in sports science: the launch of BMC Sports Science, Medicine and Rehabilitation.

PubMed

Moylan, Elizabeth C; Horne, Genevieve

2013-03-28

This Editorial celebrates the launch of BMC Sports Science, Medicine and Rehabilitation within the BMC series of journals published by BioMed Central. BMC Sports Science, Medicine and Rehabilitation incorporates the recently closed Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology (SMARTT) with an expanded scope and Editorial Board. BMC Sports Science, Medicine and Rehabilitation will fill its own niche in the BMC series alongside other companion journals including BMC Physiology, BMC Musculoskeletal Disorders and BMC Surgery.

Transitions of care and rehabilitation after fragility fractures.

PubMed

Eslami, Michelle; Tran, Hong-Phuc

2014-05-01

Transitions in care are a vulnerable time period for patients during which unintended errors may occur. This article discusses potential risks that could occur during care transitions, suggested improvements, and the transition from hospital to skilled nursing facilities for patients needing rehabilitation after their discharge from the hospital. Different rehabilitation settings and their reimbursement are reviewed. Common potential medical conditions arising in patients undergoing rehabilitation, rehabilitation goals, and secondary prevention also are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

[Paediatric Rehabilitation by the German Pension Insurance - Status Quo and Future Developments].

PubMed

Widera, T; Baumgarten, E; Druckenmüller, A; Niehues, C

2017-04-01

In Germany inpatient rehabilitation plays a major role for the treatment of children and adolescents with chronic health conditions. The German Pension Insurance carries out the rehabilitation of children and adolescents with high commitment. Paediatric rehabilitation enables children to go to kindergarten and school without interruption and participate in later professional life. The article specifies the basics of paediatric rehabilitation, describes the disease structure, defines the therapeutic care and explicates survey results. © Georg Thieme Verlag KG Stuttgart · New York.

[Medical and psychological rehabilitation of patients and disabled persons].

PubMed

Zaĭtsev, V P

2013-01-01

The paper unveils the concept of medical rehabilitation and defines its place in clinical medicine. It underlines the inextricable link and interaction of different components of a rehabilitation system. The value of the psychological aspect of rehabilitation is considered. Categories of patients and disabled persons who need psychological rehabilitation are identified; a classification of personal reactions to disease and the changes in the psychological state of patients in different periods after disease onset are given. The factors influencing the process of psychological readjustment in patients and the disabled are analyzed. The psychological rehabilitation system for patients and disabled persons is considered in detail. Data on its medical and socioeconomic efficiency are presented.

Robotics in Lower-Limb Rehabilitation after Stroke

PubMed Central

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots. PMID:28659660

Recommendations for managing patients with diabetes mellitus in cardiopulmonary rehabilitation: an American Association of Cardiovascular and Pulmonary Rehabilitation statement.

PubMed

Lopez-Jimenez, Francisco; Kramer, Valerie Carroll; Masters, Barbara; Stuart, Patricia Mickey W; Mullooly, Cathy; Hinshaw, Ling; Haas, Linda; Warwick, Kathy

2012-01-01

Diabetes mellitus is a highly prevalent condition in patients participating in cardiopulmonary rehabilitation. However, research and subsequent guidelines specifically applicable to patients with diabetes, participating in cardiopulmonary rehabilitation, are limited. Recognizing this limitation, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) initiated this statement, with the goal of developing a template that incorporated recommendations provided in the AACVPR Core Components and the American Association of Diabetes Educators 7 Self-Care Behaviors. This statement describes key processes regarding evaluation, interventions, and expected outcomes in each of the core components for the management of patients with diabetes in a cardiopulmonary rehabilitation program.

Robotics in Lower-Limb Rehabilitation after Stroke.

PubMed

Zhang, Xue; Yue, Zan; Wang, Jing

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

[Relevance of medical rehabilitation in disease management programmes].

PubMed

Lüngen, M; Lauterbach, K W

2003-10-01

Disease management programmes will increasingly be introduced in Germany due to the new risk adjustment scheme. The first disease management programmes started in 2003 for breast cancer and diabetes mellitus type II. German rehabilitation will have to face several challenges. Disease management programmes are strongly based on the notion of Evidence so that proof of the efficacy of a care giving task should be present. Verification of the evidence of the specifically German rehabilitation treatments must therefore be given. However, integration of rehabilitation in disease management programmes could lead to changes in the alignment of German rehabilitation. The essence of German rehabilitation, notably its holistic approach, could get lost with integration in disease management programmes.

Vision rehabilitation in the case of blindness.

PubMed

Veraart, Claude; Duret, Florence; Brelén, Marten; Oozeer, Medhy; Delbeke, Jean

2004-09-01

This article examines the various vision rehabilitation procedures that are available for early and late blindness. Depending on the pathology involved, several vision rehabilitation procedures exist, or are in development. Visual aids are available for low vision individuals, as are sensory aids for blind persons. Most noninvasive sensory substitution prostheses as well as implanted visual prostheses in development are reviewed. Issues dealing with vision rehabilitation are also discussed, such as problems of biocompatibility, electrical safety, psychosocial aspects, and ethics. Basic studies devoted to vision rehabilitation such as simulation in mathematical models and simulation of artificial vision are also presented. Finally, the importance of accurate rehabilitation assessment is addressed, and tentative market figures are given.

Optimizing Language for Stroke Motor Rehabilitation: Recommendations from the ACRM Stroke Movement Interventions Subcommittee

PubMed Central

Page, Stephen J.; Schmid, Arlene; Harris, Jocelyn

2012-01-01

As knowledge and interest in stroke motor rehabilitation continue to increase, consistent terminologies that are specific to this discipline must be established. Such language is critical to effective rehabilitative team communication, and is important to facilitating communication among the diverse groups interested in the science and practice of stroke motor rehabilitation. The purpose of this paper is to provide operational definitions for three concepts that are common - and commonly mislabeled - attributes of stroke motor rehabilitation interventions: intensity, duration, and frequency. In developing these guidelines, conceptual frameworks used in the pharmaceutical, exercise, and rehabilitative therapy realms were used. Implications of these definitions for research and clinical practice are also discussed. PMID:22446292

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral Rehabilitation

PubMed Central

FREITAS, José Alberto de Souza; de ALMEIDA, Ana Lúcia Pompéia Fraga; SOARES, Simone; NEVES, Lucimara Teixeira das; GARIB, Daniela Gamba; TRINDADE-SUEDAM, Ivy Kiemle; YAEDÚ, Renato Yassutaka Faria; LAURIS, Rita de Cássia Moura Carvalho; OLIVEIRA, Thais Marchini; PINTO, João Henrique Nogueira

2013-01-01

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients. PMID:23857655

Learning to design rehabilitation devices through the H-CARD course: project-based learning of rehabilitation technology design.

PubMed

Roach, Nick; Hussain, Asif; Burdet, Etienne

2012-01-01

The aging population and the wish to improve quality of life, as well as the economic pressure to work longer, call for intuitive and efficient assistive and rehabilitation technologies. Therefore, we have developed a project based education paradigm in the design of assistive and rehabilitation devices. Using a miniature wireless sensing and feedback platform, the multimodal interactive motor assessment and training environment (MIMATE), students from different engineering backgrounds were able to develop innovative devices implementing rehabilitative games in the short span of a one-term course. We describe here this novel H-CARD course on the human-centered design of assistive and rehabilitative devices.

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

PubMed

Loghmani, M Terry; Roche, Joseph A

2018-04-03

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

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: oral rehabilitation.

PubMed

Freitas, José Alberto de Souza; Almeida, Ana Lúcia Pompéia Fraga de; Soares, Simone; Neves, Lucimara Teixeira das; Garib, Daniela Gamba; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Lauris, Rita de Cássia Moura Carvalho; Oliveira, Thais Marchini; Pinto, João Henrique Nogueira

2013-01-01

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

Ecotoxicity of Mine Tailings: Unrehabilitated Versus Rehabilitated.

PubMed

Maboeta, M S; Oladipo, O G; Botha, S M

2018-05-01

Earthworms are bioindicators of soil pollution. The ecotoxicity of tailings from selected gold mines in South Africa was investigated utilizing Eisenia andrei bioassays and biomarkers. Samples were obtained from unrehabilitated, rehabilitated and naturally vegetated sites. Biomass, neutral red retention time (NRRT), survival and reproduction were assessed using standardized protocols. Earthworm biomass, NRRT and reproductive success in rehabilitated tailings (comparable to naturally vegetated site) were significantly higher (p < 0.05) than in unrehabilitated tailings. In addition, significantly lower (p < 0.05) body tissue concentrations of As, Cd, Co, Cu and Ni contents were found in the rehabilitated tailings compared to the unrehabilitated. Further, significantly lower (p < 0.05) soil Mn and Zn concentrations were obtained in unrehabilitated tailings than the rehabilitated and naturally vegetated sites. Overall, reduced ecotoxicity effects were confirmed in rehabilitated compared to unrehabilitated tailings. This suggests that rehabilitation as a post-mining restorative strategy has strong positive influence on mine tailings.

Exercise Training and Cognitive Rehabilitation: A Symbiotic Approach for Rehabilitating Walking and Cognitive Functions in Multiple Sclerosis?

PubMed

Motl, Robert W; Sandroff, Brian M; DeLuca, John

2016-07-01

The current review develops a rationale and framework for examining the independent and combined effects of exercise training and cognitive rehabilitation on walking and cognitive functions in persons with multiple sclerosis (MS). To do so, we first review evidence for improvements in walking and cognitive outcomes with exercise training and cognitive rehabilitation in MS. We then review evidence regarding cognitive-motor coupling and possible cross-modality transfer effects of exercise training and cognitive rehabilitation. We lastly present a macro-level framework for considering mechanisms that might explain improvements in walking and cognitive dysfunction with exercise and cognitive rehabilitation individually and combined in MS. We conclude that researchers should consider examining the effects of exercise training and cognitive rehabilitation on walking, cognition, and cognitive-motor interactions in MS and the possible physiological and central mechanisms for improving these functions. © The Author(s) 2015.

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

[Interdisciplinary Cooperation as a Characteristic of Successful Rehabilitation Facilities--Results from the Project MeeR].

PubMed

Kleineke, V; Stamer, M; Zeisberger, M; Brandes, I; Meyer, T

2015-08-01

To determine if there is a difference between successful and less successful rehabilitation facilities concerning their extent and quality of interdisciplinary cooperation? This analysis is part of the project MeeR, that aims to identify characteristics of rehabilitation facilities related to successful rehabilitation. 6 facilities were recruited based on a quantitative analysis; 3 facilities that ranked as above average and 3 as below average in terms of their success in rehabilitating patients. Comprehensive qualitative data were collected on these 6 facilities. In above average rehabilitation facilities, the extent of interdisciplinary cooperation was higher than in below average facilities; the position of the medical profession was less dominant and there was a wider access to team meetings. Promotion of interdisciplinary cooperation is an important component for the improvement of the success of rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

Dissemination, analysis, and implementation of the World Report on Disability: the roadmap of the International Society for Physical and Rehabilitation Medicine.

PubMed

Gutenbrunner, Christoph; Bethge, Matthias; Stucki, Gerold; Li, Jianan; Lains, Jorge; Olver, John; Frontera, Walter; von Groote, Per; Giustini, Alessandro; Imamura, Marta

2014-01-01

The International Society for Physical and Rehabilitation Medicine has recognized the World Report on Disability as a guide for its future activities and endorsed its responsibility to disseminate, to analyze, and to implement the report's recommendations. The activities of the International Society for Physical and Rehabilitation Medicine on the global stage are embedded in a strategy that includes national and regional associations. This article reports on recent and forthcoming activities of the International Society for Physical and Rehabilitation Medicine regarding the World Report on Disability and identifies five major challenges that will impact future International Society for Physical and Rehabilitation Medicine activities. These challenges relate to (1) education and training, (2) the support of strong role models, (3) disaster management, (4) the development of innovative rehabilitation services, and (5) rehabilitation research.

Rehabilitating sea otters: Feeling good versus being effective; Chapter 20

USGS Publications Warehouse

Estes, James A.; Tinker, M. Tim; Kareiva, Peter; Marvier, Michelle; Silliman, Brian

2017-01-01

This chapter examines the complexities of assessing the merits and drawbacks of wildlife rehabilitation. Wildlife rehabilitation is often costly, and the resulting benefits differ depending on whether one’s interest is in the welfare of individual animals or conserving populations. Two examples of this dilemma include the rehabilitation of oiled sea otters following the Exxon Valdez spill in Prince William Sound, Alaska, and the rehabilitation of stranded sea otter pups in central California. In the first example, substantial financial investment resulted in little or no benefits for population conservation. In the second example, the potential for population-level benefits is context dependent: in populations near carrying capacity the conservation impacts are negligible, whereas in isolated, low-density populations rehabilitation and release can be an effective conservation tool. Wildlife rehabilitation is valued by people for various reasons, but recognizing and acknowledging the difference between individual and population welfare is an important step toward effective wildlife conservation.

The psychological, political, and economic realities of brain injury rehabilitation in the 1990s.

PubMed

Leri, J E

1995-07-01

Gans, in 1983, detailed the prevalence, causes, and implications of hate in the rehabilitation setting, and offered suggestions for therapeutic responses to it. Mullins, in 1989, noted that during the 1980s rehabilitation became a rapidly expanding, increasingly privatized, big business, with seemingly limitless opportunities for advancement and profit. He asserted that during those years hate had been joined by power, envy and greed in the rehabilitation setting. The present article builds upon the two earlier ones and reviews recent events and their effects, including: the continued development of rehabilitation as a business, the national economic slow down, the health-care crisis, the rise of managed care, the fear that rehabilitation workers feel for their jobs, and the loss of control that people feel throughout rehabilitation. Suggestions for improving the current situation are offered to clinicians, administrators, insurers, and educators, and all are urged to do what they know is right.

Recent trends for practical rehabilitation robotics, current challenges and the future.

PubMed

Yakub, Fitri; Md Khudzari, Ahmad Zahran; Mori, Yasuchika

2014-03-01

This paper presents and studies various selected literature primarily from conference proceedings, journals and clinical tests of the robotic, mechatronics, neurology and biomedical engineering of rehabilitation robotic systems. The present paper focuses of three main categories: types of rehabilitation robots, key technologies with current issues and future challenges. Literature on fundamental research with some examples from commercialized robots and new robot development projects related to rehabilitation are introduced. Most of the commercialized robots presented in this paper are well known especially to robotics engineers and scholars in the robotic field, but are less known to humanities scholars. The field of rehabilitation robot research is expanding; in light of this, some of the current issues and future challenges in rehabilitation robot engineering are recalled, examined and clarified with future directions. This paper is concluded with some recommendations with respect to rehabilitation robots.

Experiments and kinematics analysis of a hand rehabilitation exoskeleton with circuitous joints.

PubMed

Zhang, Fuhai; Fu, Yili; Zhang, Qinchao; Wang, Shuguo

2015-01-01

Aiming at the hand rehabilitation of stroke patients, a wearable hand exoskeleton with circuitous joint is proposed. The circuitous joint adopts the symmetric pinion and rack mechanism (SPRM) with the parallel mechanism. The exoskeleton finger is a serial mechanism composed of three closed-chain SPRM joints in series. The kinematic equations of the open chain of the finger and the closed chains of the SPRM joints were built to analyze the kinematics of the hand rehabilitation exoskeleton. The experimental setup of the hand rehabilitation exoskeleton was built and the continuous passive motion (CPM) rehabilitation experiment and the test of human-robot interaction force measurement were conducted. Experiment results show that the mechanical design of the hand rehabilitation robot is reasonable and that the kinematic analysis is correct, thus the exoskeleton can be used for the hand rehabilitation of stroke patients.

[Robot--a member of (re)habilitation team].

PubMed

Krasnik, Rastislava; Mikov, Aleksandra; Golubović, Spela; Komazec, Zoran; Komazec, Slobodanka Lemajić

2012-01-01

The rehabilitation process involves a whole team of experts who participate in it over a long period oftime. The Intensive development of science and technology has made it possible to design a number of robots which are used for therapeutic purposes and participate in the rehabilitation process. During the long history of technological development of mankind, a number of conceptual and technological solutions for the construction of robots have been known. By using robots in medical rehabilitation it is possible to implement the rehabilitation of peripheral and central motor neurons by increasing the motivation of patients for further recovery and effectiveness of therapy. The paper presents some technological solutions for robot-assisted rehabilitation of patients of different age groups and some possibilities of its use in the treatment. Using robots in standard physiotherapy protocols that involve a number of repetitions, exact dosage, quality design and adaptability to each individual patient leads to the significant progress in the rehabilitation of patients.

Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study.

PubMed

Burres, Stephanie; Edwards, Nancy E; Beck, Alan M; Richards, Elizabeth

2016-11-01

The use of animals in various healthcare settings dates as far back as the 19th century, and is still a widely practiced intervention even today. The use of animals in the acute rehabilitation setting is a common practice that benefits both the patient's therapy progression and allows the opportunity for financial reimbursement for the facility. As acute rehabilitation facilities continue to cope with ever changing rules and guidelines, the use of alternate modalities can help the facility overcome difficult challenges while focusing on the needs of the patients. The use of animal assisted therapy is illustrated with a stroke patient at an acute rehabilitation facility who benefited from implementing a pet therapy regimen when regular therapy modalities were not helping. Incorporating animal assisted therapy in acute rehabilitation settings is described to obtain greater satisfaction for patients and staff and to facilitate reimbursement for rehabilitation settings. © 2016 Association of Rehabilitation Nurses.

23 CFR 661.21 - When is a bridge eligible for rehabilitation?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false When is a bridge eligible for rehabilitation? 661.21... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.21 When is a bridge eligible for rehabilitation? To be eligible for rehabilitation, the bridge must be considered structurally deficient or...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... knowledge of students of the role and responsibilities of the vocational rehabilitation (VR) counselor and of the benefits of counseling in State VR agencies. This priority focuses attention on and intends to strengthen the unique role of rehabilitation educators and State VR agencies in the preparation of qualified...

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...

Benchmarking the Importance and Use of Labor Market Surveys by Certified Rehabilitation Counselors

ERIC Educational Resources Information Center

Barros-Bailey, Mary; Saunders, Jodi L.

2013-01-01

The purpose of this research was to benchmark the importance and use of labor market survey (LMS) among U.S. certified rehabilitation counselors (CRCs). A secondary post hoc analysis of data collected via the "Rehabilitation Skills Inventory--Revised" for the 2011 Commission on Rehabilitation Counselor Certification job analysis resulted in…

Use of Hypnosis in Self-Esteem Building: Review and Model for Rehabilitation.

ERIC Educational Resources Information Center

Klich, Beatriz de M.; Miller, Mary Ball

Hypnotherapeutic approaches in helping physically disabled patients cope with stress and plan further goals during the rehabilitation period are discussed. Several techniques possible in a rehabilitation setting are presented, including integration of ego strengthening and self-esteem building. It is noted that, in rehabilitation, a major goal of…

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Unifying and Elevating Rehabilitation Counseling through Model-Driven, Diversity-Sensitive Evidence-Based Practice

ERIC Educational Resources Information Center

Chan, Fong; Tarvydas, Vilia; Blalock, Kacie; Strauser, David; Atkins, Bobbie J.

2009-01-01

Rehabilitation counseling must embrace an evidence-based practice paradigm to remain a vital and respected member of the future community of professions in rehabilitation and mental health care and to fully discharge its responsibility to assist consumers in accessing effective rehabilitation interventions and exercising truly informed choice. The…

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

ERIC Educational Resources Information Center

McGuire-Kuletz, Maureen; Hergenrather, Kenneth C.

2008-01-01

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

Changes in Vocational Rehabilitation Practice since the 1992 Rehabilitation Act Amendments.

ERIC Educational Resources Information Center

Whitney-Thomas, Jean; Timmons, Jaimie Ciulla; Thomas, Dawna M.; Gilmore, Dana Scott; Fesko, Sheila Lynch

This study sought to understand how the 1992 Rehabilitation Act Amendments have been implemented and whether practices since its passage have changed from the perspectives of vocational rehabilitation administrators and counselors as of 1996. Through the use of a national, cross-sectional survey, data were collected from 251 administrators and 254…

34 CFR 350.10 - What are the general requirements for Disability and Rehabilitation Research Projects?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Rehabilitation Research Projects? 350.10 Section 350.10 Education Regulations of the Offices of the Department of... DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does the Secretary Assist? § 350.10 What are the general requirements for Disability and Rehabilitation Research Projects...

The Rehabilitation Counselor Scale: A New Scale for the Revised Strong Interest Inventory

ERIC Educational Resources Information Center

Leierer, Stephen J.; Strohmer, Douglas C.; Blackwell, Terry L.; Thompson, Richard C.; Donnay, David A. C.

2008-01-01

The vocational interests of rehabilitation counselors were explored by developing an occupational scale for the "Strong Interest Inventory, Revised Edition" (SII; 2004). A sample of 414 rehabilitation counselors who were satisfied with rehabilitation counseling as their profession completed an experimental version of the SII. Based on these data,…

Rehabilitation Counselor Education Students' Career Goals: A Partial Replication Study

ERIC Educational Resources Information Center

Chapin, Martha H.; Goodwin, Lloyd R., Jr.

2006-01-01

Rehabilitation counselor education (RCE) students from one RCE program in the Southeastern region of the United States were surveyed in 1993 and 2003 to determine their career goals and if career goals changed a decade later. Other goals were to assess influencing factors for entering rehabilitation counseling or rehabilitation related professions…

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Code of Federal Regulations, 2010 CFR

2010-04-01

... rehabilitation of an existing building or to new construction shall be based upon all the facts and circumstances... a credit is first claimed for qualified rehabilitation expenditures with respect to such buildings... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified rehabilitated building; expenditures...

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Code of Federal Regulations, 2012 CFR

2012-04-01

... rehabilitation of an existing building or to new construction shall be based upon all the facts and circumstances... a credit is first claimed for qualified rehabilitation expenditures with respect to such buildings... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Qualified rehabilitated building; expenditures...

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Code of Federal Regulations, 2011 CFR

2011-04-01

... rehabilitation of an existing building or to new construction shall be based upon all the facts and circumstances... a credit is first claimed for qualified rehabilitation expenditures with respect to such buildings... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Qualified rehabilitated building; expenditures...

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Code of Federal Regulations, 2014 CFR

2014-04-01

... rehabilitation of an existing building or to new construction shall be based upon all the facts and circumstances... a credit is first claimed for qualified rehabilitation expenditures with respect to such buildings... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Qualified rehabilitated building; expenditures...

26 CFR 1.48-12 - Qualified rehabilitated building; expenditures incurred after December 31, 1981.

Code of Federal Regulations, 2013 CFR

2013-04-01

... rehabilitation of an existing building or to new construction shall be based upon all the facts and circumstances... a credit is first claimed for qualified rehabilitation expenditures with respect to such buildings... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Qualified rehabilitated building; expenditures...

The History and Development of the Alabama Division of the American Rehabilitation Counseling Association

ERIC Educational Resources Information Center

Templeton, Mary Anne

2007-01-01

The Alabama Division of the American Rehabilitation Association is an organization committed to representing those counselors who work in the field of rehabilitation across the state. The division is focused on offering leadership within the field of rehabilitation counseling, promoting professional development opportunities for counselors, and…