Pub Date : 2018-04-01DOI: 10.1177/1179572718765138
A. Zissler, W. Stoiber, S. Pittner, A. Sänger
Objectives: We provide a systematic review of the literature to identify clinical studies assessing the effects of extracorporeal shock wave therapy (ESWT) on acutely injured tissues of human subjects, also highlighting the biological mechanisms by which the technique is proposed to promote the processes of early tissue repair. Special attention is also paid to the progress of research in animal models. Method: A systematic review of the literature on ESWT of acute injuries of bone and soft tissue as available in the PubMed/MEDLINE, Cochrane CENTRAL, SPORTDiscus, and CINAHL databases up to December 2017 was conducted. Results: A total of 10 studies were included. There is some evidence for the application of ESWT in an early postacute injury phase. Most studies report benefits with no or minimal side effects. However, different types of treated tissues and wounds (varying cause and severity) and resulting heterogeneity in study design and outcome measurement make it difficult to compare studies. The picture of knowledge remains limited by an apparent lack of data on optimal treatment timing and on tissue- and injury-specific parameters. Conclusions: Although the amount of studies to date is still limited, recent clinical research has presented first successful steps to introduce ESWT as a means of treatment in acute injury care. Therefore, on the basis of the analyzed data, further testing is encouraged to validate optimal timing, physical settings, and possible long-term effects to exclude potential risks.
{"title":"Extracorporeal Shock Wave Therapy in Acute Injury Care: A Systematic Review","authors":"A. Zissler, W. Stoiber, S. Pittner, A. Sänger","doi":"10.1177/1179572718765138","DOIUrl":"https://doi.org/10.1177/1179572718765138","url":null,"abstract":"Objectives: We provide a systematic review of the literature to identify clinical studies assessing the effects of extracorporeal shock wave therapy (ESWT) on acutely injured tissues of human subjects, also highlighting the biological mechanisms by which the technique is proposed to promote the processes of early tissue repair. Special attention is also paid to the progress of research in animal models. Method: A systematic review of the literature on ESWT of acute injuries of bone and soft tissue as available in the PubMed/MEDLINE, Cochrane CENTRAL, SPORTDiscus, and CINAHL databases up to December 2017 was conducted. Results: A total of 10 studies were included. There is some evidence for the application of ESWT in an early postacute injury phase. Most studies report benefits with no or minimal side effects. However, different types of treated tissues and wounds (varying cause and severity) and resulting heterogeneity in study design and outcome measurement make it difficult to compare studies. The picture of knowledge remains limited by an apparent lack of data on optimal treatment timing and on tissue- and injury-specific parameters. Conclusions: Although the amount of studies to date is still limited, recent clinical research has presented first successful steps to introduce ESWT as a means of treatment in acute injury care. Therefore, on the basis of the analyzed data, further testing is encouraged to validate optimal timing, physical settings, and possible long-term effects to exclude potential risks.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572718765138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43514014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-22DOI: 10.1177/1179572718761379
J. Neal, Samman Shahpar, G. Spill, P. Semik, C. Marciniak
Objectives: To determine incidence of bleeding in thrombocytopenic patients with cancer undergoing acute inpatient rehabilitation. Design: This is an observational cross-sectional retrospective study. Setting: Acute inpatient academic rehabilitation facility. Participants: Adult patients admitted to acute inpatient rehabilitation with functional impairments secondary to cancer. Methods: Electronic records were reviewed for thrombocytopenic patients with cancer to determine platelet counts, bleeding events during rehabilitation, and anticoagulant medications prescribed. Main outcomes measurements: Type and number of bleeding events, severity of bleeding by World Health Organization criteria. Results: Of the 278 patients with cancer admitted to acute rehabilitation over a 27-month time frame, 119 had at least one platelet count <150 000/µL. In all, 37 (31.1%) had a history of a bleeding event prior to the rehabilitation admission and 34 (28.6%) had at least one bleeding complication during their stay. Most events (87.5%) were of low grade (Grade 1 and 2 World Health Organization criteria). There was no association between platelet counts <11 000 or counts 11 000 to 20 000/µL and the occurrence of bleeding (P = .106 and P = .319, respectively). Although anticoagulants were common, there was no association found with a bleeding event and either anticoagulation status (receiving or not on such agents), specific anticoagulant or antiplatelet agents, or a combination. Conclusions: Bleeding events in patients with cancer with thrombocytopenia during acute rehabilitation stay are not uncommon but are typically mild in severity and not associated with the degree of thrombocytopenia. Patients taking anticoagulants when platelet levels rose did experience bleeding events, but not at a statistically greater rate than those not taking such medications.
{"title":"Bleeding Events in Thrombocytopenic Patients With Cancer Undergoing Acute Rehabilitation","authors":"J. Neal, Samman Shahpar, G. Spill, P. Semik, C. Marciniak","doi":"10.1177/1179572718761379","DOIUrl":"https://doi.org/10.1177/1179572718761379","url":null,"abstract":"Objectives: To determine incidence of bleeding in thrombocytopenic patients with cancer undergoing acute inpatient rehabilitation. Design: This is an observational cross-sectional retrospective study. Setting: Acute inpatient academic rehabilitation facility. Participants: Adult patients admitted to acute inpatient rehabilitation with functional impairments secondary to cancer. Methods: Electronic records were reviewed for thrombocytopenic patients with cancer to determine platelet counts, bleeding events during rehabilitation, and anticoagulant medications prescribed. Main outcomes measurements: Type and number of bleeding events, severity of bleeding by World Health Organization criteria. Results: Of the 278 patients with cancer admitted to acute rehabilitation over a 27-month time frame, 119 had at least one platelet count <150 000/µL. In all, 37 (31.1%) had a history of a bleeding event prior to the rehabilitation admission and 34 (28.6%) had at least one bleeding complication during their stay. Most events (87.5%) were of low grade (Grade 1 and 2 World Health Organization criteria). There was no association between platelet counts <11 000 or counts 11 000 to 20 000/µL and the occurrence of bleeding (P = .106 and P = .319, respectively). Although anticoagulants were common, there was no association found with a bleeding event and either anticoagulation status (receiving or not on such agents), specific anticoagulant or antiplatelet agents, or a combination. Conclusions: Bleeding events in patients with cancer with thrombocytopenia during acute rehabilitation stay are not uncommon but are typically mild in severity and not associated with the degree of thrombocytopenia. Patients taking anticoagulants when platelet levels rose did experience bleeding events, but not at a statistically greater rate than those not taking such medications.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572718761379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41330368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-16DOI: 10.1177/1179572717745836
D. Lala, P. Houghton, P. Holyoke, D. Wolfe
Objectives: To apply a modified ADAPTE process to adapt best practices to a local context for successful implementation of electrical stimulation therapy (EST) for treating pressure injuries in persons with spinal cord injury (SCI). Participants: An expert team of health care professionals and a consumer participated in a 2-day workshop to assist in the development of the locally adapted EST document in Southwest Ontario, Canada. Results: A process map illustrating the flow of activities to initiate EST for treating pressure injuries in persons with SCI based on the challenges and opportunities existing within this region was created. The team also developed a summary of roles and responsibilities delineating tasks specific to providing EST and identified a set of challenges likely to be encountered. Conclusions: The modified ADAPTE process provided a clear and flexible structure to adaptation when used for implementation planning. This article shares some challenges associated with using this process for local adaptation and shares strategies of improvement for future studies aimed at adapting a practice to their local environment.
{"title":"Using a Modified ADAPTE Process to Enable Effective Implementation of Electrical Stimulation Therapy for Treating Pressure Ulcers in Persons With Spinal Cord Injury","authors":"D. Lala, P. Houghton, P. Holyoke, D. Wolfe","doi":"10.1177/1179572717745836","DOIUrl":"https://doi.org/10.1177/1179572717745836","url":null,"abstract":"Objectives: To apply a modified ADAPTE process to adapt best practices to a local context for successful implementation of electrical stimulation therapy (EST) for treating pressure injuries in persons with spinal cord injury (SCI). Participants: An expert team of health care professionals and a consumer participated in a 2-day workshop to assist in the development of the locally adapted EST document in Southwest Ontario, Canada. Results: A process map illustrating the flow of activities to initiate EST for treating pressure injuries in persons with SCI based on the challenges and opportunities existing within this region was created. The team also developed a summary of roles and responsibilities delineating tasks specific to providing EST and identified a set of challenges likely to be encountered. Conclusions: The modified ADAPTE process provided a clear and flexible structure to adaptation when used for implementation planning. This article shares some challenges associated with using this process for local adaptation and shares strategies of improvement for future studies aimed at adapting a practice to their local environment.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572717745836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47737467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-28DOI: 10.1177/1179572717734204
G. Kingston
A traumatic hand injury can involve damage to a number of structures including skin, nerves, tendons, muscle bone, and soft tissue. Impairments such as pain or stiffness and loss of range of motion can last for many years and result in a moderate to extreme impact on a person’s day-to-day life. Work, leisure, financial security, and emotional well-being often most affected. This commentary provides an analysis of those factors that inhibit (barriers) and support (enablers) the provision of hand therapy rehabilitation in rural and remote areas. Providing a collaborative and flexible rehabilitation programme to rural and remote residents following a traumatic hand injury can be seen as a challenge due to issues such as a limited access to health care services. Established protocols that work in regional or metropolitan locations are unlikely to be effective and innovative and pragmatic strategies are required. The provision of a collaborative and flexible rehabilitation programme regardless of residential location is an important part of the therapist’s intervention plan.
{"title":"Commentary: Rehabilitation for Rural and Remote Residents Following a Traumatic Hand Injury *","authors":"G. Kingston","doi":"10.1177/1179572717734204","DOIUrl":"https://doi.org/10.1177/1179572717734204","url":null,"abstract":"A traumatic hand injury can involve damage to a number of structures including skin, nerves, tendons, muscle bone, and soft tissue. Impairments such as pain or stiffness and loss of range of motion can last for many years and result in a moderate to extreme impact on a person’s day-to-day life. Work, leisure, financial security, and emotional well-being often most affected. This commentary provides an analysis of those factors that inhibit (barriers) and support (enablers) the provision of hand therapy rehabilitation in rural and remote areas. Providing a collaborative and flexible rehabilitation programme to rural and remote residents following a traumatic hand injury can be seen as a challenge due to issues such as a limited access to health care services. Established protocols that work in regional or metropolitan locations are unlikely to be effective and innovative and pragmatic strategies are required. The provision of a collaborative and flexible rehabilitation programme regardless of residential location is an important part of the therapist’s intervention plan.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572717734204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45779999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-25DOI: 10.1177/1179572717732996
Gagan Bajaj, M. Anil, A. Varghese, J. Bhat, Pooja Sheth, Anjana Hoode
Purpose: A common question encountered by speech-language pathologists while dealing with adults who stutter (AWS) is whether their disclosure of stuttering to listeners would change their perception. The purpose of this study was to assess the impact of self-disclosure and speaker sex on adult listeners’ perceptions of simulated stuttering. Method: The study involved a group of 100 college students between the age range of 18 and 25 years, who judged the videotaped speech samples of 1 male and 1 female person, who simulated stuttering in disclosed and undisclosed state. The listener perception was evaluated through a questionnaire developed for the purpose. Results: The trends suggested that a female AWS possessed overall better listener perception as compared with male AWS in undisclosed condition and received better perception by listeners in more domains than male AWS in disclosed state. Conclusions: Listener perception seems to be a sex-specific phenomenon which gets affected by one’s disclosure about stuttering and the culture of the listeners.
{"title":"Me, My Stuttering, and Them! Effect of Self-Disclosure of Stuttering on Listener Perception","authors":"Gagan Bajaj, M. Anil, A. Varghese, J. Bhat, Pooja Sheth, Anjana Hoode","doi":"10.1177/1179572717732996","DOIUrl":"https://doi.org/10.1177/1179572717732996","url":null,"abstract":"Purpose: A common question encountered by speech-language pathologists while dealing with adults who stutter (AWS) is whether their disclosure of stuttering to listeners would change their perception. The purpose of this study was to assess the impact of self-disclosure and speaker sex on adult listeners’ perceptions of simulated stuttering. Method: The study involved a group of 100 college students between the age range of 18 and 25 years, who judged the videotaped speech samples of 1 male and 1 female person, who simulated stuttering in disclosed and undisclosed state. The listener perception was evaluated through a questionnaire developed for the purpose. Results: The trends suggested that a female AWS possessed overall better listener perception as compared with male AWS in undisclosed condition and received better perception by listeners in more domains than male AWS in disclosed state. Conclusions: Listener perception seems to be a sex-specific phenomenon which gets affected by one’s disclosure about stuttering and the culture of the listeners.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572717732996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43703790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-21DOI: 10.1177/1179572717711433
Clare L. Clarke, M. Witham
Multiple medication use, or polypharmacy, is common in people undergoing rehabilitation. Polypharmacy is also common in older people, where it has the potential to impact on habitual physical activity. Despite this, the interactions between medication, disease, activity, and rehabilitation outcomes are insufficiently researched. In this review, we consider common classes of medications that can affect physical activity levels and outcomes of rehabilitation. We consider medications that improve disease processes and improve limiting symptoms (eg, breathlessness in heart failure and lung disease, pain in arthritis), unwanted side effects of medications (eg, central slowing caused by opioids and hypnotics), and also medication classes that might have the ability to improve activity and rehabilitation outcomes via beneficial effects on neuromuscular function (eg, angiotensin-converting enzyme inhibitors). We conclude by giving practical advice on how to review and optimise medication use to support habitual physical activity and ensure the best results from rehabilitation.
{"title":"The Effects of Medication on Activity and Rehabilitation of Older People – Opportunities and Risks","authors":"Clare L. Clarke, M. Witham","doi":"10.1177/1179572717711433","DOIUrl":"https://doi.org/10.1177/1179572717711433","url":null,"abstract":"Multiple medication use, or polypharmacy, is common in people undergoing rehabilitation. Polypharmacy is also common in older people, where it has the potential to impact on habitual physical activity. Despite this, the interactions between medication, disease, activity, and rehabilitation outcomes are insufficiently researched. In this review, we consider common classes of medications that can affect physical activity levels and outcomes of rehabilitation. We consider medications that improve disease processes and improve limiting symptoms (eg, breathlessness in heart failure and lung disease, pain in arthritis), unwanted side effects of medications (eg, central slowing caused by opioids and hypnotics), and also medication classes that might have the ability to improve activity and rehabilitation outcomes via beneficial effects on neuromuscular function (eg, angiotensin-converting enzyme inhibitors). We conclude by giving practical advice on how to review and optimise medication use to support habitual physical activity and ensure the best results from rehabilitation.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572717711433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41603169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-15DOI: 10.1177/1179572717715433
A. Loyola-Sanchez, J. Richardson, I. Peláez-Ballestas, J. Alvarez-Nemegyei, J. Lavis, Michael G. Wilson, S. Wilkins
Objectives: To assess the physical function of people living with osteoarthritis in a Maya-Yucateco rural community from 3 perspectives and explore factors associated with the presence of disability. Design: Physical function and social, physical, psychological, and behavioral factors were evaluated in all adults detected with hand, hip, and/or knee osteoarthritis (n = 144) through a Community-Oriented Program for the Control of Rheumatic Diseases–based census in the Mayan community of Chankom, Yucatán. All cases fulfilled the American College of Rheumatology criteria. Physical function was assessed from 3 perspectives: hypothetical or “what people think they can do” (Health Assessment Questionnaire-Disability Index [HAQ-DI]), experimental or “what people could do in standardized conditions” (6-minute walk test [6MWT] + the Functional Dexterity Test) and enacted or “what people actually do” (personal care, work, and leisure activities’ self-report). Results: About 80% of participants reported “mild” disability (HAQ-DI ≤ 1) in the hypothetical function perspective, whereas average experimental function scores were low (6MWT: 206 m, Functional Dexterity Test: 64 seconds), and 78% of participants reported problems with enacted function (ie, work). Pain was significantly associated with disability in the hypothetical perspective (odds ratio [OR] = 3 [95% confidence interval [CI]: 1-4]); levels of wealth (β = 5 [95% CI: 1-9]) and muscle strength (β = 54 [95% CI: 20-87]) were significantly associated with functioning in the experimental perspective; and lower levels of self-efficacy (OR = 12 [95% CI: 6-27]) and physical activity (OR = 12 [95% CI: 6-27]) were significantly associated with work disability in the enacted function perspective. Conclusions: People living with osteoarthritis in Chankom show important issues when assessing physical function at the experimental and enacted perspectives, which could have been overlooked if only the hypothetical perspective was considered. Different factors were associated with different physical function perspectives and all should be addressed to decrease disability in this community.
{"title":"Physical Function Assessment of a Mayan Population Living With Osteoarthritis: The Importance of Considering Different Aspects of Functioning","authors":"A. Loyola-Sanchez, J. Richardson, I. Peláez-Ballestas, J. Alvarez-Nemegyei, J. Lavis, Michael G. Wilson, S. Wilkins","doi":"10.1177/1179572717715433","DOIUrl":"https://doi.org/10.1177/1179572717715433","url":null,"abstract":"Objectives: To assess the physical function of people living with osteoarthritis in a Maya-Yucateco rural community from 3 perspectives and explore factors associated with the presence of disability. Design: Physical function and social, physical, psychological, and behavioral factors were evaluated in all adults detected with hand, hip, and/or knee osteoarthritis (n = 144) through a Community-Oriented Program for the Control of Rheumatic Diseases–based census in the Mayan community of Chankom, Yucatán. All cases fulfilled the American College of Rheumatology criteria. Physical function was assessed from 3 perspectives: hypothetical or “what people think they can do” (Health Assessment Questionnaire-Disability Index [HAQ-DI]), experimental or “what people could do in standardized conditions” (6-minute walk test [6MWT] + the Functional Dexterity Test) and enacted or “what people actually do” (personal care, work, and leisure activities’ self-report). Results: About 80% of participants reported “mild” disability (HAQ-DI ≤ 1) in the hypothetical function perspective, whereas average experimental function scores were low (6MWT: 206 m, Functional Dexterity Test: 64 seconds), and 78% of participants reported problems with enacted function (ie, work). Pain was significantly associated with disability in the hypothetical perspective (odds ratio [OR] = 3 [95% confidence interval [CI]: 1-4]); levels of wealth (β = 5 [95% CI: 1-9]) and muscle strength (β = 54 [95% CI: 20-87]) were significantly associated with functioning in the experimental perspective; and lower levels of self-efficacy (OR = 12 [95% CI: 6-27]) and physical activity (OR = 12 [95% CI: 6-27]) were significantly associated with work disability in the enacted function perspective. Conclusions: People living with osteoarthritis in Chankom show important issues when assessing physical function at the experimental and enacted perspectives, which could have been overlooked if only the hypothetical perspective was considered. Different factors were associated with different physical function perspectives and all should be addressed to decrease disability in this community.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179572717715433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45455487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Kuptniratsaikul, P. Wattanapan, Ubonwon Wathanadilokul, K. Sukonthamarn, Pranee Lukkanapichonchut, K. Ingkasuthi, P. Massakulpan, J. Klaphajone, S. Suethanapornkul, Punjama Tunwattanapong, W. Laksanakorn, Pitagorn Thamronglaohaphan, W. Leelasamran, Wuttiganok Wangno
Objective To investigate the effectiveness and efficiency of inpatient rehabilitation. Methods A total of 2,081 patients across 14 hospitals were recruited in this prospective, multicenter cohort study. Data on the diagnoses, types of admission, length of stay (LOS), and functional ability score based on a modified Barthel index (BI) at admission (BIa) and at discharge (BId) were collected. Effectiveness was defined as the difference of BI (ΔBI) and efficiency as ΔBI divided by LOS. Results The majority of patients were diagnosed with spinal cord injury and stroke (41.8% and 37.5%, respectively). The mean age was 52.4 ± 18.6 years with a mean LOS of 23.9 ± 19.9 days, BIa of 9.4 ± 6.1, and BId of 12.3 ± 5.7. The overall effectiveness and efficiency were 2.9 ± 3.4 and 0.16 ± 0.30 scores/day, respectively; stroke rehabilitation provided the most effective and efficient BI improvement compared with rehabilitation for other diseases. Most patients (54.5%) received intensive functional rehabilitation, which was the most effective and efficient program (4.4 ± 3.6 and 0.23 ± 0.32 scores/day, respectively); the efficiency of the intensive program was not different among various diseases (P = 0.726). Conclusion Stroke rehabilitation had the highest efficiency compared with rehabilitation for other neurological diseases. The most efficient type of admission was intensive rehabilitation, regardless of the disease being treated.
{"title":"The Effectiveness and Efficiency of Inpatient Rehabilitation Services in Thailand: A Prospective Multicenter Study","authors":"V. Kuptniratsaikul, P. Wattanapan, Ubonwon Wathanadilokul, K. Sukonthamarn, Pranee Lukkanapichonchut, K. Ingkasuthi, P. Massakulpan, J. Klaphajone, S. Suethanapornkul, Punjama Tunwattanapong, W. Laksanakorn, Pitagorn Thamronglaohaphan, W. Leelasamran, Wuttiganok Wangno","doi":"10.4137/RPO.S34816","DOIUrl":"https://doi.org/10.4137/RPO.S34816","url":null,"abstract":"Objective To investigate the effectiveness and efficiency of inpatient rehabilitation. Methods A total of 2,081 patients across 14 hospitals were recruited in this prospective, multicenter cohort study. Data on the diagnoses, types of admission, length of stay (LOS), and functional ability score based on a modified Barthel index (BI) at admission (BIa) and at discharge (BId) were collected. Effectiveness was defined as the difference of BI (ΔBI) and efficiency as ΔBI divided by LOS. Results The majority of patients were diagnosed with spinal cord injury and stroke (41.8% and 37.5%, respectively). The mean age was 52.4 ± 18.6 years with a mean LOS of 23.9 ± 19.9 days, BIa of 9.4 ± 6.1, and BId of 12.3 ± 5.7. The overall effectiveness and efficiency were 2.9 ± 3.4 and 0.16 ± 0.30 scores/day, respectively; stroke rehabilitation provided the most effective and efficient BI improvement compared with rehabilitation for other diseases. Most patients (54.5%) received intensive functional rehabilitation, which was the most effective and efficient program (4.4 ± 3.6 and 0.23 ± 0.32 scores/day, respectively); the efficiency of the intensive program was not different among various diseases (P = 0.726). Conclusion Stroke rehabilitation had the highest efficiency compared with rehabilitation for other neurological diseases. The most efficient type of admission was intensive rehabilitation, regardless of the disease being treated.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/RPO.S34816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70714234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The World Health Organization's International Classification of Functioning, Disability and Health identifies environmental and personal factors as contextually relevant to functioning following disability. Goal setting is also central to rehabilitation practice and enhances functioning. No current assessment exists that recognizes the interaction of environmental factors as they relate to goal setting in rehabilitation. The person-environment profile (PEP) was developed to explore an individual's subjective view of personal and environmental factors on the achievement of rehabilitation goals. A draft PEP underwent initial face validity testing, and the resulting version was then piloted with 13 participants across 34 rehabilitation goals within a goal-based community rehabilitation setting. Results of this pilot suggest that PEP may have the ability to detect differences in perceived barriers and facilitators across personal and environmental factors for different rehabilitation goals. While showing promise as a clinical tool, the pilot identified feasibility concerns over implementation as a standardized assessment. Substantial additional psychometric evaluation and testing needs to be undertaken before the tool can be recommended for clinical use.
{"title":"The Person-Environment Profile: Preliminary Development of a Clinical Tool for Enhancing Goal-Based Rehabilitation Programs","authors":"D. Amsters, M. Kendall, P. Kuipers, S. Schuurs","doi":"10.4137/RPO.S40455","DOIUrl":"https://doi.org/10.4137/RPO.S40455","url":null,"abstract":"The World Health Organization's International Classification of Functioning, Disability and Health identifies environmental and personal factors as contextually relevant to functioning following disability. Goal setting is also central to rehabilitation practice and enhances functioning. No current assessment exists that recognizes the interaction of environmental factors as they relate to goal setting in rehabilitation. The person-environment profile (PEP) was developed to explore an individual's subjective view of personal and environmental factors on the achievement of rehabilitation goals. A draft PEP underwent initial face validity testing, and the resulting version was then piloted with 13 participants across 34 rehabilitation goals within a goal-based community rehabilitation setting. Results of this pilot suggest that PEP may have the ability to detect differences in perceived barriers and facilitators across personal and environmental factors for different rehabilitation goals. While showing promise as a clinical tool, the pilot identified feasibility concerns over implementation as a standardized assessment. Substantial additional psychometric evaluation and testing needs to be undertaken before the tool can be recommended for clinical use.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/RPO.S40455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70714542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Froehlich-Grobe, S. Driver, Katherine D. Sanches
Introduction This focused review examines the use and effectiveness of self-management strategies in preventing or managing pain, which is among the most common secondary conditions faced by individuals with a mobility disability. Methods This focused review was part of a two-phase comprehensive scoping review. Phase I was a comprehensive scoping review of the literature targeting multiple outcomes of self-management interventions for those with mobility impairment, and Phase II was a focused review of the literature on self-management interventions that target pain as a primary or secondary outcome. Two authors searched CINAHL, PubMed, and PsyclNFO for papers published from January 1988 through August 2014 using specified search terms. Following the scoping review, the authors independently screened and selected the studies and reviewed the eligible studies, and the first author extracted data from the included studies. Results The scoping review yielded 40 studies that addressed pain self-management interventions for those living with mobility impairment. These 40 accumulated papers revealed a heterogeneous evidence base in terms of setting (clinic, community, and online), target populations, intervention duration (3 weeks to 24 months), and mode (health-care providers and lay leaders). Most of the reviewed studies reported that the self-management intervention led to significant reduction of pain over time, suggesting that self-management may be a promising approach for addressing pain experienced by people who live with mobility limitations. Discussion This review also reveals moderate-to-high bias across studies, and findings indicate that future research should enhance the methodological quality to provide stronger evidence about the effectiveness of self-management strategies for reducing pain among those with mobility impairments.
{"title":"Self-Management Interventions to Prevent the Secondary Condition of Pain in People with Disability Due to Mobility Limitations","authors":"Katherine Froehlich-Grobe, S. Driver, Katherine D. Sanches","doi":"10.4137/RPO.S12339","DOIUrl":"https://doi.org/10.4137/RPO.S12339","url":null,"abstract":"Introduction This focused review examines the use and effectiveness of self-management strategies in preventing or managing pain, which is among the most common secondary conditions faced by individuals with a mobility disability. Methods This focused review was part of a two-phase comprehensive scoping review. Phase I was a comprehensive scoping review of the literature targeting multiple outcomes of self-management interventions for those with mobility impairment, and Phase II was a focused review of the literature on self-management interventions that target pain as a primary or secondary outcome. Two authors searched CINAHL, PubMed, and PsyclNFO for papers published from January 1988 through August 2014 using specified search terms. Following the scoping review, the authors independently screened and selected the studies and reviewed the eligible studies, and the first author extracted data from the included studies. Results The scoping review yielded 40 studies that addressed pain self-management interventions for those living with mobility impairment. These 40 accumulated papers revealed a heterogeneous evidence base in terms of setting (clinic, community, and online), target populations, intervention duration (3 weeks to 24 months), and mode (health-care providers and lay leaders). Most of the reviewed studies reported that the self-management intervention led to significant reduction of pain over time, suggesting that self-management may be a promising approach for addressing pain experienced by people who live with mobility limitations. Discussion This review also reveals moderate-to-high bias across studies, and findings indicate that future research should enhance the methodological quality to provide stronger evidence about the effectiveness of self-management strategies for reducing pain among those with mobility impairments.","PeriodicalId":41347,"journal":{"name":"Rehabilitation Process and Outcome","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/RPO.S12339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70714205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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