Background/Aims Loneliness and social isolation have a negative impact on the health and wellbeing of older adults. The aim of this study was to explore the lived experiences of a group of older adults involved in a range of occupational-focused leisure activities provided by the Weekday Wow Factor, a small social enterprise led by an occupational therapist to understand their perceptions of positive ageing and occupational participation. Methods This small-scale qualitative research project explored the experiences of participants attending a weekly daytime disco that took place in a city centre nightclub. Participants also engaged in a number of other activities offered by the Weekday Wow Factor and discussed these during the focus groups. A total of 26 participants took part in four focus groups, with topics for discussion being informed by the 4D cycle of appreciative enquiry: discovery, dream, design and destiny. Results Three overarching themes with sub-themes were found: mental wellbeing with sub-themes of social isolation, occupational participation and health promotion; inclusivity with sub-themes of positive ageing and community; and engagement with sub-themes of environment, occupational flow and occupational justice. Conclusions Activities that facilitated friendship, a feeling of usefulness and belonging to a community were valued by participants, along with a sense of adventure from a range of activities that are not traditionally associated with older people. These activities need to be easily accessible to the community with implications for public transport and the social prescribing agenda. Occupational justice is important to the provision of community-based resources for older people to promote healthy and active ageing, which contributes to wellbeing.
{"title":"‘Getting old is not all bingo and knitting’. An exploration of positive ageing and occupational participation through engagement with community leisure activities: a qualitative study","authors":"Julie-Anne Lowe, Tracy Collins, Pasna Sallis","doi":"10.12968/ijtr.2022.0170","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0170","url":null,"abstract":"Background/Aims Loneliness and social isolation have a negative impact on the health and wellbeing of older adults. The aim of this study was to explore the lived experiences of a group of older adults involved in a range of occupational-focused leisure activities provided by the Weekday Wow Factor, a small social enterprise led by an occupational therapist to understand their perceptions of positive ageing and occupational participation. Methods This small-scale qualitative research project explored the experiences of participants attending a weekly daytime disco that took place in a city centre nightclub. Participants also engaged in a number of other activities offered by the Weekday Wow Factor and discussed these during the focus groups. A total of 26 participants took part in four focus groups, with topics for discussion being informed by the 4D cycle of appreciative enquiry: discovery, dream, design and destiny. Results Three overarching themes with sub-themes were found: mental wellbeing with sub-themes of social isolation, occupational participation and health promotion; inclusivity with sub-themes of positive ageing and community; and engagement with sub-themes of environment, occupational flow and occupational justice. Conclusions Activities that facilitated friendship, a feeling of usefulness and belonging to a community were valued by participants, along with a sense of adventure from a range of activities that are not traditionally associated with older people. These activities need to be easily accessible to the community with implications for public transport and the social prescribing agenda. Occupational justice is important to the provision of community-based resources for older people to promote healthy and active ageing, which contributes to wellbeing.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134968995","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}
H. J. Gooch, Stephanie P. Jones, Rachel C. Stockley
Therapeutic positioning is believed to enable the achievement of a good postural alignment, optimise rehabilitation and prevent the complications of immobility. It is considered important in the management of people with physical neurological impairments, but achieving a favourable position in a bed can be challenging. There is little evidence to inform present practice. Therefore, this study explored staff views and experiences of bed positioning practice on a regional neurological rehabilitation unit. Face-to-face, semi-structured interviews were completed with a purposive sample of nurses, physiotherapists and occupational therapists working on a neurological rehabilitation unit. The interviews were audio recorded, transcribed and analysed using inductive thematic analysis. A total of 12 participants completed an interview and six themes were identified relating to positioning practice. An interaction of four of these themes (patient needs, staff role, communication and knowledge) influenced a fifth theme of staff experiences. The sixth theme of practical positioning resources identified a pattern of resource use within current practice. Positioning was recognised as integral to rehabilitation, and staff experiences were influenced by the interaction of a range of factors. The participants’ views and experiences around practical positioning resources provide a valuable new insight into positioning practice. Further research is needed to evaluate these resources.
{"title":"Evaluating the current practice of therapeutic positioning in neurological rehabilitation: a qualitative interview study","authors":"H. J. Gooch, Stephanie P. Jones, Rachel C. Stockley","doi":"10.12968/ijtr.2022.0016","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0016","url":null,"abstract":"Therapeutic positioning is believed to enable the achievement of a good postural alignment, optimise rehabilitation and prevent the complications of immobility. It is considered important in the management of people with physical neurological impairments, but achieving a favourable position in a bed can be challenging. There is little evidence to inform present practice. Therefore, this study explored staff views and experiences of bed positioning practice on a regional neurological rehabilitation unit. Face-to-face, semi-structured interviews were completed with a purposive sample of nurses, physiotherapists and occupational therapists working on a neurological rehabilitation unit. The interviews were audio recorded, transcribed and analysed using inductive thematic analysis. A total of 12 participants completed an interview and six themes were identified relating to positioning practice. An interaction of four of these themes (patient needs, staff role, communication and knowledge) influenced a fifth theme of staff experiences. The sixth theme of practical positioning resources identified a pattern of resource use within current practice. Positioning was recognised as integral to rehabilitation, and staff experiences were influenced by the interaction of a range of factors. The participants’ views and experiences around practical positioning resources provide a valuable new insight into positioning practice. Further research is needed to evaluate these resources.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48704848","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}
Hypermobility spectrum disorders and hypermobile Ehlers–Danlos syndrome are multisystem, connective tissue disorders, associated with problems such as joint hyperextensibility, tissue fragility, poor proprioception and pain. Fabric orthoses might improve proprioception and assist with joint protection. No previous research has investigated this possibility. This study aimed to explore the perceptions and experiences of experts with experience of fabric orthoses who have used fabric orthoses with individuals with hypermobility spectrum disorders and hypermobile Ehlers–Danlos syndrome. A total of six experts in fabric orthoses and hypermobility spectrum disorders/hypermobile Ehlers–Danlos syndrome participated in semi-structured interviews. A thematic analysis was undertaken by two analysers. Themes were validated with a member checking exercise involving three of the original participants. Three themes were identified. The first theme, ‘it is immediate’, described the reported positive effects when the orthosis is first donned. The second theme described a proposed mechanism of effect in which improved proprioception and realignment work together to support improved joint stability. The third theme, ‘tips for success’, captured ways in which effectiveness and acceptability are maximised, with importance ascribed to collaborative assessment. Fabric orthoses have the potential to be effective in people with hypermobile Ehlers–Danlos syndrome or hypermobility spectrum disorders. This study is to inform futher research into the use of fabric orthoses. Further research could prioritise short-term effect, using mixed methods to explore users’ experiences alongside measures of pain, joint stability and function. Crossover studies could compare custom-made orthoses vs off-the-shelf, or orthoses with directional support vs compression alone. If short-term studies support effectiveness and acceptability, longer-term studies could include the role of fabric orthoses in prevention of disability.
{"title":"Perceptions and experiences of allied health professionals of fabric orthoses for people with joint hypermobility syndromes: a qualitative study","authors":"N. Snowdon, Sakina A Dadla","doi":"10.12968/ijtr.2022.0148","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0148","url":null,"abstract":"Hypermobility spectrum disorders and hypermobile Ehlers–Danlos syndrome are multisystem, connective tissue disorders, associated with problems such as joint hyperextensibility, tissue fragility, poor proprioception and pain. Fabric orthoses might improve proprioception and assist with joint protection. No previous research has investigated this possibility. This study aimed to explore the perceptions and experiences of experts with experience of fabric orthoses who have used fabric orthoses with individuals with hypermobility spectrum disorders and hypermobile Ehlers–Danlos syndrome. A total of six experts in fabric orthoses and hypermobility spectrum disorders/hypermobile Ehlers–Danlos syndrome participated in semi-structured interviews. A thematic analysis was undertaken by two analysers. Themes were validated with a member checking exercise involving three of the original participants. Three themes were identified. The first theme, ‘it is immediate’, described the reported positive effects when the orthosis is first donned. The second theme described a proposed mechanism of effect in which improved proprioception and realignment work together to support improved joint stability. The third theme, ‘tips for success’, captured ways in which effectiveness and acceptability are maximised, with importance ascribed to collaborative assessment. Fabric orthoses have the potential to be effective in people with hypermobile Ehlers–Danlos syndrome or hypermobility spectrum disorders. This study is to inform futher research into the use of fabric orthoses. Further research could prioritise short-term effect, using mixed methods to explore users’ experiences alongside measures of pain, joint stability and function. Crossover studies could compare custom-made orthoses vs off-the-shelf, or orthoses with directional support vs compression alone. If short-term studies support effectiveness and acceptability, longer-term studies could include the role of fabric orthoses in prevention of disability.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45813656","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}
In this editorial, Massimiliano Polastri and Justyna Swol discuss the need for health professionals who help to mobilise patients who have experienced prolonged bed rest.
{"title":"Implementing lift teams in respiratory care settings: a luxury or a necessity?","authors":"M. Polastri, J. Swol","doi":"10.12968/ijtr.2023.0072","DOIUrl":"https://doi.org/10.12968/ijtr.2023.0072","url":null,"abstract":"In this editorial, Massimiliano Polastri and Justyna Swol discuss the need for health professionals who help to mobilise patients who have experienced prolonged bed rest.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42451574","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}
Fibromyalgia is a complex syndrome characterised by chronic widespread pain, postural problems, sleep disorders, fatigue and psychiatric disorders. This study investigated the effect of scapular stabilisation exercises on cervical posture and pain in patients with fibromyalgia. The study included 59 patients between the ages of 18–60 years. Individuals were divided into two groups: the study group (n=29) and control group (n=30). Both groups underwent hot pack application, transcutaneous electrical nerve stimulation and ultrasonography before the exercises. This application continued for a total of 6 weeks in both groups, 5 days a week. After this treatment, the control group was asked to perform conventional shoulder exercises and the scapular stabilisation group was asked to perform scapular stabilisation exercises. The patients were evaluated in terms of pain and cervical posture. Pain levels significantly decreased in both groups after the treatment (P=0.019). A decrease in tragus-to-wall distance occurred in the conventional exercise group (P=0.005). Scapular stabilisation exercises were found to be more effective than conventional exercises In terms of pain (P<0.001) and cervical posture, (P=0.024). Both exercise programmes reduced pain levels in patients with fibromyalgia. However, scapular stabilisation exercises were more effective at both reducing pain and improving posture. Physiotherapists can use scapular stabilisation exercises to patients with fibromyalgia to reduce pain, improve posture and reduce the load on the joints.
{"title":"The effect of scapular stabilisation exercises on posture and pain in patients with fibromyalgia: a randomised controlled trial","authors":"H. Polat, K. Bayramlar, Begümhan Turhan","doi":"10.12968/ijtr.2022.0094","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0094","url":null,"abstract":"Fibromyalgia is a complex syndrome characterised by chronic widespread pain, postural problems, sleep disorders, fatigue and psychiatric disorders. This study investigated the effect of scapular stabilisation exercises on cervical posture and pain in patients with fibromyalgia. The study included 59 patients between the ages of 18–60 years. Individuals were divided into two groups: the study group (n=29) and control group (n=30). Both groups underwent hot pack application, transcutaneous electrical nerve stimulation and ultrasonography before the exercises. This application continued for a total of 6 weeks in both groups, 5 days a week. After this treatment, the control group was asked to perform conventional shoulder exercises and the scapular stabilisation group was asked to perform scapular stabilisation exercises. The patients were evaluated in terms of pain and cervical posture. Pain levels significantly decreased in both groups after the treatment (P=0.019). A decrease in tragus-to-wall distance occurred in the conventional exercise group (P=0.005). Scapular stabilisation exercises were found to be more effective than conventional exercises In terms of pain (P<0.001) and cervical posture, (P=0.024). Both exercise programmes reduced pain levels in patients with fibromyalgia. However, scapular stabilisation exercises were more effective at both reducing pain and improving posture. Physiotherapists can use scapular stabilisation exercises to patients with fibromyalgia to reduce pain, improve posture and reduce the load on the joints.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46985428","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}
Timothy P Sheehy, Karol A. Connors, Christine Wools
Neck weakness and head drop can occur in individuals with motor neurone disease, further contributing to disability and lower quality of life. The aims of this study were to explore the characteristics of neck weakness in motor neurone disease and the different types of head support used by patients. A cross-sectional study was performed, where 33 participants with motor neurone disease-related neck weakness answered a 17-item questionnaire. The questions covered their neck weakness and the types of head support they used at the time. All participants reported that their quality of life was negatively impacted by their neck weakness. Of the participants, 51.5% reported forward head drop and 42.4% reported that their head dropped both forward and to the side. The most common head support strategy was tilting their chair backwards, followed by the soft neck collar and a rigid collar (Aspen Vista). The majority used either two or three head support strategies in a given day. A total of 26 participants used neck collars, with 11 requiring modifications to their neck collars and 13 reporting not being able to use their neck collar for as long as they wished. This study identified the negative impact that neck weakness has on the quality of life for people living with motor neurone disease, and how varied people’s experiences are of living with and attempting to manage this symptom. This is a complex symptom for allied health professionals to manage and an individualised approach is required.
{"title":"Neck weakness in individuals with motor neurone disease: an insight into head support","authors":"Timothy P Sheehy, Karol A. Connors, Christine Wools","doi":"10.12968/ijtr.2022.0079","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0079","url":null,"abstract":"Neck weakness and head drop can occur in individuals with motor neurone disease, further contributing to disability and lower quality of life. The aims of this study were to explore the characteristics of neck weakness in motor neurone disease and the different types of head support used by patients. A cross-sectional study was performed, where 33 participants with motor neurone disease-related neck weakness answered a 17-item questionnaire. The questions covered their neck weakness and the types of head support they used at the time. All participants reported that their quality of life was negatively impacted by their neck weakness. Of the participants, 51.5% reported forward head drop and 42.4% reported that their head dropped both forward and to the side. The most common head support strategy was tilting their chair backwards, followed by the soft neck collar and a rigid collar (Aspen Vista). The majority used either two or three head support strategies in a given day. A total of 26 participants used neck collars, with 11 requiring modifications to their neck collars and 13 reporting not being able to use their neck collar for as long as they wished. This study identified the negative impact that neck weakness has on the quality of life for people living with motor neurone disease, and how varied people’s experiences are of living with and attempting to manage this symptom. This is a complex symptom for allied health professionals to manage and an individualised approach is required.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48206224","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}
Rosemary Johnson discusses her personal health journey and the role physiotherapists have played in helping her to overcome her health issues.
罗斯玛丽·约翰逊讨论了她的个人健康之旅，以及物理治疗师在帮助她克服健康问题方面所扮演的角色。
{"title":"In praise of physiotherapists: a personal view","authors":"Rosemary Johnson","doi":"10.12968/ijtr.2023.0089","DOIUrl":"https://doi.org/10.12968/ijtr.2023.0089","url":null,"abstract":"Rosemary Johnson discusses her personal health journey and the role physiotherapists have played in helping her to overcome her health issues.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44463567","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}
Julie A Derbyshire, Joanne Atkinson, Yvonne Dunn, Julie-Anne Lowe
Motor neurone disease is associated with rapid disease progression and disability, and receiving a diagnosis can cause shock and fear in the patient and their carers. Prompt access to services and psychological support are important to improving quality of life in individuals with motor neurone disease and their carers. The early-access Living Well support group, led by an occupational therapist and a registered nurse, was developed to support people with motor neurone disease and their carers. The objective of this study was to explore the carers’ lived experiences of being part of this support group. Qualitative semi-structured interviews were conducted with eight carers who attended the Living Well group, using a phenomenological research design. These carers had attended a minimum of two sessions with a relative with motor neurone disease. Thematic analysis was used to examine the data. Five key themes were generated from the study: diagnosis and fear of hospice; being human; connection with others; escapism; and access to expertise. These themes emphasised the importance of personalisation of support groups that meet the specific needs of those living with motor neurone disease and their carers. The findings of this study have implications for palliative care services and occupational therapists who work to improve the quality of life for people living with motor neurone disease and their carers. A more holistic approach towards palliative care, including the involvement of carers in support groups similar to Living Well, is strongly recommended.
{"title":"Living well: exploring experiences of carers of people with motor neurone disease attending an early-access support group","authors":"Julie A Derbyshire, Joanne Atkinson, Yvonne Dunn, Julie-Anne Lowe","doi":"10.12968/ijtr.2022.0172","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0172","url":null,"abstract":"Motor neurone disease is associated with rapid disease progression and disability, and receiving a diagnosis can cause shock and fear in the patient and their carers. Prompt access to services and psychological support are important to improving quality of life in individuals with motor neurone disease and their carers. The early-access Living Well support group, led by an occupational therapist and a registered nurse, was developed to support people with motor neurone disease and their carers. The objective of this study was to explore the carers’ lived experiences of being part of this support group. Qualitative semi-structured interviews were conducted with eight carers who attended the Living Well group, using a phenomenological research design. These carers had attended a minimum of two sessions with a relative with motor neurone disease. Thematic analysis was used to examine the data. Five key themes were generated from the study: diagnosis and fear of hospice; being human; connection with others; escapism; and access to expertise. These themes emphasised the importance of personalisation of support groups that meet the specific needs of those living with motor neurone disease and their carers. The findings of this study have implications for palliative care services and occupational therapists who work to improve the quality of life for people living with motor neurone disease and their carers. A more holistic approach towards palliative care, including the involvement of carers in support groups similar to Living Well, is strongly recommended.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46218397","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}
Ilkem Ceren Sigirtmac, O. Arslan, Barış Seven, C. Oksuz, G. Leblebicioğlu
Mirror hand (ulnar dimelia) is a very rare congenital anomaly of the upper extremity. This report presents the results of a therapy programme given to a patient with mirror hand. Pollicisation, opponensplasty, triceps lengthening and elbow arthrolysis were performed when the child was 2, 3, 4 and 7 years old respectively. Hand rehabilitation was planned in early (4–8 weeks), mid (9–12 weeks), and late (12 weeks) postoperative periods. The main purposes of the rehabilitation were to help the child recognise their hands and to use them functionally, ensure cortical reorganisation, improve independence and participate in activities of daily living. Range of motion, muscle and grip strength, sensation and hand function assessment results from an 8-year follow-up are presented. After 8 years of follow-up, the child was able to use his hand functionally, his grip strength was 1 kg, and his sensation was typical. Although he was independent in performing activities of daily living, because he did not have sufficient elbow flexion, he used excessive wrist flexion in some activities. The treatment was satisfactory for the child and the family. The child displayed typical motor development similar to his peers. Planning the treatment and therapy in coordination with hand surgeons is essential for optimal hand function.
{"title":"A clinical approach to a child with mirror hand malformation: 8-year follow-up results","authors":"Ilkem Ceren Sigirtmac, O. Arslan, Barış Seven, C. Oksuz, G. Leblebicioğlu","doi":"10.12968/ijtr.2022.0157","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0157","url":null,"abstract":"Mirror hand (ulnar dimelia) is a very rare congenital anomaly of the upper extremity. This report presents the results of a therapy programme given to a patient with mirror hand. Pollicisation, opponensplasty, triceps lengthening and elbow arthrolysis were performed when the child was 2, 3, 4 and 7 years old respectively. Hand rehabilitation was planned in early (4–8 weeks), mid (9–12 weeks), and late (12 weeks) postoperative periods. The main purposes of the rehabilitation were to help the child recognise their hands and to use them functionally, ensure cortical reorganisation, improve independence and participate in activities of daily living. Range of motion, muscle and grip strength, sensation and hand function assessment results from an 8-year follow-up are presented. After 8 years of follow-up, the child was able to use his hand functionally, his grip strength was 1 kg, and his sensation was typical. Although he was independent in performing activities of daily living, because he did not have sufficient elbow flexion, he used excessive wrist flexion in some activities. The treatment was satisfactory for the child and the family. The child displayed typical motor development similar to his peers. Planning the treatment and therapy in coordination with hand surgeons is essential for optimal hand function.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46115863","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}
A. H. Zamli, S. Lim, Amitha Sherng Lhung Na, Fatnin Faqiha Azmi Mahmud, Reginald Valentino Rapieng, C. Yeong, Li-Shun Chua
Evidence-based, specialised rehabilitation interventions are key to improving functional outcomes for patients with complications caused by severe COVID-19 infection, who often have complex needs and a wide range of functional impairments. The aims of this study were to determine the effectiveness of a structured inpatient, personalised, interdisciplinary rehabilitation programme, namely the COVID-19 Rehabilitation Inpatient Specialised Services, and to identify clinical predictors of rehabilitation effectiveness in patients after contracting COVID-19. This retrospective study involved 154 patients who underwent rehabilitation under the COVID-19 Rehabilitation Inpatient Specialised Services programme at a single centre between 1 July and 31 October 2021. The modified Barthel Index, Post-COVID-19 Functional Scale, modified Medical Research Council Dyspnoea Scale scores, and actual effectiveness derived from the modified Barthel Index scores were used to measure outcomes. The mean age of patients was 49.8 ± 14.3 years. Overall 48.1% (n=74) had required intubation, 70.1% (n=108) had been critically ill, and 21.4% (n=33) remained dependent on oxygen therapy beyond discharge. There was a statistically significant improvement in mean modified Barthel Index scores (45.2 vs 66.3, P<0.001), median post-COVID-19 Functional Scale score (4 vs 3, P<0.001) and median modified Medical Research Council scores (4 vs 3, P<0.001) following the rehabilitation intervention. Acute kidney injury, oxygen therapy dependency, neurological complications and initial modified Barthel Index scores were significant predictors of rehabilitation effectiveness (adjusted R2=0.23, P<0.001). The COVID-19 Rehabilitation Inpatient Specialised Services programme was effective in improving functional outcomes of hospitalised patients with severe to critical COVID-19 infection. By identifying factors that predict rehabilitation effectiveness, allied healthcare professionals can administer more focused rehabilitation efforts tailored to the specific needs of patients, thereby enabling them to achieve their maximum potential functional outcomes.
{"title":"Effectiveness of a multidisciplinary programme to improve functional outcomes of patients following severe COVID-19 infection in Malaysia: a retrospective study","authors":"A. H. Zamli, S. Lim, Amitha Sherng Lhung Na, Fatnin Faqiha Azmi Mahmud, Reginald Valentino Rapieng, C. Yeong, Li-Shun Chua","doi":"10.12968/ijtr.2022.0096","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0096","url":null,"abstract":"Evidence-based, specialised rehabilitation interventions are key to improving functional outcomes for patients with complications caused by severe COVID-19 infection, who often have complex needs and a wide range of functional impairments. The aims of this study were to determine the effectiveness of a structured inpatient, personalised, interdisciplinary rehabilitation programme, namely the COVID-19 Rehabilitation Inpatient Specialised Services, and to identify clinical predictors of rehabilitation effectiveness in patients after contracting COVID-19. This retrospective study involved 154 patients who underwent rehabilitation under the COVID-19 Rehabilitation Inpatient Specialised Services programme at a single centre between 1 July and 31 October 2021. The modified Barthel Index, Post-COVID-19 Functional Scale, modified Medical Research Council Dyspnoea Scale scores, and actual effectiveness derived from the modified Barthel Index scores were used to measure outcomes. The mean age of patients was 49.8 ± 14.3 years. Overall 48.1% (n=74) had required intubation, 70.1% (n=108) had been critically ill, and 21.4% (n=33) remained dependent on oxygen therapy beyond discharge. There was a statistically significant improvement in mean modified Barthel Index scores (45.2 vs 66.3, P<0.001), median post-COVID-19 Functional Scale score (4 vs 3, P<0.001) and median modified Medical Research Council scores (4 vs 3, P<0.001) following the rehabilitation intervention. Acute kidney injury, oxygen therapy dependency, neurological complications and initial modified Barthel Index scores were significant predictors of rehabilitation effectiveness (adjusted R2=0.23, P<0.001). The COVID-19 Rehabilitation Inpatient Specialised Services programme was effective in improving functional outcomes of hospitalised patients with severe to critical COVID-19 infection. By identifying factors that predict rehabilitation effectiveness, allied healthcare professionals can administer more focused rehabilitation efforts tailored to the specific needs of patients, thereby enabling them to achieve their maximum potential functional outcomes.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43000104","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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