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Παρασκευή, 26 Ιουλίου 2019

Algorithm for selection of balance assessment tools in post-stroke patients
The aim of the study was to design an algorithm of selecting the balance assessment tool in patients after stroke, which could be used in a subacute rehabilitation setting. A retrospective study was carried out to analyse results of standardized balance measurements in three groups of stroke patients classified by Functional Ambulation Category (FAC) (FAC 1 or 2, non-functional ambulation; FAC 3 or 4, ambulatory dependent; FAC 5 or 6, ambulatory independent). Balance functions were evaluated in 62 out of 70 patients (88.6%) at admission and discharge with at least with one standardized assessment tool. In 21 patients (30%), two or more assessment tools were used. From admission to discharge significant changes in balance functions in the non-functional ambulatory group were detected by Postural Assessment Scale for Stroke (PASS) (P = 0.003), in the ambulatory dependent group with PASS (P = 0.025) and Berg Balance Scale (BBS) (P = 0.009) and in the ambulatory independent group with the Timed Up and Go Test (P = 0.002) and Functional Gait Assessment (P = 0.029). In a post-stroke rehabilitation most commonly used BBS and PASS are sensitive enough in non-functional ambulatory and ambulatory dependent patients, though they do not reflect the overall balance function. In ambulatory independent patients, significant changes in balance functions can be detected only with the assessment tools that include the measurements of dynamic balance. Based on the findings, the algorithm for the selection of balance assessment tools in post-stroke rehabilitation setting was formulated according to FAC. Received 13 May 2019 Accepted 4 June 2019 Correspondence to Nika Goljar, MD, PhD, University Rehabilitation Institute, Republic of Slovenia, 1000 Ljubljana, Linhartova 51, Slovenia, Tel: +386 1 47 58 343; fax: +386 1 437 20 70; e-mail: nika.goljar@ir-rs.si Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Development of an extensive assessment list for knee osteoarthritis based on the International Classification of Functioning, Disability and Health: a Delphi study
The objective of this study was to develop an extensive assessment list for individuals with knee osteoarthritis based on the International Classification of Functioning, Disability and Health (ICF) osteoarthritis comprehensive Core Set. Ten experienced physical therapists including five lecturers and five clinicians were purposively nominated to form an expert panel. Consensus among the experts was obtained through a four-iteration Delphi technique. A list of ICF categories and their third- and fourth-level categories were selected and matched with outcome measures associated with knee osteoarthritis. The expert panel agreed that 26 out of 38 second-level categories of the comprehensive ICF core set for osteoarthritis were relevant to identify problems related to knee osteoarthritis. The information relevant to the specific categories for knee osteoarthritis was obtained from self-reported, subjective observation and physical examination. The extensive assessment list for knee osteoarthritis based on the comprehensive ICF core set for osteoarthritis was assembled. This assessment tool can be used to expansively identify the multidimensional disabilities of impairment, activity limitation and participation restriction in individuals with knee osteoarthritis. Received 28 February 2019 accepted 12 June 2019 Correspondence to Mantana Vongsirinavarat, PhD, DPT, Faculty of Physical Therapy, Mahidol University, Putthamonthon, Nakhon Pathom, 73170, Thailand, Tel: +66 24415450 x20803; fax: +66 24415454; e-mail: mantana.von@mahidol.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Functional improvement after severe brain injury with disorder of consciousness paralleling treatment for comorbid obstructive sleep apnoea: a case report
Survivors of brain injury who have disorders of consciousness often have chronic functional deficits and disability. Obstructive sleep apnoea, a sleep-related breathing disorder, is a medical comorbid condition common among persons with brain injury and is injurious to health. Research on obstructive sleep apnoea treatment among brain-injured patients–particularly persons with disorders of consciousness–is sparse. This case study describes a patient with severe brain injury admitted for neurorehabilitation in a minimally conscious state. Obstructive sleep apnoea was identified and treated. Treatment compliance was variable, and functional motor and cognitive improvement were observed during periods of better compliance. Study design does not permit casual attribution for functional improvement, but identification and treatment of obstructive sleep apnoea are suggested as a possible way to promote recovery after brain injury. Received 17 May 2019 Accepted 20 June 2019 Portions of this work were presented at the 92nd annual meeting of American Congress of Rehabilitation Medicine, Dallas, Texas. No work resembling the enclosed article has been published or is being submitted for publication elsewhere. Correspondence to Marc A. Silva, PhD, James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd. (116-B), Tampa, FL 33612, USA, Tel: +813 972 2000; fax: +813 631 3057; e-mail: marc.silva1@va.gov Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Factors associated with functional recovery in Japanese patients with convalescent stroke stratified by age: a multicenter observational study
Factors associated with functional recovery after stroke may differ by age demographics because the aging process leads to various regressive changes. The aim of this study was to identify factors related to functional recovery in Japanese patients with convalescent stroke stratified by age. A multicenter retrospective observational study was conducted in 243 patients from six convalescent inpatient rehabilitation wards. Participants were categorized into three groups: 40–64, 65–74, and ≥75 years. Demographic data, laboratory data, physical function, and cognitive function were collected upon admission, and outcome measures were represented using the relative gain of the Functional Independence Measure (FIM effectiveness) during hospitalization. Stepwise multivariate logistic analysis was performed to identify the significant factors for functional recovery in each group. In the 40–64 years group, stroke type [odds ratio (OR), 10.38; 95% confidence interval (CI), 2.22–48.59], spatial neglect (OR, 7.61; 95% CI, 2.07–28.00), and memory disorder (OR, 4.68; 95% CI, 1.08–20.30) were shown to be significant factors. In the 65–74 years group, only memory disorder (OR, 3.42; 95% CI, 1.19–9.81) was significant. In the ≥75 years group, low albumin level (OR, 3.35; 95% CI, 1.05–10.67), severe motor impairment (OR, 5.11; 95% CI, 1.14–22.97), and memory disorder (OR, 4.34; 95% CI, 1.43–13.23) were significantly related to poor functional recovery. In conclusions, the findings showed that there were different trends among the factors related to poststroke functional recovery among the three age groups. Received 18 March 2019 Accepted 23 May 2019 Correspondence to Yosuke Kimura, PT, MSc, Department of Rehabilitation, Tokyo Shinjuku Medical Center, Japan Community Healthcare Organization, 5-1 Tsukudo-cho, Shinjuku-ku, Tokyo, 162-8543, Japan, Tel: +81 3 3269 8111; fax: +81 3 3260 7840; e-mail: mcbb10ver@yahoo.co.jp Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Trajectories of functional performance and muscle strength recovery differ after total knee and total hip replacement: a performance-based, longitudinal study
Total joint replacement is indicated to alleviate pain and disability associated with hip and knee osteoarthritis. Arthroplasty outcomes are typically reported together, or anecdotal comparisons are made between total knee arthroplasty (TKA) and total hip arthroplasty (THA) recovery. Limited data quantifies differences in recovery trajectories, especially with respect to performance-based outcomes. Seventy-nine people undergoing total knee or THA were followed over 6 months. Functional performance was measured using the stair climb test, timed-up-and-go test, and 6-min walk test. Surgical limb isometric strength was also measured. All outcomes significantly declined 1 month after surgery. Participants in the TKA group showed a greater decline in climbing stairs (P < 0.001), timed-up-and-go (P = 0.01), and 6-min walk distance (P < 0.01). Further, the TKA group lost more strength (P < 0.001) and were weaker than those after THA (P < 0.001). Differences in postoperative outcomes between groups at 3 and 6 months were also observed. The TKA group experiences a greater decline in measured outcomes than the THA group, and muscle strength and functional recovery occurred differently in each group. These findings should be considered in rehabilitation priorities after arthroplasty surgery. Received 25 January 2019 Accepted 15 February 2019 Correspondence to Dana L. Judd, PT, DPT, PhD, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado Anschutz Medical Campus, 13121 E. 17th Avenue, Mail Stop C244, Aurora, CO 80045, USA Tel: +1 303 724 8814; fax: +1 303 724 9016; e-mail: dana.judd@ucdenver.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
The effect of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease: a systematic review and meta-analysis of systematic reviews
The overall aim of the treatment in Parkinson’s disease is to optimize functional independence, safety, well-being and thereby health-related quality of life. Tai Chi and Qigong are widely used exercises in Parkinson’s disease, but there is insufficient evidence to support or refute the efficacy of Tai Chi and Qigong, especially on health-related quality of life in patients with Parkinson’s disease. The aim of this study was to conduct a systematic review and a meta-analysis from the systematic reviews that evaluate the effectiveness of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease. A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses by using Cochrane Library, MEDLINE, PubMed, etc., databases up to the end of November 2018. From 1504 articles, seven fulfilled the inclusion criteria and were included in our study. Five of the included systematic reviews were about Tai Chi, and two of them were about both Tai Chi and Qigong. According to our meta-analysis, there was no significant effect of Tai Chi and Qigong on health-related quality of life in patients with Parkinson’s disease, when compared to the control group (standardized mean difference −0.166, 95% confidence interval −0.676 to 0.344; P = 0.523). In conclusion, our systematic review and meta-analysis showed no significant effect of Tai Chi and Qigong statistically on health-related quality of life in patients with Parkinson’s disease, but the small effect size in our study favoured the potential benefit of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease. Received 14 March 2019 Accepted 7 May 2019 Correspondence to Bahar Aras, PhD, PT, Assist Prof, Faculty of Health Sciences, Evliya Celebi Campus, Kutahya Health Sciences University, Kutahya, Turkey, Tel: +90 274 2652191/1462; fax: +90 274 2652191; e-mail: dpuaras@yahoo.com Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Body weight supported treadmill vs. overground gait training for acute stroke gait rehabilitation
The purpose of this study was to evaluate the clinical efficacy of body weight supported treadmill training for acute post-stroke rehabilitation, relative to conventional therapy. Forty individuals were randomized to receive either body weight supported treadmill training or conventional therapy as part of standard care at an acute rehabilitation facility. As part of normal care patients were evaluated using the Functional Independence Measure; gait units and length of stay were also recorded. Within 48 hours of discharge, participants were evaluated using a Qualisys motion capture system to measure spatiotemporal gait parameters. Participants allocated to the body weight supported treadmill training group had a significantly lower admission Functional Independence Measure, but had a longer length of stay, and did not have significantly different discharge Functional Independence Measure scores. Gait speed was the only spatiotemporal outcome that was significantly different at discharge, and was lower for the body weight supported treadmill training group. As seen in previous literature, the clinical efficacy of body weight supported treadmill training seems to be similar to that of conventional overground therapy. Accounting for difference in admission scores the body weight supported treadmill training and conventional therapy groups, both methods performed comparably. Received 26 February 2019 Accepted 2 May 2019 Correspondence to Derek J. Lura, PhD, Assistant Professor, Department of Bioengineering, Florida Gulf Coast University, 10501 FGCU Boulevard South, Fort Myers, FL 33965–6565, USA, Tel: +1 239 590 7832; fax: +1 239 590 7304; e-mail: dlura@fgcu.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Some thoughts on bibliometrics, usage metrics and altmetrics concerning the International Journal of Rehabilitation Research
No abstract available
Predictors of community reintegration and quality of life after hip fracture among community-dwelling older adults
We aim to explore factors contributing to community reintegration and health-related quality of life (HRQoL) among community-dwelling older adults three months after discharge from inpatient rehabilitation following hip fracture. We performed a prospective cohort study with follow-up. Thirty-three consecutive patients (age 66–89) after surgery for hip fracture repair were recruited from an inpatient rehabilitation unit. Participants were 65+ years old, did not have dementia, and were independent in basic activities of daily living (BADL) at discharge. We examined the contribution of independent variables measuring BADL, cognition, emotional status, pain and social support to the explained variance of two main outcomes: the Reintegration to Normal Living Index (RNLI), measuring self-reported ability to participate in activities and return to life roles; and the Medical Outcomes Study Short-Form Health Survey (SF-12), assessing mental and physical aspects of HRQoL. Stepwise regression analyses revealed that: social support and pain while walking significantly explained 42.1% of variance in the RNLI; social support significantly explained 31.1% of the variance in the SF-12-physical subscale; the number of falls in the previous year, social support and executive functions assessed by the clock drawing test significantly explained 61.9% of the variance in the SF-12 mental subscale. Social support, pain while walking and the number of falls in the previous year can predict community reintegration and HRQoL among older adults three months after discharge from rehabilitation following a surgical hip fracture repair. These factors need to be addressed in rehabilitation programs. The work submitted is our own and copyright has not been breached in seeking its publication. The submitted work and its essential substance have not previously been published and are not being considered for publication elsewhere. Received 10 March 2019 Accepted 18 April 2019 Correspondence to Yafit Gilboa, OT, PhD, Faculty of Medicine, School of occupational therapy, Hebrew University of Jerusalem, Mount Scopus, Jerusalem 91240, Israel, Tel: +972 2 5845312; fax: +972 2 5324985; e-mail: Yafit.gilboa@mail.huji.ac.il Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
The Prosthetic Mobility Questionnaire, a tool for assessing mobility in people with lower-limb amputation: validation of PMQ 2.0 in Slovenia
The aim of this study was to examine the metric properties of the Prosthetic Mobility Questionnaire, an outcome measure of mobility following lower-limb amputation, in Slovene outpatients undergoing rehabilitation. The 12-item Prosthetic Mobility Questionnaire was administered to 148 Slovene adults (74% men) with unilateral lower-limb amputation since >12 months and regularly wearing a prosthesis. The psychometric analysis included classical test theory methods and Rasch models. Rasch analysis disclosed two pairs of locally dependent items (same task but in opposite directions: walk up/down stairs; walk up/down a hill). Thus, we devised a new version (PMQ 2.0) assessing all 12 Prosthetic Mobility Questionnaire items but calculating the global score on only 10, i.e. considering–for each pair of locally dependent items–just the item with worst performance. The PMQ 2.0 demonstrated correct functioning of rating scale categories, construct validity (item fit, hierarchy of item difficulties), convergent validity, high-reliability indices and unidimensionality. In conclusion, the new 10-item PMQ 2.0 shows good reliability and validity, and an excellent overall metric quality for measuring perceived mobility capabilities in people with lower-limb amputation. Received 8 April 2019 Accepted 16 April 2019 Correspondence to Franco Franchignoni, MD, Istituti Clinici Scientifici Maugeri, IRCCS, Via Mons. Bernasconi, 16, 20851 Lissone (MB), Italy, Tel: 39 039 46571; e-mail: franco.franchignoni@icsmaugeri.it Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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