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Search Results: 1 - 10 of 2629 matches for " rehabilitation. "
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Comparison of the Folstein Mini Mental State Examination (MMSE) to the Montreal Cognitive Assessment (MoCA) as a Cognitive Screening Tool in an Inpatient Rehabilitation Setting  [PDF]
Arun Aggarwal, Emma Kean
Neuroscience & Medicine (NM) , 2010, DOI: 10.4236/nm.2010.12006
Abstract: Identifying the presence of cognitive impairment in patients admitted for inpatient rehabilitation is important as it may impact on their ability to participate in a rehabilitation program. The Folstein Mini Mental State Examination (MMSE) has been used by clinicians as a cognitive screening tool for its convenience, even though it is not sensitive, and often fails to detect cognitive impairment. Recently, the Montreal Cognitive Assessment (MoCA) has been developed as a brief cognitive screening tool to detect mild-moderate cognitive impairment. We performed a longitudinal study to compare the utility of the MMSE and MoCA in an inpatient rehabilitation setting. A total of 50 consecutive patients were studied with an average age of 71.7 years of age. The mean test score for MMSE was 26.5 and 22.2 for the MoCA. The Pearson’s correlation coefficient between the scores was 0.695 (p < 0.003). The mean performance time for the MMSE was 7.4 minutes and 14.8 minutes for the MoCA. MMSE did not perform well as a screening instrument for mild cognitive impairment as there were 43 patients who scored 24 or more on MMSE, and 25 patients (58%) scored 25 or less on MoCA, indicating the presence of cognitive impairment. Even though the MoCA takes longer to administer, the additional important information provided indicates that the MoCA should be used rather than the MMSE as a cogni-tive screening tool.
Efficacy of rehabilitation program in addition to pharmacological treatment during 8 months in Parkinson patients  [PDF]
Jesús Seco Calvo, Inés Gago Fernández, Juan Azael Herrero Alonso, Javier González Gallego, Nuria Garatachea Vallejo
Advances in Parkinson's Disease (APD) , 2012, DOI: 10.4236/apd.2012.12003
Abstract: Objective: To compare 8-month effects ofmedical treatment plusrehabilitation on UPDRS scores ofparkinsonian patientswith that ofmedical treatment withoutrehabilitation.Design: Longtudinal randomized study. Participants:27 parkinsonian patients (69.50 ± 10.34 years). We divided our patient into two groups: control group (n = 9, received only medication therapy) and experiment- tal group (n = 18, received physiccal therapy and medication therapy). Intervention:The 8-month exercise interventions were twice-weekly 90-min sessions in group. UPDRS scales were measured before and after the interventions. Results: Two- factor ANOVA analyses revealed a significant main effect fromrehabilitation (p < 0.01) on UPDRS motor, ADL, and total, but not on UPDRS mental (p > 0.05). Post-hoc analysis shows that UPDRS motor increased in control group (+37%) meanwhile decreased in experimental group (–17%). UPDRS ADL increased significantly more in control group (+26%) than experimental group (+5%).UPDRS total increased in control group (+33%) meanwhile decreased in experimental group(–11%). Conclusions:The results of the study suggest that exercise interventions should be a necessary ongoing adjunct toparkinson’s diseasemedication.
Could Resilience Predict the Outcome of Psychiatric Rehabilitation Patients?  [PDF]
Birk Engmann
Open Journal of Depression (OJD) , 2013, DOI: 10.4236/ojd.2013.22002
Abstract: Background: Individual resistance to burdens such as stress, adversity, and even disasters is called “resilience”. Whereas most studies of resilience investigate post-traumatic stress disorder, fewer studies treat anxiety and depressiveness in mentally healthy populations. The present pilot study investigates whether resilience lessens the severity of depressive symptoms. Aim was to figure out whether further research is needed on the relation of resilience both to depression and to rehabilitation from it in regard to fitness for work. Design/Setting/Population: A retrospective, non-blind, non-randomized analysis of charts of 503 stationaryinpatient-patients was performed. Patients without age limits who suffered from diseases of the depressive spectrum (F32, F33) and also adjustment disorder (F43.2), dysthymia (F34.1), and neuras-thenia (F48) according to ICD 10 were included. BDI and resilience scale, state of fitness or unfitness for work, were analysed with correlation analysis and descriptive statistics by the SPSS program. Results: Analysis revealed that resilience and depressive symptoms are inversely related. The higher the resilience the lower the BDI score, indicating a lower burden of depressive symptoms. Resilience also seems to influence important outcome factors of rehabilitation such as reintegration in work and remission of depressive symptoms. Patients who either were fit for work at the beginning of rehabilitation or were dismissed as fit for work had higher resilience scores than those who were unfit for work. Conclusion: This pilot study encourages further investigation of the relation of resilience not only to depressive disorders, but also to rehabilitation and social reintegration after depression.
A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation  [PDF]
Gabrielle McHugh, Ian D. Swain
Health (Health) , 2013, DOI: 10.4236/health.2013.56A2016
Abstract:

Objective: Major improvement has been made in the medical management of stroke in the UK between 2008 and 2010 based on the indicators measured in the National Sentinel Audit. However based on the same audit, no corresponding improvement has been effected to patient functional impairment levels on hospital discharge in the corresponding time frame. This study derived patient-to-therapist ratios as a means of exploring the amount of rehabilitation time for stroke patients while in hospital care. Method: A purpose specific survey was developed for completion by stroke teams. From a contact list compiled primarily in collaboration with the 28 National Stroke Improvement Networks, the Nth name technique was used to target stroke teams in each geographical area covered by the 28 networks. Results: A total of 53 surveys were returned representing 20 of the 28 network areas providing 71% national coverage. Analysis conducted on 19 of the 37 inpatient hospital care units that were discrete units, had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and unit occupancy rates. Staffing levels for some therapies were below the Department of Health staffing assumptions suggesting that stroke units are challenged to provide the recommended therapy time. Conclusions: Most stroke units surveyed are operating below the DH staffing assumption levels and are therefore challenged in providing the amount of therapy and patient time recommended in the National Institute of Clinical Excellence guidelines to facilitate optimal functional recovery for stroke patients.

Cognitive Deficits in Primary Brain Tumours: A Framework for Management and Rehabilitation  [PDF]
Michael Back, Elizabeth Back, Marina Kastelan, Helen Wheeler
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.51010
Abstract:

Cognitive deficits related to tumour or treatment are estimated to be present in the majority of patients diagnosed with a primary brain tumour, with a large variation based on tumour site, extent, and grade, as well as nature of intervention. These deficits have a significant impact on patient’s quality of life and functional status. The improved patient survival duration in recent years has increased the need to detect, understand and intervene on these cognitive deficits, and optimise patient pathways for treatment. This article reviews the nature of deficits arising in patients with primary brain tumour, and the association of the deficits with neuroanatomical site of tumour. The approach to interventions through adaptation and remediation is outlined, with aim of improving function, promoting generalization of outcomes and optimizing any neuroplasticity that may arise. The evidence for pharmacological therapies and cognitive rehabilitation is presented, and a framework for implementation is provided.

Approaches to Delivery of Care at Home Following Elective Hip and Knee Joint Replacement Surgery  [PDF]
M. Alnaib, N. R. Agni, N. Shaw
Open Journal of Therapy and Rehabilitation (OJTR) , 2015, DOI: 10.4236/ojtr.2015.33013
Abstract: Arthritis has a worldwide increasing prevalence with increased demands on healthcare systems to provide arthroplasty surgery. There is growing evidence that early discharge and rehabilitation at home following hip and knee replacement provide similar or better results in function, complication rates and patient satisfaction. We suggest that this method of rehabilitation is a cost-effective viable option in fitter patients whose medical demands will be low postoperatively.
Pain and Radiographic Outcomes in Adult Idiopathic Scoliosis Patients Using a Scoliosis Activity Suit: An 18-Month Case Controlled Chart Review  [PDF]
Mark W. Morningstar, Aatif Siddiqui, Clayton J. Stitzel, Brian Dovorany
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.69080
Abstract: There are few conservative treatment options for patients with adult idiopathic scoliosis. These typically include pharmacologic pain management, epidural injections, and generalized CAM treatments such as massage and chiropractic manipulation. The purpose of this study was to compare the post-treatment results in patients wearing the scoliosis activity suit versus baseline assessments as well as adult scoliosis patients who did not wear the activity suit. The pain and Cobb angle outcomes of 53 consecutive patients with adult idiopathic scoliosis following a trial of a scoliosis activity suit were reviewed. The average scores and measurements at 18 months were statistically significantly improved for both the quadruple numerical pain rating scale as well as Cobb angle. The scoliosis activity suit may be a viable supportive therapy for the treatment of chronic pain associated with adult idiopathic scoliosis. Further prospective studies should evaluate treatment effects of this suit using intent-to-treat methodology.
Is Surgery a Good Choice for Patients over 100 Years with Hip Fracture?  [PDF]
Bogdan Deleanu, Radu Prejbeanu, Dinu Vermesan, Lucian Honcea, Cristina Nuta, Vlad Predescu
Case Reports in Clinical Medicine (CRCM) , 2015, DOI: 10.4236/crcm.2015.48056
Abstract: Introduction: Elderly patients represent a difficult category of surgical candidates for orthopedic surgery because they have multiple associated diseases and a high degree of osteoporosis. Presentation of Case: We present the case of a 103 years old woman with a pertrohanteric hip fracture treated successfully using a 135° dynamic hip screw. Discussion: There are many discussions about this kind of patients regarding postoperative complications, duration of hospitalization, stage of recovery and the patient’s status at discharge. Conclusion: We conclude that surgery may benefit patients who are over 100 year-old.
Chiropractic Rehabilitation of a Scoliosis Family: Results from a 9-Year Follow-Up  [PDF]
Mark W. Morningstar, Aatif Siddiqui, Clayton Stitzel, Brian Dovorany
Open Journal of Therapy and Rehabilitation (OJTR) , 2017, DOI: 10.4236/ojtr.2017.51003
Abstract: Scoliosis bracing is typically prescribed when the curvature reaches to between 30° - 50°. Although there has been a vast amount of bracing literature published, the results remain equivocal. Many patients face issues of compliance, comfort, and decreased self-esteem due to social stigmas with bracing. This has caused many patients to seek non-bracing options. Although these treatments are plausible, they lack the research background that bracing has. Therefore, many physicians are reluctant to prescribe exercise-based rehabilitation for their scoliosis patients. This study reports on 3 patients who sought non-bracing, exercise-based chiropractic rehabilitation for their scoliosis. Their results before, after, and at long term follow up are included.
Assessing the Effectiveness of a Practice Improvement Project to Reduce Falls after Discharge from an Inpatient Rehabilitation Facility  [PDF]
Jun Zhang, Jamal Khan, Claudia Echaide, Karen Imbrosciano-Kemper, Michael Scicchitano, Jennifer Semel
Open Journal of Therapy and Rehabilitation (OJTR) , 2018, DOI: 10.4236/ojtr.2018.62006
Abstract: Objective: To undertake a qualitative investigation of Fall Prevention and Home Safety Education Program’s efficacy to decrease the risk of falling after discharge from inpatient rehabilitation facility. Design: Structured Telephone interviews. Setting: Inpatient Rehabilitation Facility. Participants: 1317 inpatients from the Rehabilitation Unit. Interventions: The Fall Prevention and Home Safety Education program. Main Outcome Measures: The percentage of patients that fell. Results: Since the inception of the program the fall rate has reduced significantly (χ2 = 6.38; P < 0.05), reaching the historical minimum of this facility (n = 1174). The percentage of falls dropped 5.6% in only 11 months and the attendance to the class has been increasing at a steady rate. Conclusions: Implementation of a Fall Prevention and Home Safety Education program significantly reduced the rate of falls in the three months post discharge from acute inpatient rehabilitation.
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