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International Journal of Environmental... Oct 2022Rehabilitation is a crucial part of recovery for stroke survivors, and numerous studies have examined various exercises and treatments of stroke. In addition, it is very... (Review)
Review
Rehabilitation is a crucial part of recovery for stroke survivors, and numerous studies have examined various exercises and treatments of stroke. In addition, it is very important for patients to choose the timing of rehabilitation and what kind of rehabilitation they will proceed with. The purpose of the current study is to examine research investigating the effects of rehabilitation exercise programs in recovery of physical function in patients with stroke, based on aspects of their physical function, physical strength, and daily activities, and systematically examine their effects. Therefore, through systematic review, we have investigated the effects of interventions in rehabilitation exercise programs for recovery of physical function in patients with stroke. We collected relevant publications through the databases MEDLINE/PubMed and Google scholar. Twenty-one articles were ultimately selected for the analysis. We classified the rehabilitation programs and identified the trends of treatment for stroke survivors. Our review indicated that task-oriented therapy is still dominant, but various types of combined rehabilitations have been attempted. In addition, it was identified that physical and active rehabilitation were required rather than unconditional rest, even at an early stage. Home-based treatment was used for rapid recovery and adaptation to daily life during the mid-term period.
Topics: Activities of Daily Living; Exercise; Exercise Therapy; Humans; Stroke; Stroke Rehabilitation
PubMed: 36232038
DOI: 10.3390/ijerph191912739 -
Stroke Jun 2016The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. (Review)
Review
PURPOSE
The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke.
METHODS
Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee.
RESULTS
Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.
CONCLUSIONS
As systems of care evolve in response to healthcare reform efforts, postacute care and rehabilitation are often considered a costly area of care to be trimmed but without recognition of their clinical impact and ability to reduce the risk of downstream medical morbidity resulting from immobility, depression, loss of autonomy, and reduced functional independence. The provision of comprehensive rehabilitation programs with adequate resources, dose, and duration is an essential aspect of stroke care and should be a priority in these redesign efforts. (Stroke.2016;47:e98-e169. DOI: 10.1161/STR.0000000000000098.).
Topics: Adult; American Heart Association; Comorbidity; Health Personnel; Humans; Recovery of Function; Stroke; Stroke Rehabilitation; United States
PubMed: 27145936
DOI: 10.1161/STR.0000000000000098 -
Clinical Interventions in Aging 2019After hospitalization, 11% of the older patients are referred to rehabilitation facilities. Nowadays, there is a trend to formalize the rehabilitation process for these... (Review)
Review
INTRODUCTION
After hospitalization, 11% of the older patients are referred to rehabilitation facilities. Nowadays, there is a trend to formalize the rehabilitation process for these patients in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support and the environment on a rehabilitation ward. However, since literature on the principles of CRE is scarce, this review aimed to explore and describe the principles of CRE.
METHODS
A search was made in PubMed for relevant literature concerning CRE. Then, articles were hand searched for relevant keywords (ie, task-oriented training, therapy intensity, patient-led therapy, group training), references were identified, and topics categorized.
RESULTS
After evaluating 51 articles, 7 main topics of CRE were identified: 1) Therapy time; ie, the level of (physical) activity; the intensity of therapy and activity is related to rehabilitation outcomes, 2) group training; used to increase practice time and can be used to achieve multiple goals (eg, activities of daily living, mobility), 3) patient-regulated exercise; increases the level of self-management and practice time, 4) family participation; may lead to increased practice time and have a positive effect on rehabilitation outcomes, 5) task-oriented training; in addition to therapy, nurses can stimulate rehabilitants to perform meaningful tasks that improve functional outcomes, 6) enriched environment; this challenges rehabilitants to be active in social and physical activities, and 7) team dynamics; shared goals during rehabilitation and good communication in a transdisciplinary team improve the quality of rehabilitation.
DISCUSSION
This is the first description of CRE based on literature; however, the included studies discussed rehabilitation mainly after stroke and for few other diagnostic groups.
CONCLUSION
Seven main topics related to CRE were identified that may help patients to improve their rehabilitation outcomes. Further research on the concept and effectivity of CRE is necessary.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Female; Health Services for the Aged; Humans; Patient Care Team; Rehabilitation; Treatment Outcome
PubMed: 31496672
DOI: 10.2147/CIA.S207863 -
The Journal of Head Trauma... 2019To characterize the indications, timing, barriers, and perceived value of rehabilitation currently provided for individuals with moderate or severe traumatic brain...
OBJECTIVE
To characterize the indications, timing, barriers, and perceived value of rehabilitation currently provided for individuals with moderate or severe traumatic brain injury (TBI) admitted to the intensive care unit (ICU) based on the perspectives of providers who work in the ICU setting.
PARTICIPANTS
Members (n = 66) of the Neurocritical Care Society and the American Congress of Rehabilitation Medicine.
DESIGN
An anonymous electronic survey of the timing of rehabilitation for patients with TBI in the ICU.
MAIN MEASURES
Questions asked about type and timing of rehabilitation in the ICU, extent of family involvement, participation of physiatrists in patient care, and barriers to early rehabilitation.
RESULTS
Sixty-six respondents who reported caring for patients with TBI in the ICU completed the survey; 98% recommended rehabilitative care while patients were in the ICU. Common reasons to wait for the initiation of physical therapy and occupational therapy were normalization of intracranial pressure (86% and 89%) and hemodynamic stability (66% and 69%).
CONCLUSIONS
The majority of providers caring for patients with TBI in the ICU support rehabilitation efforts, typically after a patient is extubated, intracranial pressure has normalized, and the patient is hemodynamically stable. Our findings describe current practice; future studies can be designed to determine optimal timing, intensity, and patient selection for early rehabilitation.
Topics: Brain Injuries, Traumatic; Clinical Decision-Making; Hemodynamics; Hospitalization; Humans; Intensive Care Units; Intracranial Pressure; Occupational Therapy; Patient Care Team; Physical Therapy Modalities; Speech Therapy; Surveys and Questionnaires; Time-to-Treatment
PubMed: 30829824
DOI: 10.1097/HTR.0000000000000477 -
PM & R : the Journal of Injury,... Sep 2009The aquatic environment has broad rehabilitative potential, extending from the treatment of acute injuries through health maintenance in the face of chronic diseases,... (Review)
Review
The aquatic environment has broad rehabilitative potential, extending from the treatment of acute injuries through health maintenance in the face of chronic diseases, yet it remains an underused modality. There is an extensive research base supporting aquatic therapy, both within the basic science literature and clinical literature. This article describes the many physiologic changes that occur during immersion as applied to a range of common rehabilitative issues and problems. Because of its wide margin of therapeutic safety and clinical adaptability, aquatic therapy is a very useful tool in the rehabilitative toolbox. Through a better understanding of the applied physiology, the practitioner may structure appropriate therapeutic programs for a diverse patient population.
Topics: Athletic Injuries; Cardiac Rehabilitation; Exercise Therapy; Humans; Hydrotherapy; Musculoskeletal Diseases; Osteoporosis; Respiratory Therapy; Water
PubMed: 19769921
DOI: 10.1016/j.pmrj.2009.05.017 -
International Urogynecology Journal Nov 2019Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION AND HYPOTHESIS
Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a multidisciplinary approach may be required to treat it. Musculoskeletal factors play an important role; thus, rehabilitating the pelvic floor and modifying the tone of the pelvic floor muscles (PFMs) may be an effective way to treat this dysfunction. The aim of this randomized controlled clinical study was to evaluate the effects of pelvic floor rehabilitation techniques on dyspareunia.
METHODS
Of 84 women, assessed for eligibility, 64 women with dyspareunia were randomized into two groups: the experimental group (n = 32) received electrotherapy, manual therapy, and PFM exercises and the control group (n = 32) had no treatment while on the waiting list. Evaluations of PFM strength and endurance, sexual function, and pain were made directly before and after 3 months of treatment and at the 3-month follow-up.
RESULTS
Between-group changes showed significant improvement in the experimental group in comparison with control group. Mean difference in the PFM strength (according to the 0-5 Oxford scale) between groups was 2.01 and the mean difference of endurance was 6.26 s. Also, the mean difference in the Female Sexual Function Index score (the score ranges from 2 to 95) was 51.05, and the mean difference in the VAS score was 7.32. All of the changes were statistically significant (p < 0.05).
CONCLUSIONS
According to the results, pelvic floor rehabilitation is an important part of a multidisciplinary treatment approach to dyspareunia.
Topics: Adult; Dyspareunia; Electric Stimulation Therapy; Exercise Therapy; Female; Humans; Musculoskeletal Manipulations; Pelvic Floor
PubMed: 31286158
DOI: 10.1007/s00192-019-04019-3 -
Child and Adolescent Psychiatric... Jan 2020Recovery-oriented treatment for youth with psychosis goes beyond a symptom and deficit-amelioration model, promoting engagement and functioning within the community.... (Review)
Review
Recovery-oriented treatment for youth with psychosis goes beyond a symptom and deficit-amelioration model, promoting engagement and functioning within the community. Given the challenges young people with psychosis face, early psychosis treatment programs often integrate rehabilitative components targeting functional outcomes. The current article reviews 4 community rehabilitation programs in early psychosis: care coordination, cognitive rehabilitation, supported education and employment, and peer support. For each of these rehabilitative intervention programs, we discuss challenges faced by youth with psychosis, clinical intervention practices, the current state of evidence, and clinical and/or research considerations.
Topics: Adolescent; Adult; Cognitive Remediation; Community Mental Health Services; Employment, Supported; Humans; Peer Group; Psychiatric Rehabilitation; Psychotic Disorders; Young Adult
PubMed: 31708049
DOI: 10.1016/j.chc.2019.08.012 -
Maryland Medical Journal (Baltimore,... Feb 1989Prevention of disease should be every physician's goal, however, when primary or secondary prevention fail, rehabilitation of the patient becomes an additional goal.... (Review)
Review
Prevention of disease should be every physician's goal, however, when primary or secondary prevention fail, rehabilitation of the patient becomes an additional goal. Elderly patient can be as successfully rehabilitated as younger patients, but their special needs are most successfully met by a multidisciplinary team. Almost every patient with a disability warrants a trial of rehabilitation aimed toward placing the patient in the least restrictive environment possible. Rehabilitation is especially useful in patients with arthritis, and following stroke, joint replacement, and amputation.
Topics: Activities of Daily Living; Aged; Humans; Orthopedic Equipment; Patient Care Team; Prognosis; Rehabilitation; Social Support
PubMed: 2644514
DOI: No ID Found -
Current Opinion in Rheumatology Mar 1993In this review, we discuss large epidemiologic and focused clinical and laboratory studies published over the past year that advanced our current knowledge of the... (Review)
Review
In this review, we discuss large epidemiologic and focused clinical and laboratory studies published over the past year that advanced our current knowledge of the physical and functional impairments, societal handicaps, and disability related to the rheumatic diseases. Studies of rehabilitative methods appropriate for patients with a variety of rheumatic and musculoskeletal disorders are presented.
Topics: Arthritis; Biomechanical Phenomena; Disabled Persons; Female; Humans; Male; Rehabilitation; Workplace
PubMed: 8452765
DOI: 10.1097/00002281-199305020-00005 -
Hand Clinics Nov 2004The rehabilitation of elbow trauma presents numerous challenges. Involvement of the osseous structures, compromise of the ligamentous stability, and loss of the soft... (Review)
Review
The rehabilitation of elbow trauma presents numerous challenges. Involvement of the osseous structures, compromise of the ligamentous stability, and loss of the soft tissue excursion necessary for elbow motion and function require due consideration during the treatment of elbow joint injuries. Stiffness of the elbow joint following trauma is common. This stiffness is caused by extrinsic and intrinsic factors. Contractures of the elbow joint develop as a result of contractures of the joint capsule, ligamentous structures, musculotendinous structures, intra-articular adhesions,and ectopic ossification. Early mobilization and splinting of the elbow following injury, within a safe arc of elbow motion, makes the elbow joint more compliant to the rehabilitative techniques outlined. Understanding the details of elbow anatomy, biomechanics, trauma, and surgical procedures for repairing the osseous and the ligamentous structures thus are the key factors in rehabilitating the elbow joint successfully.
Topics: Humans; Humeral Fractures; Joint Dislocations; Physical Therapy Modalities; Radius Fractures; Splints; Elbow Injuries
PubMed: 15539093
DOI: 10.1016/j.hcl.2004.06.004