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Handbook of Clinical Neurology 2010This chapter retraces the history and evolution of rehabilitative efforts by physicians and other health professionals to alleviate the symptoms and disabilities... (Review)
Review
This chapter retraces the history and evolution of rehabilitative efforts by physicians and other health professionals to alleviate the symptoms and disabilities associated with neurological disorders. Rehabilitation therapies often provide interventions that go beyond traditional medical treatment aimed at treating impairments, and help those with neurological injuries and illness to re-establish themselves as productive and socially-integrated citizens by reducing their functional disabilities. The chapter considers the early history of practical treatments developed in Greek and Roman times, reviews the scattered attempts at treatment during the Middle Ages and Renaissance, examines the more recent development of specific rehabilitative techniques and disciplines in the 20th century, and also provides discussion of the contemporary application of empirically validated rehabilitation strategies and techniques that emphasize treatment efficacy. The evolution of medical and physical rehabilitation, occupational and vocational rehabilitation, aphasia and cognitive rehabilitation, are all discussed, with additional review of the influence of some of the military conflicts and wars in history that have stimulated the advancement of the clinical practice of rehabilitation. A critique of the benefits of comprehensive rehabilitative programs for traumatic brain injury and stroke is specifically included. The varied skepticism and optimism of treating neurological disorders throughout history is also highlighted.
Topics: Cognitive Behavioral Therapy; Disabled Persons; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; Nervous System Diseases; Rehabilitation, Vocational
PubMed: 19892156
DOI: 10.1016/S0072-9752(08)02153-2 -
Minerva Ginecologica Aug 2004Pelvic floor rehabilitation (PFR) is an important and recommended strategy for the treatment of many urogynecological disorders including urinary incontinence (UI). The... (Review)
Review
Pelvic floor rehabilitation (PFR) is an important and recommended strategy for the treatment of many urogynecological disorders including urinary incontinence (UI). The recognised pioneer of PFR is the American gynecologist Arnold Kegel who, over 50 years ago, proposed pelvic floor muscle exercises (PFME) to prevent and/or treat female UI. Kegel's techniques were successfully used by others too, but as the years passed these techniques sank into unjustified oblivion. In the 1980s in Europe the medical world's interest in PFME techniques gained ground, contemporaneously with functional electrical stimulation (FES) and biofeedback (BFB). As a general rule, the least invasive and least dangerous procedure for the patient should be the first choice, and behavioural and rehabilitative techniques should be considered as the first line of therapy for UI. The behavioural approaches in women with UI and without cognitive deficits are tailored to the patient's underlying problem, such as bladder training or retraining (BR) for urge UI. BR has many variations but generally consists of education, scheduled voiding, and positive reinforcements. The rehabilitative approaches comprise BFB, FES, PFME, and vaginal cones (VC). BFB allows the subject to modify the unconscious physiological events, while FES is aimed at strengthening perineal awareness, increasing the tone and trophism of the pelvic floor, and inhibiting detrusor overactivity. PFME play an extremely important role in the conservative treatment of UI and overactive bladder, and many studies have demonstrated their effectiveness. Many authors have used the different methods for PFR in a heterogeneous manner: the best results were obtained when protocols requiring the contemporary use of 2 or more techniques were followed.
Topics: Biofeedback, Psychology; Electric Stimulation Therapy; Exercise Therapy; Female; Humans; Patient Education as Topic; Urinary Incontinence
PubMed: 15377984
DOI: No ID Found -
British Journal of Sports Medicine May 2020To summarise recommendations and appraise the quality of international clinical practice guidelines (CPGs) for rehabilitation after ACL reconstruction.
How should clinicians rehabilitate patients after ACL reconstruction? A systematic review of clinical practice guidelines (CPGs) with a focus on quality appraisal (AGREE II).
OBJECTIVES
To summarise recommendations and appraise the quality of international clinical practice guidelines (CPGs) for rehabilitation after ACL reconstruction.
DESIGN
Systematic review of CPGs (PROSPERO number: CRD42017020407).
DATA SOURCES
Pubmed, EMBASE, Cochrane, SPORTDiscus, PEDro and grey literature databases were searched up to 30 September 2018.
ELIGIBILITY CRITERIA
English-language CPGs on rehabilitation following ACL reconstruction that used systematic search of evidence to formulate recommendations.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report the systematic review. Two appraisers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to report comprehensiveness, consistency and quality of CPGs. We summarised recommendations for rehabilitation after ACL reconstruction.
RESULTS
Six CPGs with an overall median AGREE II total score of 130 points (out of 168) and median overall quality of 63% were included. One CPG had an overall score below the 50% (poor quality score) and two CPGs scored above 80% (higher quality score). The lowest domain score was 'applicability' (can clinicians implement this in practice?) (29%) and the highest 'scope and purpose' (78%) and 'clarity of presentation' (75%). CPGs recommended immediate knee mobilisation and strength/neuromuscular training. Early full weight-bearing exercises, early open and closed kinetic-chain exercises, cryotherapy and neuromuscular electrostimulation may be used according individual circumstances. The CPGs recommend against continuous passive motion and functional bracing.
CONCLUSION
The quality of the CPGs in ACL postoperative rehabilitation was good, but all CPGs showed poor applicability. Immediate knee mobilisation and strength/neuromuscular training should be used. Continuous passive motion and functional bracing should be eschewed.
Topics: Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Cryotherapy; Early Ambulation; Electric Stimulation Therapy; Exercise Therapy; Humans; Practice Guidelines as Topic; Range of Motion, Articular; Resistance Training
PubMed: 31175108
DOI: 10.1136/bjsports-2018-100310 -
Bundesgesundheitsblatt,... Apr 2017It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to...
It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession. Whereas geriatric and neurological early rehabilitation are reflected in the DRG system, the former provided in many general hospitals and the latter mainly in specialized institutions, interdisciplinary early rehabilitation has only occasionally been represented in the DRG system so far. If all acute in-patients who require early rehabilitation should receive such an intervention, an additional fee must be implemented for this this interdisciplinary service.
Topics: Diagnosis-Related Groups; Disabled Persons; Germany; Health Care Costs; Hospitalization; Humans; Models, Economic; Rehabilitation; Secondary Prevention
PubMed: 28197663
DOI: 10.1007/s00103-017-2522-0 -
Revista de NeurologiaThe aim of this paper is to theoretically define some aspects related with cognitive rehabilitation, as well as the methodological principles needed to draw up a... (Review)
Review
AIMS
The aim of this paper is to theoretically define some aspects related with cognitive rehabilitation, as well as the methodological principles needed to draw up a programme of rehabilitation for these functions.
METHOD
We performed an analysis of the definitions developed by different contemporary authors, of the theoretical approaches to cognitive rehabilitation, and the modes and models of how the functions are organised within the brain. Lastly, we set out the fundamental methodological principles to be taken into account in the production of a cognitive intervention programme, and describe the advantages offered by computer aided procedures as compared to the conventional methods of rehabilitation.
CONCLUSIONS
Cognitive rehabilitation is currently considered one of the most important tasks or directions in neuropsychology and a number of theoretical and methodological approaches have been developed to deal with it. Over the past few years there has been a notable increase in the number of studies carried out involving cognitive intervention, especially in patients who are carriers of brain injuries of a traumatic or vascular aetiology and which give rise to a collection of motor, sensory and cognitive disorders. The level of development achieved in the cognitive neurosciences and IT have contributed to the conventional methods being substituted by computer applications that allow greater effectiveness in the rehabilitating process
Topics: Brain; Brain Injuries; Cognition Disorders; Humans; Microcomputers; Recovery of Function; Rehabilitation
PubMed: 12436386
DOI: No ID Found -
Acta Otorhinolaryngologica Italica :... Oct 2017In the last 20 years, neonatal survival has progressively increased due to the constant amelioration of neonatal medical treatment and surgical techniques. Thus, the... (Review)
Review
In the last 20 years, neonatal survival has progressively increased due to the constant amelioration of neonatal medical treatment and surgical techniques. Thus, the number of children with congenital malformations and severe chronic pathologies who need rehabilitative care has progressively increased. Rehabilitation programs for paediatric patients with disorders of voice, speech and language, communication and hearing, deglutition and breathing are not widely available in hospital settings or in long-term care facilities. In most countries, the number of physicians and technicians is still inadequate; moreover, multidisciplinary teams dedicated to paediatric patients are quite rare. The aim of the present study is to present some new trends in ENT paediatric rehabilitation.
Topics: Child; Humans; Otorhinolaryngologic Diseases; Rehabilitation
PubMed: 28530252
DOI: 10.14639/0392-100X-1426 -
Best Practice & Research. Clinical... Oct 2003Rehabilitation, as an adjunct to pharmacological and surgical therapies in patients with rheumatoid arthritis (RA), aims to minimize the consequences of the disease. For... (Review)
Review
Rehabilitation, as an adjunct to pharmacological and surgical therapies in patients with rheumatoid arthritis (RA), aims to minimize the consequences of the disease. For a systematic assessment of the consequences of disease, an appropriate definition and evaluation of the goals of therapy and interventions, and an active partnership with the patient, a structured approach to rehabilitation management is needed.Despite widespread positive clinical experience with rehabilitative interventions, the scientific evidence of their effectiveness is, in general, scanty, owing to a lack of studies with sufficient methodological quality. Further well-designed clinical studies are warranted with respect to several interventions where evidence is falling short.
Topics: Arthritis, Rheumatoid; Exercise Therapy; Humans; Occupational Therapy; Orthotic Devices; Patient Education as Topic; Physical Therapy Modalities
PubMed: 12915161
DOI: 10.1016/s1521-6942(03)00043-3 -
Clinics in Geriatric Medicine May 2006Numerous studies support the use of rehabilitative interventions in the older adult. Given the many fiscal challenges in health care today, it is of utmost importance... (Review)
Review
Numerous studies support the use of rehabilitative interventions in the older adult. Given the many fiscal challenges in health care today, it is of utmost importance that funding for rehabilitation result in fruitful outcomes. Specific rehabilitative interventions have been found to be very effective in the elderly and can be demonstrated through numerous studies. Outcomes for conditions including stroke, traumatic brain injury, spinal cord injury, amputation, hip fracture, and joint replacement are discussed. There is great need for ongoing research to determine optimal rehabilitative interventions in the elderly.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Amputation, Surgical; Disability Evaluation; Disabled Persons; Female; Geriatric Assessment; Hip Fractures; Humans; Male; Prognosis; Risk Assessment; Spinal Cord Injuries; Stroke Rehabilitation; Treatment Outcome
PubMed: 16627077
DOI: 10.1016/j.cger.2005.12.015 -
The American Journal of the Medical... Feb 2004Older persons with cancer can often benefit from rehabilitative care. Rehabilitation may be of benefit to the patient whether or not their malignancy is curable.... (Review)
Review
Older persons with cancer can often benefit from rehabilitative care. Rehabilitation may be of benefit to the patient whether or not their malignancy is curable. Rehabilitative programs must be tailored to the patient's abilities, endurance, prognosis, and individual goals.
Topics: Activities of Daily Living; Aged; Health Services for the Aged; Humans; Neoplasms; Palliative Care
PubMed: 14770025
DOI: 10.1097/00000441-200402000-00006 -
Journal of Occupational Rehabilitation Mar 2019Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a...
Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a growing number of young people with psychological disabilities in vocational rehabilitation can be observed. The study at hand focuses on this group and examines their (un-)unemployment biographies before vocational rehabilitation, their access to vocational rehabilitation and identifies their individual challenges within the process of vocational rehabilitation. Methods Using a multi-methods approach, we analyze representative administrative data of the German Federal Employment Agency as well as biographical interviews conducted with young rehabilitants. We compare the population of young rehabilitants with psychological disorders to those with other disabilities in terms of vocational rehabilitation and initial labor market entry in order to get a representative picture about their school to work transitions. Since rehabilitants with psychological disabilities tend to be older than the remaining population, analyses are stratified by age groups. In addition, qualitative in-depth interviews provide an additional and deeper understanding of specific employment barriers youth with psychological disorders have to overcome. Furthermore, the individual perspective gives insight on how the crucial transition from school to work is perceived by the population under study. Results The pathway into vocational rehabilitation of youth with psychological disorders is often characterized by obstacles in their transition from school to work. During rehabilitation, it appears essential to provide psychological stabilization along with vocational training. Although their average level of education is higher than those of other rehabilitants, labor market transition after (often company-external) vocational training challenges many young people with psychological disabilities, leaving many of them with comparatively poor labor market prospects. Conclusions Young persons with psychological disabilities, who come from regular schools or dropped out from regular school or university, seem to find their way to vocational rehabilitation more indirectly. Furthermore, vocational rehabilitation itself is often prolonged for those with psychological disabilities possibly due to a corresponding stabilization process. However, vocational rehabilitation can be a core element within the stabilization process of a psychological disease.
Topics: Adolescent; Adult; Age Distribution; Case-Control Studies; Disabled Persons; Employment; Female; Germany; Humans; Male; Mental Disorders; Qualitative Research; Rehabilitation, Vocational; Time Factors; Young Adult
PubMed: 29744627
DOI: 10.1007/s10926-018-9773-y