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Journal of Rehabilitation Medicine Aug 2017With increasing frequency of natural disasters, there has been greater focus recently on the importance and role of rehabilitation services in disaster management. In... (Review)
Review
With increasing frequency of natural disasters, there has been greater focus recently on the importance and role of rehabilitation services in disaster management. In past disasters, rehabilitative needs were often neglected, with emphasis on acute response plans focused on saving lives and treating acute injuries. There was a lack of, or inadequate, rehabilitation-inclusive disaster response plans and rehabilitation services in many disaster-prone developing countries. The World Health Organization (WHO) Emergency Medical Team (EMT) initiative recognizes rehabilitation as an integral part of medical response and patient-centred care in disaster settings. Current developments under this initiative include: the development of minimum standards for rehabilitation in emergencies to allow rapid, professional, coordinated medical response by both national and international EMTs. These guidelines ensure that EMTs deliver effective and coordinated patient care during disasters and continuum of care beyond their departure. The aim is to strengthen national capacity, foster an environment of self-empowerment of EMTs and local health services, and work in rehabilitation within defined coordination mechanisms in disaster-affected areas. A brief overview of rehabilitation in natural disasters, highlighting current developments, challenges; and gaps in the implementation of WHO guidelines for Minimum Standards for Rehabilitation in Emergencies is discussed in order to improve care for victims of future disasters.
Topics: Disaster Planning; Humans; Internationality; Rehabilitation
PubMed: 28665445
DOI: 10.2340/16501977-2250 -
Scientific Reports Sep 2023Mirror therapy is applied to reduce phantom pain and as a rehabilitation technique in post-stroke patients. Using Virtual Reality and head-mounted displays this therapy...
Mirror therapy is applied to reduce phantom pain and as a rehabilitation technique in post-stroke patients. Using Virtual Reality and head-mounted displays this therapy can be performed in virtual scenarios. However, for its efficient use in clinical settings, some hardware limitations need to be solved. A new system to perform mirror therapy in virtual scenarios for post-stroke patients is proposed. The system requires the patient a standalone virtual reality headset with hand-tracking features and for the rehabilitator an external computer or tablet device. The system provides functionalities for the rehabilitator to prepare and follow-up rehabilitation sessions and a virtual scenario for the patient to perform rehabilitation. The system has been tested on a real scenario with the support of three experienced rehabilitators and considering ten post-stroke patients in individual sessions focused on upper limb motor rehabilitation. The development team observed all the sessions and took note of detected errors regarding technological aspects. Solutions to solve detected problems will be proposed and evaluated in terms of feasibility, performance cost, additional system cost, number of solved issues, new limitations, or advantages for the patient. Three types of errors were detected and solved. The first error is related to the position of the hands relative to the head-mounted display. To solve it the exercise area can be limited to avoid objectives that require turning the head too far. The second error is related to the interaction between the hands and the virtual objects. It can be solved making the main hand non-interactive. The last type of error is due to patient limitations and can be mitigated by having a virtual hand play out an example motion to bring the patient's attention back to the exercise. Other solutions have been evaluated positively and can be used in addition or instead of the selected ones. For mirror therapy based on virtual reality to be efficient in post-stroke rehabilitation the current head-mounted display-based solutions need to be complemented with specific strategies that avoid or mitigate the limitations of the technology and the patient. Solutions that help with the most common issues have been proposed.
Topics: Humans; Mirror Movement Therapy; Hand; Stroke; Upper Extremity; Virtual Reality
PubMed: 37679388
DOI: 10.1038/s41598-023-40546-2 -
TheScientificWorldJournal 2014Medical rehabilitation is the process targeted to promote and facilitate the recovery from physical damage, psychological and mental disorders, and clinical disease. The... (Review)
Review
Medical rehabilitation is the process targeted to promote and facilitate the recovery from physical damage, psychological and mental disorders, and clinical disease. The history of medical rehabilitation is closely linked to the history of disability. In the ancient western world disabled subjects were excluded from social life. In ancient Greece disability was surmounted only by means of its complete removal, and given that disease was considered a punishment attributed by divinities to human beings because of their faults and sins, only a full physical, mental, and moral recovery could reinsert disabled subjects back in the society of "normal" people. In the Renaissance period, instead, general ideas functional for the prevention of diseases and the maintaining of health became increasingly technical notions, specifically targeted to rehabilitate disabled individuals. The history of medical rehabilitation is a fascinating journey through time, providing insights into many different branches of medicine. When modern rehabilitation emerges, around the middle of the twentieth century, it derives from a combination of management approaches focusing on the orthopaedic and biomechanical understanding of patterns of movement, on the mastering of neuropsychological mechanisms, and on the awareness of the social-occupational dimension of everyday reality.
Topics: History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Knowledge; Rehabilitation
PubMed: 24550707
DOI: 10.1155/2014/432506 -
The Cochrane Database of Systematic... Feb 2020Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics to receive training to learn to use VAE. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e. telerehabilitation).
OBJECTIVES
To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 6); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 24 June 2019.
SELECTION CRITERIA
We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach involving in-person consultations.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened titles and abstracts and then full-text articles against the eligibility criteria. We planned to have two review authors independently abstract data from the included studies. Any discrepancies were resolved by discussion.
MAIN RESULTS
We identified two ongoing studies, but did not find any completed RCTs and CCTs that met the inclusion criteria for this review. We did not conduct a quantitative analysis. We discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care.
AUTHORS' CONCLUSIONS
We did not find any evidence from RCTs or CCTs on the efficacy of using telerehabilitation for remote delivery of rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide evidence in understanding the potential for telerehabilitation as a platform for providing services to people with low vision.
Topics: Activities of Daily Living; Humans; Quality of Life; Randomized Controlled Trials as Topic; Self-Help Devices; Telerehabilitation; Vision, Low
PubMed: 32102114
DOI: 10.1002/14651858.CD011019.pub3 -
Human Resources For Health Sep 2021Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not...
Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not available or not easily accessible to those who need them. Bhutan is one such country where healthcare is provided free of cost to all, but as of 2021 physiotherapy services were available only in 26 of 48 hospitals and 19 of 20 districts. The number of physiotherapy professionals per 10,000 population is 1.4 with significant rates of attrition. There is lack of awareness among patients and other health professionals about physiotherapy and rehabilitation services. The country needs to integrate physiotherapy and rehabilitation services into the overall health policy framework and develop proper planning of human resources and infrastructure to meet the current and future demands.
Topics: Bhutan; Delivery of Health Care; Humans; Patient Care; Physical Therapy Modalities; Workforce
PubMed: 34479592
DOI: 10.1186/s12960-021-00649-1 -
Computational Intelligence and... 2019Rehabilitation is essential for disabled people to achieve the highest level of functional independence, reducing or preventing impairments. Nonetheless, this process... (Review)
Review
Rehabilitation is essential for disabled people to achieve the highest level of functional independence, reducing or preventing impairments. Nonetheless, this process can be long and expensive. This fact together with the ageing phenomenon has become a critical issue for both clinicians and patients. In this sense, technological solutions may be beneficial since they reduce the costs and increase the number of patients per caregiver, which makes them more accessible. In addition, they provide access to rehabilitation services for those facing physical, financial, and/or attitudinal barriers. This paper presents the state of the art of the assistive rehabilitation technologies for different recovery methods starting from in-person sessions to complementary at-home activities.
Topics: Disabled Persons; Humans; Recovery Room; Recovery of Function; Rehabilitation; Self-Help Devices
PubMed: 31281333
DOI: 10.1155/2019/1431509 -
Developmental Medicine and Child... Nov 2016
Topics: Child; Disabled Children; Health Facility Environment; Humans; Neurological Rehabilitation
PubMed: 27704543
DOI: 10.1111/dmcn.13246 -
Journal of Research in Health Sciences Mar 2023Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level.
STUDY DESIGN
A parallel-group, single-blinded randomized controlled trial.
METHODS
Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention.
RESULTS
After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (<0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively.
CONCLUSION
Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management.
Topics: Adult; Humans; Osteoarthritis, Knee; Activities of Daily Living; Self-Management; Treatment Outcome; Pain; Exercise Therapy
PubMed: 37571940
DOI: 10.34172/jrhs.2023.104 -
Journal of Parkinson's Disease 2024Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving...
BACKGROUND
Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD.
OBJECTIVE
The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care.
METHODS
The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions.
RESULTS
The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages.
CONCLUSIONS
Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.
Topics: Humans; Parkinson Disease; Quality of Life; Occupational Therapy; Speech Therapy; Disabled Persons
PubMed: 38277303
DOI: 10.3233/JPD-230117 -
Artificial Organs Jan 2022The coronavirus diseases 2019 (COVID-19) pandemic posed severe difficulties in managing critically ill patients in hospital care settings. Extracorporeal membrane... (Review)
Review
BACKGROUND AND PURPOSE
The coronavirus diseases 2019 (COVID-19) pandemic posed severe difficulties in managing critically ill patients in hospital care settings. Extracorporeal membrane oxygenation (ECMO) support has been proven to be lifesaving support during the SARS-CoV-2 outbreak. The purpose of this review was to describe the rehabilitative treatments provided to patients undergoing ECMO support during the COVID-19 pandemic.
METHODS
We searched PubMed and Scopus for English-language studies published from the databases' inception until June 30, 2021. We excluded editorials, letters to the editor, and studies that did not describe rehabilitative procedures during ECMO support. We also excluded those articles not written in English.
RESULTS
A total of 50 articles were identified. We ultimately included nine studies, seven of which were case reports. Only two studies had more than one patient; an observational design analyzing the clinical course of 19 patients and a case series of three patients. Extracorporeal support duration varied from 9 to 49 days, and the primary indication was acute respiratory distress syndrome COVID-19-related. Rehabilitative treatment mainly consisted of in-bed mobilization, postural transfers (including sitting), and respiratory exercises. After hospital discharge, patients were referred to rehabilitation facilities. Physiotherapeutic interventions provided during ECMO support and after its discontinuation were feasible and safe.
CONCLUSION
The physiotherapeutic treatment of patients undergoing ECMO support includes several components and must be provided in a multidisciplinary context. The optimal approach depends on the patient's status, including sedation, level of consciousness, ECMO configuration, types of cannulas, and cannulation site.
Topics: COVID-19; Extracorporeal Membrane Oxygenation; Humans; Physical Therapy Modalities; SARS-CoV-2
PubMed: 34778984
DOI: 10.1111/aor.14110