Fostering Interprofessional Learning in a Rehabilitation Setting: Development of an Interprofessional Clinical Learning Unit.

Fostering Interprofessional Learning in a Rehabilitation Setting: Development of an Interprofessional Clinical Learning Unit.

Rehabil Nurs. 2013 May 17;
Vanderzalm J, Hall MD, McFarlane LA, Rutherford L, Patterson SK

PURPOSE: The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described. METHODS: Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice. FINDINGS: Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges. CONCLUSIONS: The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success. CLINICAL RELEVANCE: The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting. HubMed – rehab


Autogeneous coronoid process as free graft for reconstruction of mandibular condyle in patients with temporomandibular ankylosis.

Oral Maxillofac Surg. 2013 May 18;
Hu W, Thadani S, Mukul SK, Sood R

OBJECTIVE: This study was conducted to determine the efficacy of using the autogeneous coronoid process as free graft for reconstruction of mandibular condyle and to achieve structural, functional, as well as esthetic rehabilitation of patients with temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS: This article presents the clinical results of an evaluation of ten cases of TMJ ankylosis treated by using autogeneous coronoid process as free graft for reconstruction of mandibular condyle after resection of ankylotic mass. RESULTS: Satisfactory mouth opening were obtained in all ten cases. No patient showed signs of re-ankylosis at 12 months follow-up. Preoperative mouth opening ranged from 0 to 15 mm with mean being 4.8 mm. As a result of successful procedure, the immediate postoperative mouth opening increased ranging from 24 to 31 mm (mean, 26.5 mm). Follow up of patients at the first and 12th month showed good results with increase in mouth opening from a range of 24 to 31 mm (mean, 27.8 mm ) to 26 to 36 mm (mean, 33.13 mm). CONCLUSION: The results of this study suggest that the autogeneous coronoid process as free graft is a suitable graft material for reconstruction of mandibular condyle after resection of ankylotic mass. HubMed – rehab


Physical activity discrimination improvement using accelerometers and wireless sensor network localization – biomed 2013.

Biomed Sci Instrum. 2013; 49: 243-50
Bashford GR, Burnfield JM, Perez LC

Automating documentation of physical activity data (e.g., duration and speed of walking or propelling a wheelchair) into the electronic medical record (EMR) offers promise for improving efficiency of documentation and understanding of best practices in the rehabilitation and home health settings. Commercially available devices which could be used to automate documentation of physical activities are either cumbersome to wear or lack the specificity required to differentiate activities. We have designed a novel system to differentiate and quantify physical activities, using inexpensive accelerometer-based biomechanical data technology and wireless sensor networks, a technology combination that has not been used in a rehabilitation setting to date. As a first step, a feasibility study was performed where 14 healthy young adults (mean age = 22.6 ± 2.5 years, mean height = 173 ± 10.0 cm, mean mass = 70.7 ± 11.3 kg) carried out eight different activities while wearing a biaxial accelerometer sensor. Activities were performed at each participant?s self-selected pace during a single testing session in a controlled environment. Linear discriminant analysis was performed by extracting spectral parameters from the subjects? accelerometer patterns. It is shown that physical activity classification alone results in an average accuracy of 49.5%, but when combined with rule-based constraints using a wireless sensor network with localization capabilities in an in silico simulated room, accuracy improves to 99.3%. When fully implemented, our technology package is expected to improve goal setting, treatment interventions and patient outcomes by enhancing clinicians? understanding of patients? physical performance within a day and across the rehabilitation program. HubMed – rehab


Improvements in Negative Symptoms and Functional Outcome After a New Generation Cognitive Remediation Program: A Randomized Controlled Trial.

Schizophr Bull. 2013 May 18;
Sánchez P, Peña J, Bengoetxea E, Ojeda N, Elizagárate E, Ezcurra J, Gutiérrez M

Cognitive remediation improves cognition in patients with schizophrenia, but its effect on other relevant factors such as negative symptoms and functional outcome has not been extensively studied. In this hospital-based study, 84 inpatients with chronic schizophrenia were recruited from Alava Hospital (Spain). All of the subjects underwent a baseline and a 3-month assessment that examined neurocognition, clinical symptoms, insight, and functional outcome according to the Global Assessment of Functioning (GAF) scale and Disability Assessment Schedule from World Health Organization (DAS-WHO). In addition to receiving standard treatment, patients were randomly assigned either to receive neuropsychological rehabilitation (REHACOP) or to a control group. REHACOP is an integrative program that taps all basic cognitive functions. The program included experts’ latest suggestions about positive feedback and activities of daily living in the patients’ environment. The REHACOP group showed significantly greater improvements at 3 months in the areas of neurocognition, negative symptoms, disorganization, and emotional distress compared with the control group (Cohen’s effect size for these changes ranged from d = 0.47 for emotional distress to d = 0.58 for disorganization symptoms). The REHACOP group also improved significantly in both the GAF (d = 0.61) and DAS-WHO total scores (d = 0.57). Specifically, the patients showed significant improvement in vocational outcomes (d = 0.47), family contact (d = 0.50), and social competence (d = 0.56). In conclusion, neuropsychological rehabilitation may be useful for the reduction of negative symptoms and functional disability in schizophrenia. These findings support the integration of neuropsychological rehabilitation into standard treatment programs for patients with schizophrenia. HubMed – rehab