Outcome Trends Post Discharge From Inpatient Rehabilitation to the Community.

Outcome Trends Post Discharge from Inpatient Rehabilitation to the Community.

Rehabil Nurs. 2013 Jun 18;
Schmidt AS

PURPOSE: This study provides evidence of the outcome trends following inpatient rehabilitation services. METHODS: The methodology of this study design uses descriptive statistical analysis, paired t-tests, and analysis of variance (ANOVA) to examine multiple variables. This quantitative, non-experimental study describes the research population and the data collection instrument, the inpatient rehabilitation facility patient assessment instrument (IRF PAI), including the Functional Independence Measure (FIM). FINDINGS: Identified trends provide evidence that functional gains of the disabled population were maintained post discharge from an inpatient rehabilitation facility. Demographics, medical information, and discharge information were studied to describe relationships between the discharge information (discharge living setting, discharge with home health services, discharge to the person living with) and maintained functional performance. CONCLUSIONS: This evidence provides essential information for healthcare providers, including nurses, policy makers, and governments regarding functional gains following inpatient rehabilitation, and community discharge trends of people receiving inpatient rehabilitation services. CLINICAL RELEVANCE: The evidence in this study supports that inpatient rehabilitation services should be provided to all persons with disabilities to increase functioning to the greatest level of independence possible. Further evidence-based knowledge regarding the proposed 75% Rule of the Prospective Payment System (PPS) is needed and required, affecting the access and delivery of rehabilitation services. All patients have a right to quality, cost-effective care without restrictions to certain populations to encourage return to community dwelling. HubMed – rehab


Geriatric rehabilitation after hip fracture : Role of body-fixed sensor measurements of physical activity.

Z Gerontol Geriatr. 2013 Jun 20;
Benzinger P, Lindemann U, Becker C, Aminian K, Jamour M, Flick SE

BACKGROUND: The demand for geriatric rehabilitation will drastically increase over the next years. It will be increasingly important to demonstrate the efficacy and effectiveness of geriatric rehabilitation. One component is the use of objective and valid assessment procedures. These should be understandable to patients, relevant for goal attainment, and able to document change. A number of currently used physical capacity measures have floor effects. The use of body-fixed sensor technology for monitoring physical activity is a possible supplement for the assessment during geriatric rehabilitation to overcome floor effects and directly monitor improvement of mobility as a component of geriatric rehabilitation in many patients. METHODS: The observational study with a pre-post design examined 65 consecutive geriatric hip fracture inpatients. Measurements were performed on admission and 2 weeks later. The capacity measures included gait speed, chair rise time, a balance test, 2-Minute-Walk test and the Timed-Up-and-Go test. Physical activity was measured over 9 h using body-fixed sensor technology and expressed as cumulated walking and walking plus standing (time on feet). RESULTS: Body-fixed sensors allowed direct measurement of physical activity in all patients available for testing. Cumulated walking and standing (time on feet) increased from a median 83.6 to 102.6 min. Cumulated walking increased from a median 7.0 to 16.3 min. The comparison with the physical capacity measures demonstrated a modest to fair correlation (rs?=?0.455 and 0.653). This indicates that physical capacity measures are not the same construct as physical activity. CONCLUSION: Body-fixed sensor-based assessment of physical activity was feasible even in geriatric patients with severe mobility problems and decreased the number of patients with missing data both on admission and 2 weeks later. Body-fixed sensor data documented change in activity level. HubMed – rehab


In Vitro Cytotoxicity of White MTA, MTA Fillapex® and Portland Cement on Human Periodontal Ligament Fibroblasts.

Braz Dent J. 2013; 24(2):
Yoshino P, Nishiyama CK, Modena KC, Santos CF, Sipert CR

The aim of this study was to compare the in vitro cytotoxicity of white mineral trioxide aggregate (MTA), MTA Fillapex® and Portland cement (PC) on human cultured periodontal ligament fibroblasts. Periodontal ligament fibroblast culture was established and the cells were used for cytotoxic tests after the fourth passage. Cell density was set at 1.25 X10 4 cells/well in 96-well plates. Endodontic material extracts were prepared by placing sealer/cement specimens (5X3mm) in 1mL of culture medium for 72 h. The extracts were then serially two-fold diluted and inserted into the cell-seeded wells for 24, 48 and 72 h. MTT assay was employed for analysis of cell viability. Cell supernatants were tested for nitric oxide using the Griess reagent system. MTA presented cytotoxic effect in undiluted extracts at 24 and 72 h. MTA Fillapex® presented the highest cytotoxic levels with important cell viability reduction for pure extracts and at ½ and ¼ dilutions. In this study, PC did not induce alterations in fibroblast viability. Nitric oxide was detected in extract-treated cell supernatants and also in the extracts only, suggesting presence of nitrite in the soluble content of the tested materials. In the present study, MTA Fillapex displayed the highest cytotoxic effect on periodontal ligament fibroblasts followed by white MTA and PC. HubMed – rehab