Post Laryngectomy Speech Rehabilitation Outcome in Elderly Patients.

Post laryngectomy speech rehabilitation outcome in elderly patients.

Eur Arch Otorhinolaryngol. 2013 Mar 22;
Cocuzza S, Bonfiglio M, Grillo C, Maiolino L, Malaguarnera M, Martines F, Serra A

The aim of our work has been to evaluate the different options of tracheoesophageal voice rehabilitation in over 70-year-old patients, who had undergone laryngectomy, assessing advantages and drawbacks of this method of vocal recovery. A retrospective study has been carried out. This has included 40 subjects, all aged more than 70 years old, who have been referred to tracheoesophageal voice rehabilitation. It has been realized a phonatory fistula between trachea and esophagus with prosthesis positioning by means of a primary puncture in 18 cases and it has been realized a secondary puncture in 22 cases. The results gathered in these patients were compared with data obtained from a group made of 39 patients, less than 70 years of age that therefore represented our control group. In primary tracheoesophageal puncture (TEP), the short-term success was 67 %, while in the 22 cases who underwent secondary TEP, the short-term success was 64 %. After 2 years from TEP, the long-term success was 82.5 %. In the control group, the short-term success was 65 % in primary TEP and 73 % in secondary TEP. After 2 years from TEP, the long-term success was 77 %. The evaluation of the results has shown the absence of a statistically significant difference both as regards complications incidence, during and after surgery (p > 0.9) and as regards overall success ratio of prosthesis implants between the two groups (p > 0.7). The possibilities of tracheoesophageal recovery of elderly patients do not show dissimilarities in comparison with the results in younger subjects. HubMed – rehab

Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial.

J Cancer Surviv. 2013 Mar 22;
Loh SY, Packer T, Chinna K, Quek KF

PURPOSE: Patient self-management enables living with a chronic disease effectively. This study examines the effectiveness of a 4-week self-management programme to enable self-management of the numerous after-effects and with breast cancer as a chronic disease. METHODS: Upon ethical approval, 147 multiethnic survivors (stages I-III breast cancer) received either a 4-week self-management intervention (n?=?68) or usual care (n?=?78) on a controlled clinical trial in a medical centre. The facilitator-led group intervention provides self-management support and skills for managing the medical, emotional and role tasks. Survivors completed the pre- and post-intervention measures on quality of life, distress and participation inventory. RESULTS: Multiple analyses of covariance (adjusted for baseline measures) showed significant differences between groups [F(6, 129)?=?2.26, p?=?0.04 at post-test and F(6, 129)?=?4.090, p?HubMed – rehab

Now You Feel both: Galvanic Vestibular Stimulation Induces Lasting Improvements in the Rehabilitation of Chronic Tactile Extinction.

Front Hum Neurosci. 2013; 7: 90
Schmidt L, Utz KS, Depper L, Adams M, Schaadt AK, Reinhart S, Kerkhoff G

Tactile extinction is frequent, debilitating, and often persistent after brain damage. Currently, there is no treatment available for this disorder. In two previous case studies we showed an influence of galvanic vestibular stimulation (GVS) on tactile extinction. Here, we evaluated in further patients the immediate and lasting effects of GVS on tactile extinction. GVS is known to induce polarity-specific changes in cerebral excitability in the vestibular cortices and adjacent cortical areas. Tactile extinction was examined with the Quality Extinction Test (QET) where subjects have to discriminate six different tactile fabrics in bilateral, double simultaneous stimulations on their dorsum of hands with identical or different tactile fabrics. Twelve patients with stable left-sided tactile extinction after unilateral right-hemisphere lesions were divided into two groups. The GVS group (N?=?6) performed the QET under six different experimental conditions (two Baselines, Sham-GVS, left-cathodal/right-anodal GVS, right-cathodal/left-anodal GVS, and a Follow-up test). The second group of patients with left-sided extinction (N?=?6) performed the QET six times repetitively, but without receiving GVS (control group). Both right-cathodal/left-anodal as well as left-cathodal/right-anodal GVS (mean: 0.7?mA) improved tactile identification of identical and different stimuli in the experimental group. These results show a generic effect of GVS on tactile extinction, but not in a polarity-specific way. These observed effects persisted at follow-up. Sham-GVS had no significant effect on extinction. In the control group, no significant improvements were seen in the QET after the six measurements of the QET, thus ruling out test repetition effects. In conclusion, GVS improved bodily awareness permanently for the contralesional body side in patients with tactile extinction and thus offers a novel treatment option for these patients. HubMed – rehab

Osteoarthritis: physical medicine and rehabilitation-nonpharmacological management.

Wien Med Wochenschr. 2013 Mar 22;
Stemberger R, Kerschan-Schindl K

Osteoarthritis (OA) is the most common joint disease, mainly affecting middle-aged and elderly persons. People with OA of the knee or hip experience pain and deconditioning that may lead to disability. Treatment goals include pain control, maximizing functional independence, and improving quality of life within the constraints imposed by both OA and comorbidities. Exercise is a core recommendation in all nonpharmacological guidelines for the management of patients with knee or hip OA; it is supposed to ameliorate pain and maybe function as well. Therapeutic ultrasound, neuromuscular as well as transcutaneous electrostimulation, pulsed magnetic field therapy, low-level laser therapy, thermal agents, acupuncture, and assistive devices such as insoles, canes, and braces can be used additionally in a multimodal therapeutic program. They may positively influence pain and function, mobility, and quality of life in patients suffering from OA of the lower limbs. HubMed – rehab

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