Rehab Centers: Attendance at Cardiac Rehabilitation Is Associated With Lower All-Cause Mortality After 14 Years of Follow-Up.
Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up.
Filed under: Rehab Centers
Heart. 2012 Dec 4;
Beauchamp A, Worcester M, Ng A, Murphy B, Tatoulis J, Grigg L, Newman R, Goble A
OBJECTIVE: To investigate whether attendance at cardiac rehabilitation (CR) independently predicts all-cause mortality over 14 years and whether there is a dose-response relationship between the proportion of CR sessions attended and long-term mortality. DESIGN: Retrospective cohort study. SETTING: CR programmes in Victoria, Australia PATIENTS: The sample comprised 544 men and women eligible for CR following myocardial infarction, coronary artery bypass surgery or percutaneous interventions. Participants were tracked 4 months after hospital discharge to ascertain CR attendance status. MAIN OUTCOME MEASURES: All-cause mortality at 14 years ascertained through linkage to the Australian National Death Index. RESULTS: In total, 281 (52%) men and women attended at least one CR session. There were few significant differences between non-attenders and attenders. After adjustment for age, sex, diagnosis, employment, diabetes and family history, the mortality risk for non-attenders was 58% greater than for attenders (HR=1.58, 95% CI 1.16 to 2.15). Participants who attended <25% of sessions had a mortality risk more than twice that of participants attending ?75% of sessions (OR=2.57, 95% CI 1.04 to 6.38). This association was attenuated after adjusting for current smoking (OR=2.06, 95% CI 0.80 to 5.29). CONCLUSIONS: This study provides further evidence for the long-term benefits of CR in a contemporary, heterogeneous population. While a dose-response relationship may exist between the number of sessions attended and long-term mortality, this relationship does not occur independently of smoking differences. CR practitioners should encourage smokers to attend CR and provide support for smoking cessation. HubMed – rehab
Benefits of a Repetitive Facilitative Exercise Program for the Upper Paretic Extremity After Subacute Stroke: A Randomized Controlled Trial.
Filed under: Rehab Centers
Neurorehabil Neural Repair. 2012 Dec 3;
Shimodozono M, Noma T, Nomoto Y, Hisamatsu N, Kamada K, Miyata R, Matsumoto S, Ogata A, Etoh S, Basford JR, Kawahira K
BACKGROUND: . Repetitive facilitative exercise (RFE), a combination of high repetition rate and neurofacilitation, is a recently developed approach to the rehabilitation of stroke-related limb impairment. Preliminary investigations have been encouraging, but a randomized controlled evaluation has yet to be performed. OBJECTIVES: . To compare the efficacy of RFE with that of conventional rehabilitation in adults with subacute stroke. METHODS: . A total of 52 adults with stroke-related upper-limb impairment (Brunnstrom stage ?III) of 3 to 13 weeks’ duration participated in this randomized, controlled, observer-blinded trial. Participants were randomized into 2 groups and received treatment on a 4-week, 40 min/d, 5 d/wk schedule. Those assigned to RFE received 100 standardized movements of at least 5 joints of their affected upper extremity, whereas those in the control group participated in a conventional upper-extremity rehabilitation program. Primary and secondary outcomes (improvement in group Action Research Arm Test [ARAT] and Fugl-Meyer Arm [FMA] scores, respectively) were assessed at the end of training. RESULTS: . In all, 49 participants (26 receiving RFE) completed the trial. ARAT and FMA scores at baseline were 19 ± 21 and 39 ± 21 (mean ± standard deviation). Evaluation at the trial’s completion revealed significantly larger improvements in the RFE group than in the control group in both ARAT (F = 7.52; P = .009) and FMA (F = 5.98; P = .019) scores. CONCLUSIONS: . These findings suggest that RFE may be more effective than conventional rehabilitation in lessening impairment and improving upper-limb motor function during the subacute phase of stroke.
HubMed – rehab
Adaptive Mixed Reality Rehabilitation Improves Quality of Reaching Movements More Than Traditional Reaching Therapy Following Stroke.
Filed under: Rehab Centers
Neurorehabil Neural Repair. 2012 Dec 3;
Duff M, Chen Y, Cheng L, Liu SM, Blake P, Wolf SL, Rikakis T
BACKGROUND: . Adaptive mixed reality rehabilitation (AMRR) is a novel integration of motion capture technology and high-level media computing that provides precise kinematic measurements and engaging multimodal feedback for self-assessment during a therapeutic task. OBJECTIVE: . We describe the first proof-of-concept study to compare outcomes of AMRR and traditional upper-extremity physical therapy. METHODS: . Two groups of participants with chronic stroke received either a month of AMRR therapy (n = 11) or matched dosing of traditional repetitive task therapy (n = 10). Participants were right handed, between 35 and 85 years old, and could independently reach to and at least partially grasp an object in front of them. Upper-extremity clinical scale scores and kinematic performances were measured before and after treatment. RESULTS: . Both groups showed increased function after therapy, demonstrated by statistically significant improvements in Wolf Motor Function Test and upper-extremity Fugl-Meyer Assessment (FMA) scores, with the traditional therapy group improving significantly more on the FMA. However, only participants who received AMRR therapy showed a consistent improvement in kinematic measurements, both for the trained task of reaching to grasp a cone and the untrained task of reaching to push a lighted button. CONCLUSIONS: . AMRR may be useful in improving both functionality and the kinematics of reaching. Further study is needed to determine if AMRR therapy induces long-term changes in movement quality that foster better functional recovery.
HubMed – rehab
Exploring Disparities in Access to Physician Services Among Older Adults: 2000-2007.
Filed under: Rehab Centers
J Gerontol B Psychol Sci Soc Sci. 2012 Dec 4;
Mahmoudi E, Jensen GA
Objectives.To compare racial/ethnic disparities in access to physician services among older adults in 2000 and 2007 and to identify potential factors driving the changes observed.Method.Using 2000 and 2007 Medical Expenditure Panel Survey data, we examine 2 measures of access for adults aged 65 and older: whether the individual reports of having a usual source of care (USC) and whether he/she made any physician visits during the past year. We model the determinants of access using logistic regressions and then calculate disparities in access between older African Americans and older Whites and between older Hispanics and older Whites applying a disparity definition suggested by the Institute of Medicine. RESULTS: In both 2000 and 2007, significant racial/ethnic disparities were evident in having no USC and in having no physician visits. Over the period, the disparity in having no physician visits diminished by 6.16% (p = .003) for African Americans, but it worsened by 5.28% (p = .021) for Hispanics. These changes were associated with a positive shift in the distribution of education among older African Americans and an erosion in Medicare among Hispanic seniors. CONCLUSION: Among older adults, disparities in access to physician services have diminished for African Americans but have grown worse for Hispanics.
HubMed – rehab
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