Rehab Centers: Development and Validation of an Innovative Tool for the Assessment of Biomechanical Strategies: The Timed “Up and Go” – Assessment of Biomechanical Strategies (TUG-ABS) for Individuals With Stroke.

Development and validation of an innovative tool for the assessment of biomechanical strategies: The Timed “Up and Go” – Assessment of Biomechanical Strategies (TUG-ABS) for individuals with stroke.

Filed under: Rehab Centers

J Rehabil Med. 2013 Feb 6;
Faria CD, Teixeira-Salmela LF, Nadeau S

Objective: To develop and validate a clinical tool based on the biomechanical strategies exhibited by people with hemiparesis due to stroke during the performance of the Timed “Up and Go” test. Design/methods: The Timed “Up and Go” Assessment of Biomechanical Strategies (TUG-ABS) was developed for subjects with stroke, based on the analyses of 3 sources of information: published evidence; opinions of rehabilitation professionals; and observations of TUG performances, followed by a multi-step approach, which involved the investigation of the reliability, content, and criterion-related validity of the preliminary version. Content validity was established by an expert panel, whereas intra- and inter-rater reliability was established by two independent examiners. Criterion-related validity was established by comparing the TUG-ABS scores at the item level obtained by independent analyses of video observations and the gold standard motion analysis system. The final tool included the items, which showed acceptable values for these psychometric properties. Results: The preliminary version consisted of 24 items with 3 response categories. Twenty-one items showed acceptable content validity (0.72???????1.00; p???0.01), 19 acceptable intra- and inter-rater reliability (0.36??????1.00; p???0.04), and 15 acceptable criterion-related validity (0.29???????1.00; p???0.04). Conclusion: The final developed 15-item TUG-ABS version proved to be valid and reliable for individuals with hemiparesis due to stroke, but it should be clinically validated before being used for clinical applications and research purposes.
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Rehabilitation of acquired brain injuries: a multicentric prospective survey.

Filed under: Rehab Centers

Eur J Phys Rehabil Med. 2013 Feb 7;
Zampolini M, Corea F, Avesani R, Boldrini P, De Tanti A, Di Stefano MG, Formisano R, Lamberti G, Lombardi F, Mazzucchi A, Pistarini C, Taricco M, Citterio A

BACKGROUND: The rehabilitation of the persons with Severe Acquired Brain Injury (ABI) is an important concern to be approached with a comprehensive program aimed to improve the recovery of patients.The efficacy of an early and intensive rehabilitation program has been shown in large number of studies. Few studies focused on the prevalence of TBI and the data are often extrapolated in indirect ways. AIM: An analysis of the demographic characteristics of the population included in the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione- Italian Group for the Study of the severe ABI) database, type and conditions associated to the index event; the treatment administered during hospitalization; and the prognosis according to outcome measures. DESIGN: The study was an observational prospective survey looking at management of ABI (both traumatic and non-traumatic). SETTING: In hospital rehabilitation. POPULATION: Patients consecutively admitted in each of the 52 GISCAR centres. METHODS: Every centre included a consecutive cohort and recorded demographic data and index event characteristics. RESULTS: In the study population were included 2626 subjects suffering of a severe ABI. The difference of length of stay (LOS) was significantly different with 67.5 days for traumatic patients compared to the 80 days of non traumatic ones. In the study population the probability of discharge at home is significantly greater for the traumatic condition (odds ratio 0,4587; CI 0.3671-0.5731). The overall benefit of the rehabilitative treatment was encountered in a net gain in all disability scores taken into account: LCF classes; DRS as well as GOS scores. At discharge the main destination for severe ABI patients was home (67.2%). CONCLUSIONS: A large number of patients admitted in Italian rehabilitative facilities for a severe ABI suffered from a TBI, more often these subjects were young male victims of road accident. The majority of subjects during the rehabilitative hospitalization demonstrated a significant recovery. CLINICAL REHABILITATION IMPACT: Considering the evidence of an early treatment benefit the delay ofthe rehabilitation program start is far from being satisfactory. The high frequency of the home discharge indicate a good compliance of national family network.
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Progressive Early-onset Scoliosis in Conradi Disease: A 34-Year Follow-up of Surgical Management.

Filed under: Rehab Centers

J Pediatr Orthop. 2013 Mar; 33(2): e4-9
Kabirian N, Hunt LA, Ganjavian MS, Akbarnia BA

: Conradi-Hunermann syndrome (CHS) is a rare metabolic syndrome with several orthopaedic problems. Early-onset scoliosis is of great importance because of often rapidly progressive nature and high risk of postoperative complications.: To report the 34-year follow-up and outcome of a patient with CHS treated with combined anterior and posterior fusion without instrumentation.: All available clinical and radiographs of a female patient with CHS retrospectively reviewed. Overall health status, sagittal and coronal deformity, pulmonary function test, and outcome questionnaires were evaluated.: Initial films at the age of 4 months showed a curve of 37 degrees from T6-T11 and a curve of 17 degrees from T11-L2. Thoracic kyphosis was measured at 43 degrees. Standing films at the age of 2 years and 2 months showed progression of both the curves to 50 and 66 degrees, respectively, and a significant spinal imbalance. The kyphosis also progressed to 57 degrees. She underwent a staged anterior inlay graft spinal fusion with autograft and allograft ribs from T8-L1 and posterior in situ fusion from T6-L1 with corticocancellous allograft. Solid radiographic fusion was observed 18 months after surgery. She was 36 years old at her latest follow-up, 34 years after surgery, with neutral clinical coronal and sagittal balance. No significant pain and respiratory complaint at moderate sports and normal daily life activity. “Vital capacity” and “total lung capacity” were 65% and 75%, respectively, of the normal. Thoracic curve of 35 degrees (T6-T11) and right thoracolumbar curve of 53 degrees from T11-L2 with a solid fusion fromT6-L1 with kyphosis measured over the fused area of 40 degrees were observed. Her overall mean Scoliosis Research Society-22 score was 3.68. She is an MBA graduate from a competitive school and currently works full-time.: Although the treatment of early-onset scoliosis has significantly evolved over the past 3 decades, the traditional method of anterior release and fusion and staged in-situ posterior fusion posterior fusion with postoperative immobilization showed acceptable deformity correction and maintenance of the pulmonary function over the 34 years.
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The CHARMS Study: cardiac patients’ experiences of sexual problems following cardiac rehabilitation.

Filed under: Rehab Centers

Eur J Cardiovasc Nurs. 2013 Feb 6;
Byrne M, Doherty S, Murphy AW, McGee HM, Jaarsma T

Background:Sexual problems are common among cardiac patients. Further information is required on patients’ experiences of sexuality and preferences for sexual counselling.Aim:To characterise sexual dysfunction and related factors among patients following cardiac rehabilitation and examine related treatment delivery.Methods:Telephone interviews with 382 patients (32% response rate) recruited from six hospital rehabilitation centres.Results:Seventy-nine per cent were male; average age was 64 years (SD 9.8). Forty-seven per cent of the total sample reported no sexual relations in the previous year, and nearly a half of sexually active respondents reported at least one sexual problem. Erectile dysfunction (reported by 33%) and lack of interest in sex (reported by 10%) were the most common problems for men and women respectively. Twenty-three per cent reported that sex had deteriorated for them since their cardiac event, and for half of these this was considered a serious problem. In logistic regression analysis, higher anxiety (Hospital Anxiety and Depression Scale) and being male were associated with reporting a sexual problem (?(2) = 37.85, p<0.001). Sixty-six per cent reported that sex was never discussed by a health professional and satisfaction with this aspect of care was low. Patients wanted these issues to be addressed and the majority (63%) claimed they would find it easy to discuss sexual problems with a health professional.Conclusions:Sexual inactivity and sexual problems are common in this group. Health professionals should address sexual issues with their patients, ideally in a private setting and within the broader context of addressing psychological wellbeing. HubMed – rehab


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