Rehab Centers: Effects of in-Patient Pulmonary Rehabilitation in Patients With Interstitial Lung Disease.

Effects of in-patient pulmonary rehabilitation in patients with interstitial lung disease.

Filed under: Rehab Centers

Eur Respir J. 2012 Oct 25;
Huppmann P, Sczepanski B, Boensch M, Winterkamp S, Schönheit-Kenn U, Neurohr C, Behr J, Kenn K

Pulmonary rehabilitation (PR) is recommended for patients with chronic lung diseases including idiopathic pulmonary fibrosis (IPF) according to international guidelines. However, data for patients with interstitial lung disease (ILD) are limited. We examined the effect of an in-patient PR on functional status and quality of life in ILD-patients.We evaluated 402 consecutive ILD-patients who were admitted to a specialized pulmonary rehabilitation centre (1999-2010). All patients performed a standardized PR program including pulmonary function tests, blood-gas analysis, 6-minute-walk test (6MWT), dyspnoea rating and health-related quality of life questionnaire (SF36) on admission and discharge.Mean duration of PR was 30±1 days. 6MWT-distance improved by 46±3 m (308±6 m vs. 354±6 m, p<0.001). Dyspnoea rating did not change. Lung function testing showed marginal improvement of vital capacity (+1±0%, p=0.002). SF-36-questionnaire demonstrated an increase in all eight sub-scores as well as in physical and mental health summary scores (physical: 6±1 points, p<0.001; mental-health: 10±1 points, p<0.001). Moreover, patients with signs of pulmonary hypertension also benefited from PR.In a large cohort of patients with ILD, PR had a positive impact on functional status and quality of life. Considering the limited treatment options in this patient-population PR appears to be a valuable adjunct therapy. HubMed – rehab


Determinants of fitness to drive in Huntington disease.

Filed under: Rehab Centers

Neurology. 2012 Oct 24;
Devos H, Nieuwboer A, Tant M, De Weerdt W, Vandenberghe W

OBJECTIVES: To identify the most accurate clinical predictors of fitness to drive (FTDr) in Huntington disease (HD). METHODS: This cross-sectional study included 60 active drivers: 30 patients with manifest HD (8 women) and 30 age- and gender-matched healthy controls. Mean (SD) age of the HD group was 50 (12) years and median (Q1-Q3) disease duration was 24 (12-48) months. A clinical battery consisting of a driving history questionnaire, the cognitive section of the Unified Huntington’s Disease Rating Scale (UHDRS), Trail Making Test, and Mini-Mental State Examination, as well as a driving simulator evaluation, were administered to all participants. Additionally, the subjects with HD completed the motor, behavioral, and Total Functional Capacity sections of the UHDRS and underwent an official FTDr evaluation comprising visual, neuropsychological, and on-road tests. The blinded neurologist’s appraisal of FTDr and the 3 most predictive clinical tests were compared with the official pass/fail FTDr decision. RESULTS: The patients with HD performed worse on all tests of the clinical battery and driving simulator than the healthy controls. Fifteen patients with HD (50%) failed the FTDr evaluation. The blinded neurologist correctly classified 21 patients (70%). The Symbol Digit Modalities Test, Stroop word reading, and Trail Making Test B provided the best model (R(2) = 0.49) to predict FTDr, correctly classifying 26 patients (87%). CONCLUSIONS: Half of active drivers with HD fail a driving evaluation and pose a potential hazard on the road. Our results suggest that those at risk can be accurately identified using a clinical screening tool.
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Effects of vertical motion of the centre of mass on walking efficiency in the early stages after total hip arthroplasty.

Filed under: Rehab Centers

Hip Int. 2012 Oct 16; 0
Nankaku M, Akiyama H, Kanzaki H, Kakinoki R

Purpose: The purpose of this study was to identify factors related to walking efficiency in the early postoperative period of total hip arthroplasty (THA). Methods: The subjects of this study were 18 women who had undergone unilateral THA 4 weeks before and 18 healthy women as control. Using a force plate and a 3-D motion analyser, we measured: 1) gait speed, stride length, cadence; 2) centre of mass displacement in the three directions; 3) asymmetry of the centre of mass movement in vertical direction; and 4) the total internal work per unit mass and distance walked (a negative index of walking efficiency). Results: Compared with healthy persons, THA patients showed significantly greater total internal work per unit mass and distance walked. The vertical centre of mass motion of the THA patients demonstrated an asymmetrical pattern. In THA patients, the stepwise multiple regression analysis selected the displacement and the asymmetrical vertical motion of centre of mass as the sole significant variable affecting walking efficiency (R2 = 0.81). Conclusions: Our findings indicated that rehabilitation programs that control the vertical movement of the centre of mass during gait are important to improve walking ability in the early post-operative phase after THA.
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Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma.

Filed under: Rehab Centers

Eur Arch Otorhinolaryngol. 2012 Oct 26;
Digonnet A, Hamoir M, Andry G, Vander Poorten V, Haigentz M, Langendijk JA, de Bree R, Hinni ML, Mendenhall WM, Paleri V, Rinaldo A, Werner JA, Takes RP, Ferlito A

Post-therapy follow-up for patients with head and neck cancer other than upper aerodigestive tract squamous cell carcinoma should meet several objectives: to detect both local, regional or distant recurrences, to evaluate acute and long-term treatment-related side effects, to guide the rehabilitation process, and to provide psychosocial support when needed. To our knowledge, there are no published reports in the literature dedicated to the follow-up of patients with these tumours. A comprehensive literature search for post-treatment follow-up strategies spanning from 1980 to 2012 was performed on several databases. This review focuses on malignant salivary gland tumors, soft tissue sarcomas, cutaneous squamous cell carcinomas, and sinonasal adenocarcinomas. Given the varying biological behavior and treatment-related factors and based on the literature, different recommendations are made on the follow-up of patients with the above-mentioned tumors.
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Evaluation of postural control impairment using Balance Error Scoring System among athletes with ankle injury: an effective tool in daily clinical practice.

Filed under: Rehab Centers

Clin Ter. 2012 Sep; 163(5): 383-6
Vikram M, Sundaraganesh K, Justine M, Kurup M, Leonard J

Objective. The main objective of the study was to investigate postural control impairment in athletes with history of ankle injury by using Balance Error Scoring System (BESS) and to compare with the controls. Patients and Methods. This is a case-control study that compared postural control among subjects with history of ankle injury with the matched controls. A total of sixty subjects (n=60) were recruited from the department of physical education and sports science from a higher learning institute. Thirty athletes who had history of ankle injury were recruited for case group and the control group had an another thirty participants who were healthy athletes with no history of ankle injury. BESS was used to measure postural control by estimating the errors committed in standing between the two group of athletes. Independent sample t test was used to compare the means between two groups and the level of significance is set at level of 0.05. Results. The athletes with history of ankle injury scored more number of errors in BESS with high mean value of (15.10 +/- 6.52 errors) than the control group (5.63 / 3.81 errors which was significant at p=0.01 level. Conclusion. Postural control impairment was identified among athletes with history of ankle injury when compared with control group. Clin Ter 2012; 163(5):383-386.
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