Rehab Centers: A Randomized Controlled Trial of Brain-Activating Rehabilitation for Elderly Participants With Dementia in Residential Care Homes.

A randomized controlled trial of brain-activating rehabilitation for elderly participants with dementia in residential care homes.

Filed under: Rehab Centers

Dement Geriatr Cogn Dis Extra. 2012 Jan; 2(1): 372-80
Yamagami T, Takayama Y, Maki Y, Yamaguchi H

We aimed to prove the effectiveness of brain-activating rehabilitation for dementia, which consisted of 5 principles: pleasant atmosphere, communication, praising, social role, and supportive care.The design was a randomized controlled trial that was not blinded. Fifty-four elderly participants with dementia (mean age: 85.2 years) were selected. Intervention based on the 5 principles of brain-activating rehabilitation was conducted for 1 h, twice a week, for 12 weeks (24 sessions). The control group had no treatment. Outcome measures consisted of two observation scales, namely sum of boxes in clinical dementia rating (CDR-SB) and the multidimensional observation scale for elderly subjects (MOSES), and two cognitive tests: the Hasegawa dementia scale revised (HDS-R) and trail making test A.Repeated measure ANCOVA showed a significant interaction for total score of CDR-SB (F = 7.190, p = 0.015) and MOSES (F = 4.525, p = 0.038). There were no significant changes in the two cognitive test scores.Intervention based on the principles of brain-activating rehabilitation was effective in maintaining and improving daily life functions in elderly participants with dementia in residential care homes.
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Primary Care Provider Receipt of Cardiac Rehabilitation Discharge Summaries: Are They Getting What They Want to Promote Long-term Risk Reduction?

Filed under: Rehab Centers

Circ Cardiovasc Qual Outcomes. 2013 Jan 8;
Polyzotis PA, Suskin N, Unsworth K, Reid RD, Jamnik V, Parsons C, Grace SL

BACKGROUND: <0.01). On a 5-point Likert scale, PCPs rated medication (4.65±0.74), patient care plan (4.43±0.87), and clinical status (4.33±0.94) as most important to include in a CR discharge summary. These were not provided in 18.8% (n=12), 4.7% (n=3), and 22.2% (n=14) of summaries, respectively.Conclusions-Approximately half of CR discharge summaries reach PCPs, revealing a large gap in continuity of patient care. HubMed – rehab

Measuring Care Transition Quality for Older Patients with Musculoskeletal Disorders.

Filed under: Rehab Centers

Musculoskeletal Care. 2013 Jan 9;
McLeod J, Stolee P, Walker J, Heckman G

OBJECTIVE: The aim of the current study was to examine the ability of a performance measurement scale, the Care Transitions Measure (CTM) adequately to assess the quality of care transitions among a complex population of older musculoskeletal (MSK) rehabilitation patients. METHODS: Fifteen older (aged 60+) patients with MSK disorders were recruited from two inpatient rehabilitation units. A telephone interview was conducted three to four weeks post-discharge; this included the CTM and global questions used for construct validation. To assess inter-rater reliability, the CTM was re-administered to ten subjects in a second interview six to ten days later. Participant comments were recorded in an effort to gauge how respondents understood and interpreted items. RESULTS: The CTM demonstrated acceptable inter-rater reliability for the overall score (intraclass correlation coefficient?=?0.77; p?=?0.03), in spite of only fair agreement for specific items. The internal consistency was high (Cronbach’s alpha?=?0.94). The construct validity was supported; however, qualitative data suggest that additional items should be considered for inclusion, and the need for revisions to the wording of the response options and some items. CONCLUSIONS: Although the CTM proved to be reliable for an MSK population, there is a need for modifications to improve the construct validity and utility of the CTM. Recommendations for scale improvement are made. The results of the present study support efforts to improve the outcomes of care transitions, care planning and the overall quality of life for older rehabilitation patients. Copyright © 2013 John Wiley & Sons, Ltd.
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Left hemiparalexia of Chinese characters: neglect dyslexia or disruption of pathway of visual word form processing?

Filed under: Rehab Centers

Brain Struct Funct. 2013 Jan 9;
Yi W, Wu T, Chen W, Yuan TF, Luo B, Shan C, Li J, He S, Weng X

The objective of the study was to further elucidate the potential mechanisms underlying left hemiparalexia induced by a splenium lesion in corpus callosum. A patient KY, who had infarctions in the splenium and the left ventral medial occipitotemporal area, was examined with neuropsychological tests and fMRI. KY presented left hemiparalexia when he read aloud characters presented in central foveal field tachistoscopically as well as in free-view field. KY also showed left hemialexia for characters in left visual field, while no left hemiparalexia occurred when characters were presented in the right visual field. KY performed poorly in lexical decision tasks. He could judge the directions of Landolt’s rings gaps in the left or right visual field equally. The result of fMRI indicated that characters in the left visual field could not activate the visual word form area (VWFA), such as left mid-fusiform cortex. All the above neuropsychological and fMRI findings have provided evidences against the assumption of left hemineglect dyslexia. Instead, they support the mechanism of disconnection of visual word form processing pathway. In conclusion, the evidences suggested that the visual information transmission of characters in the left visual field from right occipital area to the VWFA in the left hemisphere was interrupted by the splenium lesion.
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