Therapeutic Horse Back Riding of a Spinal Cord Injured Veteran: A Case Study.

Therapeutic horse back riding of a spinal cord injured veteran: a case study.

Filed under: Rehab Centers

Rehabil Nurs. 2012 Nov-Dec; 37(6): 270-6
Asselin G, Penning JH, Ramanujam S, Neri R, Ward C

To determine an incomplete spinal cord injured veteran’s experience following participation in a therapeutic horseback riding program.Following the establishment of a nationwide therapeutic riding program for America’s wounded service veterans in 2007, a Certified Rehabilitation Registered Nurse from the Michael E. DeBakey Veteran Affairs Medical Center worked with an incomplete spinal cord injured veteran who participated in the Horses for Heroes program.This program resulted in many benefits for the veteran, including an increase in balance, muscle strength, and self-esteem.A physical, psychological, and psychosocial benefit of therapeutic horseback riding is shown to have positive results for the spinal cord injured. Therapeutic riding is an emerging field where the horse is used as a tool for physical therapy, emotional growth, and learning.Veterans returning from the Iraq/Afghanistan war with traumatic brain injuries, blast injuries, depression, traumatic amputations, and spinal cord injuries may benefit from this nurse-assisted therapy involving the horse.
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Impact of an intervention to reduce medication regimen complexity for older hospital inpatients.

Filed under: Rehab Centers

Int J Clin Pharm. 2012 Dec 5;
Elliott RA, O’Callaghan C, Paul E, George J

Background Hospitalisation often leads to increased medication regimen complexity for older patients; increased complexity is associated with medication non-adherence. There has been little research into strategies for reducing the impact of hospitalisation on medication regimen complexity. Objective To investigate the impact of pharmacist medication review, together with an educational intervention targeting clinical pharmacists and junior medical officers, on the increase in medication regimen complexity that occurs during hospitalisation. Setting Two acute general medicine wards and two subacute aged care (geriatric assessment and rehabilitation) wards at a major metropolitan public hospital in Melbourne, Australia. Methods A before-after study involving patients aged 60 years and over was undertaken over two 5-week periods. During the pre-intervention period patients received usual care. During the intervention period, clinical pharmacists were encouraged to review patients’ medication regimen complexity prior to discharge, and make recommendations to hospital medical officers to simplify regimens. Prior to the intervention period, pharmacists attended an interactive case-based education session about medication regimen simplification, and completed an assessment task. A similar, but briefer, education session was delivered to junior medical officers. Main outcome measure The primary endpoint was change in medication regimen complexity index (MRCI) score (a validated measure of regimen complexity) between admission and discharge for regularly scheduled long-term medications, adjusted for age, length of hospital stay, number of medications and regimen complexity prior to admission. Results Three hundred ninety-one patients were included (mean age 80.6 years, mean 7.4 regularly scheduled long-term medications on admission). The mean increase in MRCI score between admission and discharge was significantly smaller in the 205 intervention patients than in the 186 usual care patients (2.5 vs. 4.0, p = 0.02; adjusted difference 1.6, 95 %CI 0.3, 2.9). The intervention had greatest impact in patients discharged from subacute wards (mean adjusted difference: 2.7), not using a dose administration aid after discharge (mean adjusted difference: 2.6), and not discharged to a residential care facility (mean adjusted difference: 1.9). Mean differences in MRCI scores were equivalent to ceasing one to two medications. Conclusion An educational intervention and clinical pharmacist medication review reduced the impact of hospitalisation on the complexity of older patients’ medication regimens.
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Statistical distribution of acupoint prescriptions for sensory-motor impairments in post-stroke subjects.

Filed under: Rehab Centers

Chin J Integr Med. 2012 Dec 3;
Fragoso AP, Ferreira AD

OBJECTIVE: To statistically describe the characteristics of acupoint selection for therapeutic intervention in post-stroke subjects based on pre-modern and modern literatures. METHODS: Twelve classic textbooks in Chinese medicine and fourteen research articles had their acupoints listed and organized under each author in a chronological manner. A total of 84 different acupoints were collected from pre-modern and modern authors. Descriptive analysis of the frequency counts of acupoints was performed for both groups of premodern and modern authors. Association analysis on acupoint prescriptions was performed among pre-modern, modern, and pre-modern versus modern authors. RESULTS: No significant difference was observed between premodern and modern authors regarding the frequency of acupoints grouped by channel (P=0.482) or channel nature (pre-modern: yang=76.9%, yin= 23.1%; modern: yang=77.3%, yin=22.7%; P=0.966). Considering all authors, only 1 (1.2%) acupoint (LI-4) presented the highest frequency with 12 (44.4%) authors reporting its use for sensory-motor impairments, and 49 (58.3%) acupoints were prescribed only once. CONCLUSION: It was demonstrated that pre-modern and modern authors selected channels for intervention in a similar fashion. Variability among acupoint prescriptions is higher among pre-modern authors as compared to modern works for stroke-related sensory-motor impairments.
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Indirect costs in patients with coronary artery disease and mental disorders: A systematic review and meta-analysis.

Filed under: Rehab Centers

Int J Occup Med Environ Health. 2012 Dec 3;
Haschke A, Hutter N, Baumeister H

OBJECTIVES: The aim of the present study was to systematically review the association of comorbid mental disorders with indirect health care costs in patients with coronary artery disease (CAD). MATERIALS AND METHODS: A comprehensive database search was conducted for studies investigating persons with CAD and comorbid mental disorders (Medline, EMBASE, PsycINFO, Psyndex, EconLit, IBSS). All studies were included, which allowed for a comparison of indirect health care costs between CAD patients with comorbid mental disorders and CAD patients without mental disorders. RESULTS: The literature search revealed 4962 potentially relevant studies, out of which 13 primary studies met the inclusion criteria. Depression was investigated most often (N = 10), followed by anxiety disorders (N = 3) and any mental disorder not further specified (N = 3). All studies focused on return to work as indirect cost outcome. CAD patients with depression showed diminished odds for return to work, compared to CAD patients without depression (OR = 0.37; 95% CI: 0.27-0.51). The findings for comorbid anxiety and any mental disorder were inconsistent. Indirect health care costs were exclusively assessed by a patient self-report (N = 13). CONCLUSIONS: There is strong evidence for diminished odds of return to work in CAD patients with comorbid depression, highlighting the need for integrated CAD and depression care. With regard to other comorbid mental disorders, however, the evidence is sparse and inconclusive.
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