The effect of Cerebrolysin on the development of skills in patients after acute cerebrovascular accidents

This study evaluated the thoroughness and psychometric properties of fidelity measures used by or of relevance to occupational or physical therapy. A systematic review of the literature was completed. Assessments used to measure occupational or physical therapy intervention fidelity were evaluated for thoroughness, reliability, validity, and clinical utility. Eight fidelity measures met inclusion criteria for this systematic review. Most of the measures had moderate levels of thoroughness in the coverage of key aspects of fidelity, reported adequate to excellent reliability and validity, and were highly variable in clinical utility. Additional research is recommended to validate existing occupational or physical therapy fidelity measures and to develop novel measures for other occupational therapy and physical therapy interventions. Clinicians and researchers must place greater emphasis on the development and implementation of fidelity measures to ensure uniformity in intervention delivery and high-quality, evidence-based care.

Physical Education, Exercise, Fitness and Sports: Early PM&R Leaders Build a Strong Foundation

the prognosis of recovery of patients after acute cerebrovascular accident depends on the type, severity, and area of brain damage. This article highlights standardized tests and scales for physical therapy and occupational therapy for patients after stroke. An example is given of a clinical case of a patient with stroke consequences, with right-sided spastic hemiplegia. Medical rehabilitation was provided in April 2023 at the Municipal Non-Profit Enterprise "Consultative and Diagnostic Center", branch №6, Sviatoshynskyi district, Kyiv, Department of Physical and Rehabilitation Medicine. After the patient visited the outpatient department of physical and rehabilitation medicine, the examination was conducted by the attending physician. A multidisciplinary team of a physical therapist and an occupational therapist was involved. An important step is the use of standardized tests and scales in physical therapy and occupational therapy. Based on the results of the examinations, the patient's goals are determined, and an individual rehabilitation program is built using evidence-based physical therapy and occupational therapy methods to provide a high-quality and effective rehabilitation cycle. Description of the objective. The standardized tests and scales in physical therapy, and occupational therapy are analyzed on the example of a clinical case of a patient after a stroke with right-sided spastic hemiplegia. Materials and methods. The clinician's handbook for 2020 on stroke rehabilitation was analyzed, with the justification of standardized tests and scales for physical therapy, and occupational therapy. A systematic review of the PubMed database was conducted, which included 44 scientific randomized trials and meta-analyses with accurate diagnoses of tests and scales for physical therapy and occupational therapy. The National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) were used to assess stroke. Modified Ashworth Scale for the assessment of spastic muscles in patients with neurological disorders. To determine cognitive outcomes and complications after stroke: Montreal Outcome Cognitive Assessment (MOCA); Modified Barthel Index (BI); Line Drawing Test. For motor function: Fugl-Meyer Assessment (FMA); Chedoke Arm and Hand Activity Instrument (CAHAI). Berg Balance Assessment; Morse Fall Risk Test; Stand and Walk Test. Results. The results of the initial examination in physical therapy and occupational therapy determined the patient's functional and cognitive state, consequences, and limitations arising after a stroke. The intermediate examination summarizes the effectiveness of the selected rehabilitation measures. If the patient's results remain unchanged, the physical and occupational therapist changes the approach and methods to achieve the goals. The final examination analyzes the dynamics of restoration of impaired functions, and achievement of goals by the end of the rehabilitation cycle. Therefore, we used the patient's clinical case to compare the initial, intermediate, and final examinations. This allowed us to analyze the results and determine the effectiveness of the selected individual rehabilitation program. Conclusions. The main principle of providing quality rehabilitation measures is the examination in the clinical practice of a physical therapist, and occupational therapist, which is used to measure the goals and compare the results achieved.

Distal Radius Fracture: Hep Versus Supervised Therapy: A Systematic Review

Did the 1997 Balanced Budget Act Reduce Use of Physical and Occupational Therapy Services?

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

Contents * Interprofessional Collaboration: Issues for Practice and Research * The Rural Elderly Assessment Project: A Model for Interdisciplinary Team Training * Physical Therapy and Occupational Therapy: Partners in Rehabilitation for Persons with Movement Impairments * Dementia, Nutrition, and Self-Feeding: A Systematic Review of the Literature * Promoting Awareness and Understanding of Occupational Therapy and Physical Therapy in Young School Aged Children: An Interdisciplinary Approach * Collaboration Between Team Members in Inclusive Educational Settings * A Response to Traumatized Children: Developing a Best Practices Model * Index * Reference Notes Included

Initiated by the Federal Insurance Institute for Salaried Employees (BfA, Bundesversicherungsanstalt für Angestellte), the project is aimed at developing an evidence-based guideline for rehabilitation of patients with low back pain (LBP). Guideline development will be based on a systematic review of the literature, an analysis of the treatment procedures currently employed in rehabilitation, inclusion of the patients' perspectives as well as consultation of experts' panels of clinically experienced physicians and therapists. Formulation of the guideline will then be carried out in a structured consensus building process. This article is focused on analysing the present situation with regard to the treatments received by patients insured by the BfA, using data from routine documentation according to the Classification of Therapeutic Procedures (KTL, Klassifikation Therapeutischer Leistungen). The analysis is intended to provide indications of a basic need to implement a common guideline as well as, simultaneously, to explore possible deficits in present treatment practices, hence to define priorities requiring special attention in the framework of guideline development. As a result of a systematic literature review, the KTL-defined therapeutic procedures that had emerged as relevant in the rehabilitation of LBP patients were aggregated into so-called therapeutic modules which then formed the basis of the analysis. In all, more than 46,000 KTL-data of 2438 patients with a diagnosis of "low back pain" (M54.5 ICD-10) were included. In the rehab centres investigated, rehabilitation of patients with LBP follows a multidimensional, multiprofessional therapeutic strategy. More than 90 % of all patients receive treatments from the modules "medical training therapy", "health education", "physiotherapy", and "physical therapy". Treatments provided to a majority of the patients are massage (78 %), electrotherapy (67 %) as well as psychotherapy (68 %). Women more frequently than men receive therapies belonging to the "psychological treatments" and "occupational therapies" modules; younger patients receive more of the "training therapies", and more often. When treatments are compared across centres, a large variability in the therapeutic procedures provided becomes apparent. This high degree of variability suggests that development and implementation of a common clinical practice guideline for rehabilitation of patients with chronic low back pain should receive priority attention.

Selection for Inpatient Rehabilitation After Acute Stroke: A Systematic Review of the Literature

Study (ISAT) and the International Study of Unruptured Intracranial Aneurysms (ISUIA), and anticipation of the results of ongoing carotid stenting (CAS) versus endarterectomy (CEA) trials.

Background Patients recovering from injuries or illnesses often face the dual challenges of physical dysfunction and psychological distress. While medical rehabilitation alone can improve physical symptoms, it struggles to address the psychological obstacles to the recovery process, leading to prolonged rehabilitation periods and decreased adherence. Psychological rehabilitation can enhance patients' initiative in rehabilitation through emotion regulation and cognitive restructuring. Furthermore, synergistic interventions of psychological and medical rehabilitation can create a virtuous cycle of "physical improvement - positive psychological state - accelerated rehabilitation." Existing research often examines the effects of these two types of rehabilitation in isolation, lacking sufficient exploration of the underlying mechanisms and practical pathways of their synergy. Therefore, this study aims to clarify the synergistic mechanism of psychological and medical rehabilitation, providing a basis for optimizing rehabilitation management programs. Methods Ninety patients in the recovery period were selected for this study and divided into three groups of 30 each, based on their rehabilitation protocols: a combined group receiving both psychological and medical rehabilitation, a single medical rehabilitation group receiving only their respective single psychological rehabilitation protocols, and a control group receiving routine rehabilitation guidance. The intervention period was 3 months. The Fugl-Meyer Assessment of Motor Recovery (FMA), Self-Rating Anxiety Scale (SAS), and Rehabilitation Adherence Questionnaire (RAQ) were used to assess patients at baseline and 3 months later. Data are expressed as mean ± standard deviation, and independent samples t-tests were used for inter-group comparisons. Results At baseline, there were no significant differences in FMA, SAS, SDS, and RAQ scores among the three groups (p>.05). After 3 months of intervention, the FMA score in the synergistic group increased from 45.2 ± 8.6 to 78.5 ± 7.3 (p<.001), significantly higher than the single medical rehabilitation group and the single psychological rehabilitation group (p<.001). The SAS score in the synergistic group decreased from 56.8 ± 6.5 to 34.2 ± 5.1 (p<.001), significantly lower than the two control groups (p<.01). The RAQ score in the synergistic group increased from 52.4 ± 6.8 to 81.3 ± 5.9 (p<.001), better than the two control groups (p<.01). These results indicate that synergistic intervention combining psychological and medical rehabilitation is most effective in improving physical function, alleviating psychological distress, and enhancing rehabilitation adherence. Discussion The results show that synergistic intervention of psychological and medical rehabilitation can significantly optimize patient rehabilitation outcomes. The core mechanism lies in the fact that psychological rehabilitation improves emotional state and confidence in rehabilitation, enhancing patient adherence to medical rehabilitation, while the improvement in physical function brought about by medical rehabilitation further strengthens the positive psychological experience. Future research could expand the sample size and extend the follow-up period to explore appropriate synergistic intervention programs for different disease types and rehabilitation stages, refine the synergistic implementation process, and improve the accuracy and effectiveness of rehabilitation management.

The nature of neurovascular involvement in cases of familial Mediterranean fever (FMF) has not been adequately clarified. Clinical features, infarct topography, vascular status, and stroke etiology were prospectively determined in 35 acute neurovascular events that occurred in 23 FMF patients. Clinicoradiological features were compared with an age- and gender-matched control group of 115 acute stroke patients. Characteristics of additional FMF and acute stroke cases (6 episodes in 6 patients) identified from a systematic literature review (PROSPERO registration no: CRD420212264820) were also analyzed. There were 27 acute ischemic stroke episodes in 19 patients, 7 transient ischemic attack episodes in 3 patients, and 1 patient with a single episode of parietal hematoma in our cohort. Twenty (74%) ischemic stroke episodes in 12 patients were cryptogenic. Ten of these 12 cases had a previous FMF diagnosis and were taking colchicine. There was no significant difference in the FMF group in terms of the presence of vascular risk factors and angiography-documented disease in comparison to controls. Cerebral distal artery involvement was significantly prevalent in FMF (78% vs 45%, P= .002). Especially, midbrain central deep perforating territory involvement was higher (30% vs 1%, P< .001). The long-term prognosis (median 8.5 years) under antiplatelet agents and colchicine is favorable. The acute stroke phenotype in FMF cases is herein described for the first time. Several clinicoradiological features such as thrombotic lacunar infarcts located in the central mesencephalon seem so typical that we recommend searching for FMF mutations in geographic regions where FMF is common.

AAPM&R Presentation to IOM Committee on Disability in America 2005

Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study

BackgroundDue to the difficulty children on the autism spectrum experience with social behaviours and communication, it has been suggested that engaging with people and functional tasks can impact their participation within therapy sessions. Canine-assisted therapy has been posited as an adjunct to occupational therapy sessions that may assist to facilitate engagement with the therapist and the therapy process. In spite of the increased interest in canine-assisted therapy with children on the autism spectrum over the past decade, there remains minimal research into the efficacy of including a therapy dog into occupational therapy sessions specifically. AimsThe overarching aim of this thesis was to determine the efficacy of canine-assisted occupational therapy with children on the autism spectrum. In order to achieve this aim, the objectives of this thesis were to: 1) review the current literature, exploring the impact of canine-assisted interventions on the social behaviours of children on the autism spectrum; 2) develop and conduct a pilot randomised control trial in order to determine the impact of canine-assisted occupational therapy on the on-task behaviours and goal attainment of children on the autism spectrum; 3) further our understanding of the impact of canine-assisted occupational therapy on the engagement of children on the autism spectrum within therapy sessions from the perspectives of the parents; 4) provide additional understanding of the benefits and challenges of canine-assisted occupational therapy with children on the autism spectrum through the experience of therapists; 5) determine if participation in canine-assisted occupational therapy sessions with children on the autism spectrum had an impact on a therapy dog included, and; 6) review the current literature to explore the possible challenges for occupational therapists in providing safe and ethical delivery of canine-assisted occupational therapy to children on the autism spectrum. Research designObjective one was completed through a systematic review of the literature. Objective two was achieved through the development and completion of a pilot randomised control trial exploring the impact of canine-assisted occupational therapy on the on-task behaviour and goal attainment of children on the autism spectrum when compared to occupational therapy sessions as usual. Objectives three and four were achieved through the completion of two qualitative studies following an interpretive descriptive method in order to gain an understanding of the impact of canine-assisted occupational therapy sessions on therapy engagement from the perspectives of parents and therapists, respectively. Objective five was met through the completion of a quantitative study determining the impact of involvement in canine-assisted occupational therapy sessions with children on the autism spectrum for a therapy dog, as measured by differences in behavioural observations and salivary cortisol, alpha amylase and oxytocin when compared to days spent at home. Objective six was achieved through a review of the literature and reflection on practice in order to gain an understanding of the challenges of including a therapy dog into occupational therapy sessions with children on the autism spectrum. ResultsResults from the systematic literature review presented in Chapter 2 found that although canine-assisted interventions appeared to have several benefits on the social behaviours of children on the autism spectrum, such as an increase in motivation and engagement, several methodological weaknesses were present in the reported studies. Limitations included minimal use of research protocols, lack of random assignment, and no studies exploring the efficacy of canine-assisted therapy within traditional therapy services for children on the autism spectrum, such as occupational therapy. Findings from the pilot randomised control trial (Chapter 4) found that participation in canine-assisted occupational therapy had a small but positive impact on the on-task behaviour and goal attainment of children on the autism spectrum. Results from the qualitative studies exploring the impact of canine-assisted occupational therapy from the perspective of the parents and therapists (Chapter 5 and 6) found that canine-assisted occupational therapy appeared to accelerate the children’s motivation to engage within the therapy sessions. However, both the parents and therapists highlighted that it remained the therapist’s ability to direct this motivation towards goal directed, occupational focused interventions that assisted the children to progress towards their therapy goals. The experiment exploring the welfare of a therapy dog involved in canine-assisted occupational therapy with children on the autism spectrum (Chapter 7) found that when following the research protocol outlined in Chapter 3, the therapy dog did not experience excess stress on working days compared to days spent at home. This non-adverse conclusion was determined on the basis of no significant difference in saliva cortisol, alpha amylase, oxytocin or stress related behaviours between the two conditions. The practice analysis included in Chapter 8 of this thesis found that although the literature suggests that children on the autism spectrum may benefit from participation within canine-assisted occupational therapy sessions, there is a need for national guidelines and standards to be developed in order to ensure the safe and ethical practice for both the children and the therapy dog involved. ConclusionsThe overall findings from this thesis suggest that the inclusion of a therapy dog into occupational therapy sessions with children on the autism spectrum may have a positive impact on child motivation and engagement within therapy. However, the studies included within this thesis provide pilot data only and highlight the need for additional research to be conducted to determine how canine-assisted therapy can best be included into occupational therapy sessions in order to reach its full potential. Additionally, findings highlight the need for national guidelines and clear training pathways to ensure canine-assisted occupational therapy is delivered in a way that protects the wellbeing of the children and the therapy dogs involved.