Different Phases Of Rehabilitation Research Articles

Zatrudnienie jako element resocjalizacji. Przegląd podobieństw i różnic między przestępcami płci męskiej i żeńskiej

In this review article, the latest knowledge in the area of the importance of employment in the process of rehabilitation is presented. The goal is a literature review and an analysis of the similarities and differences between female and male criminals in the context of employment during the prison sentence and the chances of finding employment after release. Also, the relationships between employment and later recidivism are analyzed. To present the relationship between employment and recidivism holistically, the following points were referred to: the role of work in rehabilitation and adaptation to freedom; differences between males and females in employment experiences and peculiarities in social background affecting their labour force attachment; the employment of prisoners before, during and after punishment; opportunities and barriers in finding a job by former prisoners; bidirectional relationship – employment as a way to reintegrate ex-offender with the society and as a way to prevent recidivism. Different phases of rehabilitation (being in prison, leaving prison) were distinguished and labour force attachment prior to imprisonment spell were also discussed. Also, the article consists of a discussion section where conclusions and recommendations are presented. The indications for further research were also listed, one of which is to examine the real benefit of the work of convicts – whether it provides the possibility of subsistence. In the article, study results from various countries, and consequently, various judicial systems, are referred to.

Stroke Inpatient Rehabilitation Environments: Aligning Building Construction and Clinical Practice Guidelines Through Care Process Mapping.

Stroke inpatient rehabilitation is a complex process involving stroke survivors, staff, and family utilizing a common space for a shared purpose: to optimize recovery. This complex pathway is rarely fully described. Stroke care is ideally guided by Clinical Practice Guidelines, and the rehabilitation built environment should serve to optimize care delivery, patient and staff experience. We aimed to articulate the inpatient stroke rehabilitation process of care in a series of process maps, and to understand the degree to which current stroke clinical and building construction (ie, design) guidelines align to support inpatient stroke rehabilitation. We used the Value-Focused Process Engineering methodology to create maps describing the events and activities that typically occur in the current stroke inpatient rehabilitation service model. These maps were completed through individual and group session consultations with stroke survivors, architects, policy makers, and clinical experts. We then determined which sections of the Australian Stroke Rehabilitation Guidelines and the Australasian Health Facility Design Guidelines could be aligned and applied to the process maps. We present a summary process map for stroke inpatient rehabilitation, alongside detailed process maps for 4 different phases of rehabilitation (admission, a normal weekday, a weekend day, and discharge) using Value-Focused Process Engineering notation. The integration of design and clinical guidelines with care pathway maps revealed where guidelines lack detail to be readily linked to current stroke inpatient care practice, providing an opportunity to design stroke inpatient rehabilitation spaces based on the activities occurring within them. Our findings highlight gaps where clinical and design experts should work together to use guidelines to their full potential; and to improve the process of planning for future stroke rehabilitation units.

Occupational therapy for persons with cognitive impairments.

Damage to the central nervous system can occur in adulthood, for example, due to stroke, trauma, tumours, or chronic diseases. After damage to the central nervous system, cognitive impairments occur in addition to physical limitations. Occupational therapy is most often prescribed for neurological diagnoses, including stroke and traumatic brain injury. The health technology assessment (HTA) report this HTA article is based on investigates the clinical effectiveness, cost-effectiveness, and patient-related, social and ethical aspects of occupational therapy for patients with cognitive impairments compared to no occupational therapy. In addition, the effects of different occupational therapy interventions with and without cognitive components were compared in an explorative overview. Patients with moderate or severe dementia are excluded from the assessment. Systematic overviews, that is, systematic reviews of systematic reviews, were conducted. For the evaluation of clinical effectiveness, a total of nine systematic reviews were included. No systematic review was identified for the assessment of costs or cost-effectiveness. Five systematic reviews were included for the assessment of patient and social aspects. For the assessment of clinical effectiveness compared with no occupational therapy, five systematic reviews comprising 20 randomised controlled trials with a total of 1,316 subjects reported small positive effects for the outcomes "global cognitive function" and "activities of daily living" as well as a non-quantified positive effect on the outcomes "health-related quality of life" and "behavioural control". No effect was found for individual components of cognition and measures of perception. The quality of the evidence for all outcomes is low due to a high risk of bias. In the supplementary presentations, no positive effects could be demonstrated on the basis of the available evidence. The quality of this evidence was not assessed. For the assessment of patient and social aspects, five systematic reviews on patients with a stroke or a traumatic brain injury - without specification regarding cognitive deficits or studies with their relatives - were included. It was reported that patients and family caregivers go through different phases of rehabilitation in which the discharge home is a decisive turning point. The discharge home represents a crucial breaking point. Regaining an active, self-determining role is a process that requires therapists to find the right level of support for patients and relatives. For the assessment of ethical aspects, nine documents were included. We identified ethical problem-solving models for occupational therapy and 16 ethical aspects in occupational therapy for cognitive deficits. The central theme of the analysis is the limited autonomy due to the consequences of the disease as well as the resulting tensions with those treating the patient. Based on this systematic overview, it can neither be proven nor excluded with certainty that occupational therapy for cognitive impairment is an effective therapy for adult patients with central nervous system injuries compared to no occupational therapy. There is a lack of randomised trials with sufficient sample size, well-defined interventions, and comparable concomitant therapies in the control groups, but there is also a lack of well-designed observational studies in routine care and health economic studies. The identified systematic reviews on patient and social aspects provide information on the needs of patients after stroke or traumatic brain injury and their relatives, but there is a lack of studies on this aspect in German-speaking countries. For the ethical assessment, in addition to the identified theoretical models for solving ethical conflicts in occupational therapy, more empirical studies on ethical aspects with patients with cognitive deficits and their relatives as well as occupational therapists are needed.

Blood flow restriction training in South Africa - a panel discussion.

Blood flow restriction (BFR) training uses a cuff to partially occlude venous blood flow and improve musculoskeletal training outcomes. Over the past 25 years, numerous studies have demonstrated its relative safety and efficacy. Blood flow restriction training is under review by the Health Professions Council of South Africa due to safety and ethical concerns. The objective of this roundtable discussion is to gain better insight into the current use and perception of blood flow restriction training in South Africa. The expert panel had experience with the use of BFR training and included one representative from each of the following professions, namely, sports medicine, physiotherapy and biokinetics. The panellists provided their unique perspectives on BFR training, whilst reaching a relative consensus on its safety, screening, efficacy, and appropriate use. Agreement on appropriate loading and occlusion pressure protocols during different phases of rehabilitation was less clear. Although BFR is a safe and effective modality, the development of evidence-based protocols among different health professionals in South Africa is required to ensure good clinical practice.

Does the Application of a Lycra Arm Sleeve Change Shoulder Biomechanics in Young Healthy People? A Mechanistic Study

ABSTRACT Introduction Glenohumeral subluxation (GHS) is commonly reported in people with stroke. Lycra sleeves provide a compressive and supportive effect, influencing the neuromuscular activity in the affected body segment. A recent study reported reduction in GHS (acromion-greater tuberosity [AGT] distance) after application of Lycra arm sleeve; however, its mechanism on the shoulder region as a whole is unclear. The aim of this study was to investigate if application of a Lycra sleeve changes the AGT distance, muscle activity around the shoulder region, and scapular position. Methods Healthy participants aged older than 18 years were recruited. Measurements were taken before and immediately after application of the sleeve. Portable diagnostic ultrasound, surface electromyography, and a tape measure were used to measure AGT distance, muscle activity (biceps, triceps, deltoid, and supraspinatus), and position of the scapula, respectively. Results Thirty-one participants (11 men, 20 women) with mean age 25 ± 10 years participated. Paired test showed significant mean reduction of 0.12 cm (95% confidence interval [CI], 0.07–0.16 cm) in AGT distance measurements (t = 5.112, df = 30, P = 0.003) and scapula measurements (0.3 cm; 95% CI, 0.04–0.4 cm; t = 2.501; df = 30, P < 0.01) when compared without and with sleeve application. Conclusions Future research should investigate the effects of the Lycra sleeve on people with GHS in the different phases of rehabilitation.

To Compare the Mean Percentage Improvement in Coordination, Strength and Disability in Overhead Throw Athletes with Partial Thickness Tear of the Rotator Cuff Following Plyometric Training in Different Phases of Rehabilitation

Background & Objectives: To compare the mean percentage improvement in coordination, strength and disability in overhead throw athletes with partial thickness tear of the rotator cuff following plyometric training in different phases of rehabilitation. Methods: a total of 30 male overhead throwers suffering from partial thickness tear of the rotator cuff injury, on the basis of inclusion criteria were taken in the study. A full description of the study, including the selection process was explained to each patient. Documented consent was obtained from each patient. Group 1 consisted of athletes with history of rotator cuff injury one and half year back and group 2 included athletes with rotator cuff injury three months back. Coordination , strength and disability were assessed pre and post plyometric training for a period of three weeks and the mean percentage of improvement were compared in both the group following plyometric training. Results: intragroup analysis showed a significant improvement in coordination, strength with the level of significance (p<0.05). Discussion & Conclusion: group 1 showed an improvement in the mean percentage in coordination, the strength of supraspinatus muscle, and bench press when compared to the group 2. While the group2 showed an improvement in mean percentage in the strength of the subscapularis, teres minor muscle and infraspinatus muscle when compared with the group 1.

An interactive distance solution for stroke rehabilitation in the home setting – A feasibility study

ABSTRACTBackground: In this study an interactive distance solution (called the DISKO tool) was developed to enable home-based motor training after stroke. Objectives: The overall aim was to explore the feasibility and safety of using the DISKO-tool, customized for interactive stroke rehabilitation in the home setting, in different rehabilitation phases after stroke. Methods: Fifteen patients in three different stages in the continuum of rehabilitation after stroke participated in a home-based training program using the DISKO-tool. The program included 15 training sessions with recurrent follow-ups by the integrated application for video communication with a physiotherapist. Safety and feasibility were assessed from patients, physiotherapists, and a technician using logbooks, interviews, and a questionnaire. Qualitative content analysis and descriptive statistics were used in the analysis. Results: Fourteen out of 15 patients finalized the training period with a mean of 19.5 minutes spent on training at each session. The DISKO-tool was found to be useful and safe by patients and physiotherapists. Conclusions: This study demonstrates the feasibility and safety of the DISKO-tool and provides guidance in further development and testing of interactive distance technology for home rehabilitation, to be used by health care professionals and patients in different phases of rehabilitation after stroke.

Comparative analysis of kinesiotherapy rehabilitation after hip arthroscopy, quantified by harris and vail hip scores: a retrospective study.

It has been proven that femoroacetabular impingement cases improve following arthroscopic surgery. However, rehabilitation has a major role in the patient's recovery. The protocol used by our institution consists of an evidence-based guideline for the different phases of rehabilitation. Describe and determine the effectiveness of our institution's kinesiotherapy rehabilitation program during 2011-2016, comparing Harris and Vail Hip Scores scales (HHS and VHS, respectively) at the beginning of each treatment phase. This is an observational, descriptive, longitudinal and retrospective study which, from a total of 684 subjects who underwent surgery, and 103 subjects who followed our institution's rehabilitation program, ultimately uses a sample of 48 subjects for analysis; these subjects were included because they completed the scales on the three occasions determined. Significant exact differences were found in: multivariate contrasts HHS (F=147.420; p=0.000); VHS (F=82,160; p=0,000). Mauchly's sphericity test: HHS (W=0.722; p=0.001); VHS (W=0.830; p=0.014). The within-subject effect showed significant exact differences in: HHS (F=169.451; p=0.000); VHS (F=115.387; p=0.000). Results showed significant exact differences p=0.00. In spite of its limitations, this study provides a guideline for a patient's safe return to daily life activities. IV.

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review.

Accurate estimation of energy needs is vital for effective nutritional management of individuals with spinal cord injury (SCI). Inappropriate energy prescription after SCI can compound the rates of malnutrition or obesity, increase the risk of complications and negatively influence outcomes. Energy requirements following SCI are not well understood, and there is currently no universally accepted method of estimating energy needs in clinical practice. This is a systematic literature review. The objectives of this study were to investigate and compare the measured resting energy needs of adults with SCI across different phases of rehabilitation, and to identify appropriate energy prediction equations for use in SCI. This study was conducted in Australia. MEDLINE, EMBASE and CENTRAL databases were searched for studies published between 1975 and April 2015, identifying 298 articles. Full articles in English language of adults with SCI who were fasted for a minimum of 8 hours before undergoing indirect calorimetry to measure resting energy expenditure (REE) for at least 20 min were selected. On the basis of the inclusion criteria, 18 articles remained for data extraction. One author extracted information from all articles, and inter-rater reliability was tested in five articles. REE across three phases of injury was assessed: acute, sub-acute and chronic. Few studies (n=2) have investigated REE in the acute and sub-acute injury stages of SCI recovery. The factors influencing chronic energy needs in SCI patient populations are many and varied, and a valid predictive equation for use in SCI remains elusive. Indirect calorimetry remains the only accurate assessment of REE for health practitioners working with patients after SCI.

Quality of life can both influence and be an outcome of general health perceptions after heart surgery.

BackgroundOur aim was to investigate the existence of a reciprocal relationship between patients' assessment of quality of life and their appraisal of health. If present, this relationship will interfere with the interpretation of heart surgery's effect on overall quality of life.MethodsPath analysis was used to investigate reciprocal causal relationships between general health perceptions and overall quality of life before and after heart surgery. Longitudinal data from a study of coronary artery bypass surgery were used to model lagged, cross-lagged, and simultaneous paths over four time-points of assessment from before surgery to one year afterwards. The conceptual framework for the analysis was the Wilson and Cleary causal pathway model. General health perceptions were measured with the Short Form 36. Overall quality of life was measured with i) a single question regarding life satisfaction and ii) the multi-item Quality of Life Survey.ResultsAcceptable model fit was obtained for reciprocal causation between general health perceptions and overall quality of life. Regression coefficients changed over different phases of rehabilitation. Serial correlation accounted for much of the variance within variables over time.ConclusionThe present analysis demonstrates that unidirectional models of causality are inadequate to explain the effect of heart surgery on overall quality of life. Overall quality of life can causally influence as well as be an outcome of health status after coronary artery bypass surgery.

Rehabilitation of patients with coronary heart disease

According to a World Health Organization (WHO) working group and experts of the International Society of Cardiology, 2,a rehabilitation of cardiac patients can be defined as the sum of activities required to insure them the best possible physical, mental, and social conditions, so that they may, by their own efforts, regain as normal as possible a place in the community and lead an active, productive life. It must be emphasized that the concept of a rehabilitation program for the Coronary patient cannot be considered an isolated form of therapy, but rather a part of a complex management schema. The integrity of rehabilitation should be based on the physical ability of the patient; thus physical capabilities and functional assessment must play a decisive role. 1 Before discussing the different phases of rehabilitation of coronary patients, the results of an international survey prepared for the Scientific Council of Cardiac Rehabilitation of the International Society of Cardiology 4 will be reviewed to emphasize the multiple complexities inherent to the field.