Effectiveness Of Rehabilitation Interventions Research Articles

Rehabilitation for distal radial fractures in adults.

Rehabilitation for distal radial fractures in adults.

Rehabilitation Interventions for Improving Social Participation After Stroke

Background. Despite the fact that social participation is considered a pivotal outcome of a successful recovery after stroke, there has been little attention on the impact of activities and services on this important domain. Objective. To present a systematic review and meta-analysis from randomized controlled trials (RCTs) on the effects of rehabilitation interventions on social participation after stroke. Methods. A total of 8 electronic databases were searched for relevant RCTs that evaluated the effects of an intervention on the outcome of social participation after stroke. Reference lists of selected articles were hand searched to identify further relevant studies. The methodological quality of the studies was assessed using the Physiotherapy Evidence Database Scale. Standardized mean differences (SMDs) and confidence intervals (CIs) were estimated using fixed- and random-effect models. Results. In all, 24 RCTs involving 2042 stroke survivors were identified and reviewed, and 21 were included in the meta-analysis. There was a small beneficial effect of interventions that utilized exercise on social participation (10 studies; SMD = 0.43; 95% CI = 0.09, 0.78; P = .01) immediately after the program ended. Exercise in combination with other interventions (13 studies; SMD = 0.34; 95% CI = 0.10, 0.58; P = .006) also resulted in beneficial effects. No significant effect was observed for interventions that involved support services over 9 studies (SMD = 0.09 [95% CI = −0.04, 0.21]; I2 = 0%; P = .16). Conclusions. The included studies provide evidence that rehabilitation interventions may be effective in improving social participation after stroke, especially if exercise is one of the components.

Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial.

BackgroundThere is an increasing amount of evidence for the effectiveness of rehabilitation interventions for people with severe mental illness (SMI). In the Netherlands, a rehabilitation methodology that is well known and often applied is the Comprehensive Approach to Rehabilitation (CARe) methodology. The overall goal of the CARe methodology is to improve the client’s quality of life by supporting the client in realizing his/her goals and wishes, handling his/her vulnerability and improving the quality of his/her social environment. The methodology is strongly influenced by the concept of ‘personal recovery’ and the ‘strengths case management model’. No controlled effect studies have been conducted hitherto regarding the CARe methodology.Methods/designThis study is a two-armed cluster randomized controlled trial (RCT) that will be executed in teams from three organizations for sheltered and supported housing, which provide services to people with long-term severe mental illness. Teams in the intervention group will receive the multiple-day CARe methodology training from a specialized institute and start working according the CARe Methodology guideline. Teams in the control group will continue working in their usual way. Standardized questionnaires will be completed at baseline (T0), and 10 (T1) and 20 months (T2) post baseline. Primary outcomes are recovery, social functioning and quality of life. The model fidelity of the CARe methodology will be assessed at T1 and T2.DiscussionThis study is the first controlled effect study on the CARe methodology and one of the few RCTs on a broad rehabilitation method or strength-based approach. This study is relevant because mental health care organizations have become increasingly interested in recovery and rehabilitation-oriented care.Trial registrationThe trial registration number is ISRCTN77355880.

Use Fugl-Meyer assessment to determine appropriate and effective rehabilitation interventions for patients with stroke

hyperglycemia on functional outcomes in patients undergoing stroke rehabilitation remains to be determined. Purpose: The purpose of this study was to investigate the relationship between hyperglycemia and clinical outcomes in patients with subacute stroke. Methods: Twenty patients with subacute stroke were recruited. All participants received 20 sessions of robotassisted therapy and customary rehabilitation. Clinical outcomes, including modified Rankin Scale (mRS), FuglMeyer Assessment (FMA), and Stroke Impact Scale (SIS), were assessed before and after treatment. Blood biomarkers, including the glycosylated hemoglobin (HbA1c) and fasting blood glucose, were also assessed. Paired sample t test was used to examine the intervention effects, while the Pearson correlation coefficient (r) was used to determine the relationships between the clinical outcomes and the blood biomarkers. Results: After treatment, the participants demonstrated a decrease in mRS scores, and an improvement in FMA, FIM, and SIS scores (P< 0.01). However, no significant changes were found in the blood glucose and HbA1c concentrations. Baseline mild hyperglycemia (fasting glucose ≥120mg/dL) correlated significantly with post-treatment mRS scores (r= 0.50; P= 0.024) and approached significant correlation with FIM (r=−0.42; P= 0.066). After rehabilitation, significant correlation was found between mRS and glucose (r= 0.59) and HbA1c (r= 0.47). Conclusion(s): Persistent mild hyperglycemia could be a biomarker of rehabilitation effects for patients with subacute stroke. Lowering blood glucose and HbA1c were associated with improved clinical outcomes. Implications: This study suggests that glycemic status is associatedwith functional outcomes in patientswith subacute stroke. Clinicians may also consider glycemic status when designing personalized therapy.

Identifying stride-to-stride control strategies in human treadmill walking.

Variability is ubiquitous in human movement, arising from internal and external noise, inherent biological redundancy, and from the neurophysiological control actions that help regulate movement fluctuations. Increased walking variability can lead to increased energetic cost and/or increased fall risk. Conversely, biological noise may be beneficial, even necessary, to enhance motor performance. Indeed, encouraging more variability actually facilitates greater improvements in some forms of locomotor rehabilitation. Thus, it is critical to identify the fundamental principles humans use to regulate stride-to-stride fluctuations in walking. This study sought to determine how humans regulate stride-to-stride fluctuations in stepping movements during treadmill walking. We developed computational models based on pre-defined goal functions to compare if subjects, from each stride to the next, tried to maintain the same speed as the treadmill, or instead stay in the same position on the treadmill. Both strategies predicted average behaviors empirically indistinguishable from each other and from that of humans. These strategies, however, predicted very different stride-to-stride fluctuation dynamics. Comparisons to experimental data showed that human stepping movements were generally well-predicted by the speed-control model, but not by the position-control model. Human subjects also exhibited no indications they corrected deviations in absolute position only intermittently: i.e., closer to the boundaries of the treadmill. Thus, humans clearly do not adopt a control strategy whose primary goal is to maintain some constant absolute position on the treadmill. Instead, humans appear to regulate their stepping movements in a way most consistent with a strategy whose primary goal is to try to maintain the same speed as the treadmill at each consecutive stride. These findings have important implications both for understanding how biological systems regulate walking in general and for being able to harness these mechanisms to develop more effective rehabilitation interventions to improve locomotor performance.

Cognitive rehabilitation in multiple sclerosis: the role of plasticity.

Cognitive deficits are common in multiple sclerosis (MS), documented at many stages of the disease. Both structural and functional neuroimaging have demonstrated a relationship with cognitive abilities in MS. Significant neuroplasticity of cognitive functions in individuals with MS is evident. Homologous region adaptation, local activation expansion, and extra-region recruitment all occur in an effort to maintain cognitive functioning. While much of this neuroplasticity is adaptive, it may also be maladaptive, particularly in individuals that are demonstrating significant cognitive impairment and/or with disease progression. This maladaptive neuroplasticity may come at the cost of other cognitive functions. Studies of cognitive rehabilitation efficacy have also recently applied neuroimaging techniques to establish outcome. Researchers have successfully applied various neuroimaging techniques to study the effects of cognitive rehabilitation in MS including task-based fMRI and resting state functional connectivity across multiple realms of cognition including episodic memory, executive functioning, attention, and processing speed. These studies have demonstrated neuroplasticity in the brains of persons with MS through the documentation of changes at the level of the cerebral substrate from before to after non-invasive, non-pharmacological, behavioral treatment for deficits in cognition. Future research should seek to identify adaptive versus maladaptive neuroplasticity associated with specific cognitive rehabilitation programs within all MS phenotypes to foster the validation of the most effective cognitive rehabilitation interventions for persons with MS.

IMPACT OF EARLY POST STROKE REHABILITATION PROGRAM ON NEUROLOGICAL AND FUNCTIONAL OUTCOME

Stroke is a common cause of death and long-term disability with varied and unpredictable outcome if not managed rapidly and in correct manner, so it requires acute phase treatments with intensive rehabilitation therapy. Stroke rehabilitation is a complex process that aims to facilitation of adaptive learning to maximize the functional independence, effective rehabilitation interventions initiated early after stroke can enhance the recovery process and minimize functional disability which leads to higher quality of life and social productivity. Therefore, the aim of the study was to examine the impact of early post stroke rehabilitation program on neurological and functional outcome. Patients and Methods: Quasi-experimental research design was conducted in both neurology department (stroke unit) and outpatient department (neurology clinic) at Mansoura University Hospital. A purposive sample of 100 adult patients of both sexes with cerebrovascular stroke, who corresponded to inclusion criteria were assigned into two equal groups, early rehab (study) group and late rehab (control) group. Results: the results indicates, early post stroke rehabilitation program (after one week) enhances neurological and functional recovery, among early rehab group comparing to late rehab group. Close correlation between neurological and functional recovery. Conclusion: Early post stroke rehabilitation program have a significant positive impact on patient's neurological and functional recovery. In addition, neurological recovery significantly correlates to functional recovery.

Advancing research and practice in HIV and rehabilitation: a framework of research priorities in HIV, disability and rehabilitation.

BackgroundHIV increasingly is experienced as a complex chronic illness where individuals are living longer with a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging, a concept that may be termed ‘disability’. Rehabilitation such as physical therapy and occupational therapy can help address disability and has the potential to improve quality of life in people living with HIV. Hence, the role for rehabilitation in the context of HIV, aging and comorbidities is emerging. Our aim was to establish a framework of research priorities in HIV, disability and rehabilitation.MethodsWe convened people living with HIV, clinicians, researchers, service providers, representatives from community-based organizations and policy and funding stakeholders to participate in the first International Forum on HIV and Rehabilitation Research. We conducted a multi-stakeholder consultation to identify current and emerging issues in HIV, disability and rehabilitation. Data were collated and analyzed using content analytical techniques.ResultsNinety-two participants attended the Forum from Canada, United Kingdom (UK), Ireland and the United States. Situated within three overarching themes (episodic health and disability across the life course; rehabilitation; and methodological advances), the Framework of Research Priorities in HIV, Disability and Rehabilitation includes six research priorities: 1) episodic health and disability; 2) aging with HIV across the life course; 3) concurrent health conditions; 4) access to rehabilitation and models of rehabilitation service provision; 5) effectiveness of rehabilitation interventions; and 6) enhancing outcome measurement in HIV and rehabilitation research. The Framework includes methodological considerations and environmental and personal contextual factors (or lenses) through which to approach research in the field. Knowledge translation should be implemented throughout the development and application of research knowledge to inform HIV clinical practice, programming and policy.ConclusionsThese priorities highlight the emerging priorities of living long-term with HIV and outline a plan for HIV and rehabilitation research in resource-rich countries such as the UK and Canada.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0724-8) contains supplementary material, which is available to authorized users.

Long-term three-stage rehabilitation intervention alleviates spasticity of the elbows, fingers, and plantar flexors and improves activities of daily living in ischemic stroke patients

To investigate the effects of rehabilitation interventions on spasticity and activities of daily living (ADL) in ischemic stroke patients. A total of 165 ischemic stroke patients were recruited and assigned randomly to a control group (CG, n=82) or a therapeutic group (TG, n=83). Rehabilitation interventions were performed in the TG. The Modified Ashworth Scale was used to evaluate the severity of spasticity in the fingers, elbows, and plantar flexors, and the Modified Barthel Index (MBI) was used to measure ADL performance. Evaluations were performed at baseline (M0) and at the end of the first, third, and sixth months (M1, M3, M6) after enrollment. At M0, 20.8% (16/77) in the CG and 29.9% (23/77) in the TG developed spasticity, whereas at M6, the incidence of spasticity increased to 36.4% (28/77) in the TG and 42.9% (33/77) of patients in the CG. Fewer patients developed spasticity in the fingers, elbows, and ankles in the TG than CG, respectively. Both groups showed significant improvements in MBI scores (M6 vs. M0, P<0.01). MBI scores correlated negatively with the severity of spasticity in both groups at M6. Long-term standardized rehabilitation interventions alleviate spasticity and promote ADL with the presence of minor spasticity (Supplementary video, Supplemental digital content 1, http://links.lww.com/WNR/A291).

Effectiveness of rehabilitation interventions in improving emotional and functional status in hearing or visually impaired older adults: a systematic review with meta-analyses

Objective: To assess the effectiveness of non-equipment based rehabilitation interventions for older adults with an age-related hearing or visual impairment. Data sources: We searched PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Central Register of Controlled Trials. Review methods: Two authors independently assessed trial eligibility, extracted data and assessed methodological quality. Controlled studies with more than 80% of participants aged ≥ 55 years and with rehabilitation interventions either separately or in combination with technical device provision were included. Meta-analyses were undertaken for the primary outcomes: emotional status, functional status, self-efficacy and social participation. All studies were categorized into 3 subgroups of intervention approaches (cognitive restructuring, education, and problem-solving), and subgroup analysis was performed. Results: Fourteen studies were identified: six on hearing impairment and eight on visual impairment, involving 1622 sensory impaired participants (mean age 70). Methodological quality of the studies was modest. Eight studies offered data for meta-analysis. No significant effects in favour of interventions on either emotional or functional status, self-efficacy, or social participation were found. In the subgroup analysis, only the problem-solving approach showed a positive effect on emotional status. Conclusions: This review found no effects of non-equipment based rehabilitation interventions on emotional and functional status, self-efficacy, and social participation. However, subgroup analysis showed problem-solving as a potential effective approach for positively affecting emotional status.

Moving toward 2017: progress in rehabilitation intervention effectiveness research.

Halfway into the 10-yr American Occupational Therapy Association Centennial Vision initiative, occupational therapy has made notable progress in establishing itself as a science-driven profession. Through the diligent work of many talented occupational therapy scholars, 42 research studies exploring interventions used in rehabilitation research were published in the past 5 years. A variety of both novel and established intervention strategies were investigated using diverse research designs and measurement tools. A predominant number of studies were conducted with the poststroke population. Moving forward to 2017 and building on our success, we can recognize our full potential by fostering knowledge translation, expanding participant numbers, exploring less-studied populations, increasing the volume of systematic reviews published, and reporting occupation-centered outcomes, the unique and defining component of our profession.

Reference values for the SF-36 in Canadian injured workers undergoing rehabilitation.

The Medical Outcomes Study 36-item Short Form Survey (SF-36) is a widely used measure of health-related quality of life and normative reference values have been published for the general population of several countries. Since injured workers often experience pain, disability and other health challenges, we evaluated SF-36 reference values for Canadian workers' compensation claimants undergoing rehabilitation. Descriptive cross-sectional design. Data were gathered as part of a study aimed at developing a tool for selecting rehabilitation programs. Data were available on a wide variety of measures, including the SF-36. We calculated age- and sex-adjusted reference values, and stratified analyses based on type of rehabilitation, employment status and diagnostic group. Data were available on 5,622 claimants undergoing rehabilitation. Claimants reported significant limitations on all SF-36 scales, but were especially limited on the Role Emotional and Bodily Pain scales (~3 standard deviations below typical Canadian norms). Unemployed, middle-aged claimants undergoing chronic pain programs reported the lowest health status, but SF-36 scores varied minimally across diagnoses. Claimant scores on the SF-36 were below population norms across all health scales and differed depending on age, employment status and type of rehabilitation. These data will be useful for assessing the health status of injured workers and evaluating the effect of rehabilitation interventions.

Cycle of coercion: experiences of maltreatment and disciplinary measures in Canadian inmates.

In spite of past and current efforts at implementing effective rehabilitative interventions in carceral settings, institutions of confinement are primarily concerned with the maintenance of order within their walls. The purpose of this paper is to better understand associations between inmates' developmental background and the experience of institutional discipline, to collect information on childhood maltreatment and disciplinary measures for a sample of Canadian prisoners. Information relative to socio-economic background, childhood maltreatment and experience of discipline while in custody was obtained using face-to-face interviews and institutional file review for a sample of 416 male and 106 female offenders in Canadian provincial institutions. Results from logistic regression analyses provided support for the association between childhood maltreatment and the experience of discipline, specifically in the form of increased monitoring from correctional staff. Furthermore, this association was found to be more pronounced for female offenders. The findings highlight the need to incorporate a developmental perspective to current understanding of the use of disciplinary interventions in a prison environment. Such an approach may allow for preventing the enactment of a cycle of coercion, with negative consequences for the inmates. This study is original in its use of latent variable analytic methods to uncover the structure underlying the construct of childhood maltreatment in adult offenders. In addition, it provides valuable data of interest to researchers, corrections personnel and policy makers on the possible links between earlier developmental experiences and adjustment to the prison environment.

The effect of rehabilitation intervention on GAIT performance in professional ballet dancers

The effect of rehabilitation intervention on GAIT performance in professional ballet dancers

Interventions for improving sit-to-stand ability following stroke.

Standing up from a seated position is one of the most frequently performed functional tasks, is an essential pre-requisite to walking and is important for independent living and preventing falls. Following stroke, patients can experience a number of problems relating to the ability to sit-to-stand independently. To review the evidence of effectiveness of interventions aimed at improving sit-to-stand ability after stroke. The primary objectives were to determine (1) the effect of interventions that alter the starting posture (including chair height, foot position, hand rests) on ability to sit-to-stand independently; and (2) the effect of rehabilitation interventions (such as repetitive practice and exercise programmes) on ability to sit-to-stand independently. The secondary objectives were to determine the effects of interventions aimed at improving ability to sit-to-stand on: (1) time taken to sit-to-stand; (2) symmetry of weight distribution during sit-to-stand; (3) peak vertical ground reaction forces during sit-to-stand; (4) lateral movement of centre of pressure during sit-to-stand; and (5) incidence of falls. We searched the Cochrane Stroke Group Trials Register (June 2013), CENTRAL (2013, Issue 5), MEDLINE (1950 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), AMED (1985 to June 2013) and six additional databases. We also searched reference lists and trials registers and contacted experts. Randomised trials in adults after stroke where: the intervention aimed to affect the ability to sit-to-stand by altering the posture of the patient, or the design of the chair; stated that the aim of the intervention was to improve the ability to sit-to-stand; or the intervention involved exercises that included repeated practice of the movement of sit-to-stand (task-specific practice of rising to stand).The primary outcome of interest was the ability to sit-to-stand independently. Secondary outcomes included time taken to sit-to-stand, measures of lateral symmetry during sit-to-stand, incidence of falls and general functional ability scores. Two review authors independently screened abstracts, extracted data and appraised trials. We undertook an assessment of methodological quality for random sequence generation, allocation concealment, blinding of outcome assessors and method of dealing with missing data. Thirteen studies (603 participants) met the inclusion criteria for this review, and data from 11 of these studies were included within meta-analyses. Twelve of the 13 included studies investigated rehabilitation interventions; one (nine participants) investigated the effect of altered starting posture for sit-to-stand. We judged only four studies to be at low risk of bias for all methodological parameters assessed. The majority of randomised controlled trials included participants who were already able to sit-to-stand or walk independently.Only one study (48 participants), which we judged to be at high risk of bias, reported our primary outcome of interest, ability to sit-to-stand independently, and found that training increased the odds of achieving independent sit-to-stand compared with control (odds ratio (OR) 4.86, 95% confidence interval (CI) 1.43 to 16.50, very low quality evidence).Interventions or training for sit-to-stand improved the time taken to sit-to-stand and the lateral symmetry (weight distribution between the legs) during sit-to-stand (standardised mean difference (SMD) -0.34; 95% CI -0.62 to -0.06, seven studies, 335 participants; and SMD 0.85; 95% CI 0.38 to 1.33, five studies, 105 participants respectively, both moderate quality evidence). These improvements are maintained at long-term follow-up.Few trials assessing the effect of sit-to-stand training on peak vertical ground reaction force (one study, 54 participants) and functional ability (two studies, 196 participants) were identified, providing very low and low quality evidence respectively.The effect of sit-to-stand training on number of falls was imprecise, demonstrating no benefit or harm (OR 0.75, 95% CI 0.46 to 1.22, five studies, 319 participants, low quality evidence). We judged the majority of studies that assessed falls to be at high risk of bias. This review has found insufficient evidence relating to our primary outcome of ability to sit-to-stand independently to reach any generalisable conclusions. This review has found moderate quality evidence that interventions to improve sit-to-stand may have a beneficial effect on time taken to sit-to-stand and lateral symmetry during sit-to-stand, in the population of people with stroke who were already able to sit-to-stand independently. There was insufficient evidence to reach conclusions relating to the effect of interventions to improve sit-to-stand on peak vertical ground reaction force, functional ability and falls. This review adds to a growing body of evidence that repetitive task-specific training is beneficial for outcomes in people receiving rehabilitation following stroke.

Emerging therapy approaches: an emphasis on function.

Children and youth with cerebral palsy receive ongoing physical and occupational therapy services to improve their functional performance and participation in activities at home, school, and in the community. Over the past 2 decades, rehabilitation interventions have become more functional and goal oriented. In this article, we discuss factors that have influenced emerging intervention approaches. These factors include greater involvement of families in decision making, changing conceptual frameworks and theories underlying skill development and improved outcome measures. New research findings indicate that rehabilitation interventions embracing family-centered services and focusing on functional improvement can be more effective in promoting participation. This knowledge can serve as the platform for further examination of the most effective rehabilitation interventions for children and youth with cerebral palsy.

Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

ObjectiveOur aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV.DesignWe conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence...

Does Task-Oriented Practice Improve Upper Extremity Motor Recovery after Stroke? A Systematic Review

Background. Stroke commonly affects upper extremity motor abilities, yet there has been very limited success in developing effective rehabilitation interventions to remediate motor impairments, particularly for the upper extremity. Objective. To determine if task-oriented practice administered soon after stroke is more effective than usual care in improving poststroke upper extremity motor recovery and to explore the optimal amount of practice. Methods. A systematic review of the literature was performed from 1950 to November 2012, to identify randomized controlled trials of task-oriented practice compared to usual care, or to different amounts of task-oriented practice to improve motor impairment and activity. Studies were excluded if specific types of interventions were used as comparators or if they were of poor methodological quality. Results. Six studies met the review criteria. Three of the six studies demonstrated a statistically significant effect of task-oriented practice. Study results could not be pooled because of a lack of homogeneity in populations and intervention. Conclusions. The results demonstrate that an increase in the amount of task-oriented practice after stroke may result in less upper extremity impairment; further research on both effect and required dosage is needed as results are inconsistent.

Deficits in spatial threshold control of muscle activation as a window for rehabilitation after brain injury.

Recovery of voluntary control of movement is the main goal of rehabilitation. Despite numerous studies aimed at identifying the most effective rehabilitation interventions, attempts to improve poststroke upper limb recovery remain disappointing: Sensorimotor deficits of the arm and hand persist in a large proportion of stroke survivors (up to 62 %). Indeed, efforts to improve upper limb recovery have been hampered by the lack of understanding of the neural mechanisms underlying spasticity, muscle weakness, and altered kinematic redundancy. Spasticity refers to the presence of hyperactive velocity-dependent stretch reflexes and is associated with disorders of upper motor neurons following central nervous system (CNS) injury such as stroke. Since it is associated with disruption of upper motor neuron function, those with spasticity typically also have weakness and decreased control of voluntary movements. Despite intensive research into these phenomena, the nature of the relationship and neural mechanisms underlying spasticity, weakness, and voluntary control remains unclear. This chapter will describe a new approach to the understanding of this relationship based on deficits in (1) the ability of the damaged CNS to control spatial thresholds (STs) of reflexes and (2) the residual capacity of corticospinal pathways to regulate STs across different regions of the arm workspace in poststroke subjects at rest and during voluntary movement. This approach is driven by recent evidence that, rather than directly specifying motor commands to muscles, the corticospinal system resets STs of reflexes to generate and control voluntary movement.

Targeting the Psychosexual Challenges Faced by Couples with Breast Cancer: Can Couples Group Psychotherapy Help?

The need for the psychosexual rehabilitation of breast cancer survivors and their intimate partners is underscored by the high prevalence of multiple psychosexual difficulties encountered by this patient population. Concerns about health, sexuality, and emotional distress are common among women with breast cancer and are often related to the side effects of cancer treatment. Additionally, both intimate relationship problems and partners’ distress are likely to influence patients’ psychosexual health. A clearer understanding of these complex clinical issues is needed in order to implement effective psychosexual rehabilitation interventions. In this article, we extended the use of the manualized and empirically validated Supportive-Expressive Group Therapy (SEGT) model to target the specific psychosexual needs of couples with breast (as well as other types of) cancer. In view of the pertinent literature in this area and based on our clinical experience utilizing this group therapy model with different patient populations, we have discussed how clinicians involved in the psychosexual care of oncology patients could apply such a model within a couples group therapy format.