Efficacy Of Inpatient Rehabilitation Research Articles

Efficacy of Inpatient Rehabilitation After Left Ventricular Assist Device Implantation

BackgroundLeft ventricular assist devices (LVADs) have become an increasingly popular and effective means for treating advanced heart failure. LVAD implantation requires extensive surgery and postoperative rehabilitation. The Functional Independence Measure (FIM) has been used to quantify functional gains in numerous patient populations, including those with stroke and spinal cord injury. This study investigated functional improvements in patients undergoing LVAD implantation using the FIM score. ObjectiveTo assess functional improvements in patients with advanced heart failure who underwent LVAD implantation. DesignRetrospective. SettingInpatient rehabilitation unit. SubjectsNinety consecutive patients who received acute inpatient rehabilitation after continuous flow LVAD implantation. MethodsDemographic, laboratory, and functional outcomes data including inpatient rehabilitation unit (IRU) length of stay (LOS), discharge disposition, and FIM score were collected for all patients. Paired t-tests were used to assess change in functional measures and laboratory data. Main Outcome MeasuresPrimary outcome measures included FIM gain, FIM efficiency, discharge disposition, rates of readmission after discharge from rehabilitation, and LOS in the rehabilitation unit. ResultsThe FIM gain was statistically significant at 28.4 ± 12.3 (P < .001) and compared favorably with benchmarks for mean FIM gains at our facility (26.4), regionally (21.5), and nationally (22.7) for patients admitted to IRUs with a cardiac diagnosis. FIM efficiency (FIM gain/IRU LOS) was 1.9 ± 1.0 compared with the mean FIM efficiency at our facility (2.2), regionally (2.1), and nationally (2.2). Seventy-four percent (n = 67) of patients were discharged directly home after inpatient rehabilitation, 17% (n = 16) were readmitted to the acute hospital service, and 8% (n = 7) required additional rehabilitation at a subacute rehabilitation facility. The IRU LOS was 16.2 ± 6.9 days. ConclusionsOur study indicates that most patients with an LVAD achieve clinically meaningful functional gains from acute inpatient rehabilitation, with the majority of patients being discharged home. Further studies need to be performed to analyze clinical outcomes after acute inpatient rehabilitation. Level of EvidenceIV

Prädiktoren und Outcome stationärer Rehabilitation bei Patienten mit Bronchialkarzinom

BACKGROUND: There are no data on the efficacy of in-patient rehabilitation after surgery and/or radiation and/or chemotherapy against lung cancer. The purpose of this prospective study was to assess changes in exercise capacity, lung function and quality of life (QoL) before and after an inhouse training programme. METHODS: 45 patients with lung cancer (WHO I-III after surgery and/or radiation and/or chemotherapy treatment) entered a 28-day in house rehabilitation programme including of standardized aerobic training (submaximal interval training on bicycle ergometer daily, 6 times a week, 30 min., heart-rate-adjusted). Functional status and the health-related quality of life (QLQ-C30, QLQ-LC13, SF-36 and MFI-20) were examined at the beginning, within the rehab stay and at day 28. RESULTS: A substantial increase of work performance (bicycle ergometry from 68 ± 3 to 86 ± 4 Watt and six-minute walking test from 322 ± 11 to 385 ± 13 meter) could be noticed. Pulmonary function (FEV1 from 70 ± 3 to 73 ± 3, also FVC from 77 ± 3 to 82 ± 3 %) rose significantly. Also, heart rates at rest could be reduced (from 84 ± 2 to 80 ± 1 beat per miniute) and the heart rate variability (measure of efficacy of endurance training) could be raised significantly (9,7 ± 1 to 12,9 ± 1 root mean square of successive differences). Moreover, health-related quality of life significantly improved (48 ± 3 to 62 ± 2) and fatigue declined from 66 ± 3 to 41 ± 4. In addition, there were no age- or gender-dependent correlations with physical performance, quality of life and the extent of fatigue. Good motivation however, was found to be a predictor for a high rehabilitation outcome. CONCLUSIONS: Standardized aerobic endurance training improves physiological and psychological parameters after surgery and/or radiation and/or chemotherapy for lung cancer. A future trial will compare this programme against a control group (no rehabilitation programme) over a 6-month period to verify a longerlasting effect of lung cancer rehabilitation.

Efficacy of inpatient rehabilitation on children and adolescents with brain tumors: Risk factor analysis and functional outcome

Efficacy of inpatient rehabilitation on children and adolescents with brain tumors: Risk factor analysis and functional outcome