Efficiency Of Rehabilitation Research Articles

The study of parental opinion concerning the organization and quality of rehabilitation treatment of the children with infectious diseases

The most important question of the modern organization of medical rehabilitation system are the issues of quality and patient satisfaction, therefore, we carried out a sociological study, which was attended by 309 parents and legal guardians of children who were on rehabilitation in the clinic of the Institute of children’s infections. The analysis of respondents answers showed that 28.5 per cent were awaiting the commencement of rehabilitation treatment of a child less than one week; 40.1 percent – from 1 to 2 weeks; 25.9 per cent for 3–4 weeks, and 5.6 percent – more than a month. 75.6% of respondents were satisfied with the rehabilitation process in the clinic. In the opinion of the vast majority (87.4%, other) status of their children after rehabilitation was improved, including 43.7 percent reported a significant improvement. Most parents are almost completely satisfied with the organization, quality and efficiency of rehabilitation of children in the basic clinic, and a significant part of the suggestions for improving the organization of the rehabilitation process expressed by respondents are reduced mainly to the organization of domestic activities (61,5%) and only 15.4% – are aimed at improving directly the rehabilitation process.

Utilization of Post-Acute Care Following Distal Radius Fracture Among Medicare Beneficiaries

To examine the utilization and cost of post-acute care following isolated distal radius fractures (DRFs) among Medicare beneficiaries. We examined utilization of post-acute care among Medicare beneficiaries who experienced an isolated DRF (n= 38,479) during 2007 using 100% Medicare claims data. We analyzed the effect of patient factors on hospital admission following DRF and the receipt of post-acute care delivered by skilled nursing facilities, inpatient rehabilitation facilities, home health care agencies, and outpatient occupational therapy/physical therapy for the recovery ofDRF. In this cohort of isolated DRF patients, 1,694 (4.4%) were admitted to hospitals following DRF, and 20% received post-acute care. Women and patients with more comorbid conditions were more likely to require hospital admission. The utilization of post-acute care was higher among women, patients who resided in urban areas, and patients of higher socioeconomic status. The average cost per patient of post-acute care services from inpatient rehabilitation facilities and skilled nursing facilities ($15,888/patient) was significantly higher than the average cost other aspects of DRF care and accounted for 69% of the total DRF-related expenditure among patients who received inpatient rehabilitation. Sociodemographic factors, including sex, socioeconomic status, and age, were significantly correlated with the use of post-acute care following isolated DRFs, and post-acute care accounted for a substantial proportion of the total expenditures related to these common injuries among the elderly. Identifying patients who will derive the greatest benefit from post-acute care can inform strategies to improve the cost efficiency of rehabilitation and optimize scarce health care resources. Therapeutic III.

Characteristic of Injuries and Rehabilitation to Professional Rugby Players

To report the occurrence of injuries and the efficiency of rehabilitation in rugby players from Poland (P) and France (F).

Formation of social and household skills in children with hand defects.

PurposeThe aim of this study was to consider the peculiarities of forming social and household skills, and the criteria for their evaluation, as well as an assessment of functional capacity, in children with hand defects both before and after surgical treatment and rehabilitation courses using a system of games.MethodsWe elaborated and implemented a program of social rehabilitation of preschool children with congenital and acquired hand defects for the development of their functional capabilities and the formation of social and household skills after surgical treatment and prosthetics using play therapy methods. As part of this work, 140 preschool children aged 3–7 years underwent social rehabilitation. Most of the children had congenital hand defects—122 children (87 %): 96 children (79 %) with ectrodactylia, adactylia, hypoplasia, aplasia, hand splitting, club hand, or partial gigantism; 26 children (21 %) with congenital syndactylism and constricted bonds and 18 children (13 %) with acquired defects (burn deformity, amputation). 110 children (79 %) had reached the stage of surgical correction; 30 children (21 %) reached the stage of prosthetics. Most of the children participating in the experiment (78 children, 56 %) had defects of fingers on one hand. The program aimed at solving specific rehabilitation tasks: formation and improvement of all possible types of grip under the existing defect including those after surgery and prosthetics; development of tactile sensations in fingers; development of fine motor skills; increase in range of motion in all joints of the damaged hand; development of attention and concentration; formation of social and household skills appropriate to age; and development of the ability to achieve the set task.ResultsAnalysis of the level of social and household skills of children with hand defects undergoing rehabilitation treatment at the hospital depending on the age prior to medical and social rehabilitation showed that preschool children with hand defects in the age category of 3 years demonstrated the highest results in the level of social and household skills (31 %) as compared with children in other age categories. The indicators for children aged 4 and 5 years were slightly lower, 25 and 26 %, respectively. The lowest values were recorded among children aged 6: 20 %.ConclusionStatistically significant parameters of the level of functional capacity of hand grip and social and household skills in children with hand defects obtained in the course of the investigation indicated that the use of play therapy measures significantly increased the effect of medical treatment irrespective of the type of defect. These data indicate that play therapy measures given immediately after surgery or prosthetics can significantly increase the efficiency of rehabilitation even in its early stages.

Efficiency of rehabilitation after acute myocardial infarction

The purpose of this study was to evaluate the recurrence rate and medical expenses of acute myocardial infarction (AMI) following inpatient cardiac rehabilitation. A total of 834 patients with AMI were divided into Group 1 (with inpatient cardiac rehabilitation) and Group 2 (without inpatient cardiac rehabilitation). The results showed that Group 1 had a lower AMI recurrence rate (a 0.640-fold lower hazards ratio) than Group 2 [95% confidence interval (CI) = 0.197–1.863; p = 0.004]. Compared with the medical costs of Group 2, Group 1 also had lower medical costs (a 0.947-fold lower hazards ratio) than Group 2 (95% CI = 0.934–0.981; p = 0.042). These findings have implications for the decision making of clinicians and health policymakers attempting to provide adequate services for patients with AMI.

THE MEANING OF PEROXIDATION AND ANTIOXIDANT SYSTEMS IN THE PATHOGENESIS OF BRONCHIAL OBSTRUCTION

The pathogenesis of several diseases of respiratory system, in particular recurrent obstructive bronchitis and bronchial asthma are founded on syndrome of bronchial obstruction. The study of the pathogenesis aspects of these diseases is essential to improve the efficiency of treatment and rehabilitation of patients. Patients with bronchial obstruction syndrome have imbalance between reactions of lipid peroxidation and antioxidant system with a significant damage to biological membranes at the cellular and subcellular level. Metabolic response in these patients have lower compensatory capacity, that leads to development of more severe forms of the disease. The analysis of the data obtained showed that prior to initiating therapy in children with recurrent obstructive syndrome was a decrease in antioxidant protection indicators (ceruloplasmin content and catalase activity in blood serum) and an increase in indicators of intoxication (malondialdehyde content in the blood serum). After the use of polyoxidonium in a complex therapy the patients showed a reliable increase in the content of ceruloplasmin and catalaza activity in the blood serum and decrease in the content of malondialdehyde in the blood serum. It was found that before treatment patients had an increase in the index of intoxication (nitric oxide), after the use of polyoxidonium in a complex therapy they had a significant reduction of nitric oxide in the blood serum.

Analysis of structure of lumbar spine dorsopathy morbidity in able-bodied age patients.

The analysis of structure of lumbar spine dorsopathy morbidity among able-bodied population of the Dnepropetrovsk area for substantiation of differentiated approach to the choice of exercise therapy methods was a research objective. The structure of dorsopathy morbidity in 371 patients in 2009-2013 period is analysed in the work. The paper presents analysis of the most frequent morphological changes in the structures of the spine, their localization and clinical course. Link of clinical manifestations of dorsopathy with structural changes of the backbone, the disease experience is revealed, efficiency of rehabilitation by means of physiotherapy exercises depending on qualitative and quantitative signs of disease is defined. Results of the research specify that more than 40% of patients were on repeated treatment, clinical manifestation in 62% of patients was observed at the most able-bodied age (from 30 to 50 years), according to the disease experience number of aggravations per a year increased, in 57,5% of cases administration of medical physical culture was limited due to development of an accompanying pathology, in 40% of cases against positive dynamics of painful syndrome insufficient changes in volume of movements of the spine segments throughout treatment were marked. It testifies to necessity of working out algorithm of differentiated approach to the choice of means medical physical culture in treatment of lumbar spine dorsopathy.

Dizziness handicap inventory - em um grupo de pacientes submetidos a reabilitação vestibular personalizada

OBJETIVO: investigar o impacto da Reabilitação Vestibular personalizada e comparar os aspectos físicos, emocionais e funcionais pré e pós a aplicação do Dizziness Handicap Inventory. MÉTODOS: participaram 10 pacientes, com sintomas decorrentes de distúrbios do sistema vestibular e hipótese diagnóstica de disfunção vestibular crônica. Estes foram avaliados quanto aos aspectos físicos, emocionais e funcionais por meio do Dizziness Handicap Inventory pré e pós reabilitação vestibular personalizada. RESULTADOS: no Dizziness Handicap Inventory pré foi verificado que o aspecto físico foi o mais pontuado, seguido pelo emocional e funcional. A reabilitação vestibular foi eficaz, uma vez que houve diminuição nas queixas de qualidade de vida, e melhores resultados em todos os aspectos avaliados no Dizziness Handicap Inventory pós, apenas um paciente obteve melhora somente dos aspectos emocionais e funcionais, além de piora dos aspectos físicos. CONCLUSÃO: o Dizziness Handicap Inventory brasileiro aplicado pré e pós reabilitação vestibular personalizada mostrou-se como um teste eficaz para acompanhar pacientes submetidos a reabilitação vestibular, capaz de mostrar a melhora significante nos sintomas da vertigem crônica, além do impacto negativo na qualidade de vida dos pacientes deste estudo.

The Effect of Anemia on the Functional Outcomes of the Stroke Patients and the Efficiency of their Stroke Rehabilitation

There has been limited study focusing on the functional outcomes of stroke patients' after rehabilitation, such as functional improvement and discharge destination, length of stay (LOS), and complication rate. A retrospective study was conducted on 123 consecutive patients who were admitted to The Prince Charles Hospital Rehabilitation Unit from January 2011 to December 2012 with clinically defined stroke syndromes. Functional Independence Measure (FIM) score was used to measure the functional improvement. Anemia is defined by using the World Health Organization's criteria (hemoglobin concentration in men <120mg/dL and in women <110mg/dL). During the 2-year period, of the 123 stroke patients, 33 were found to be anemic (26.8%). The demographic factors, baseline admission FIM score, comorbidities, and the types of stroke were all comparable in both anemic and nonanemic groups. It was found that, when selecting only the patients with ischemic stroke for comparison (103 patients), there was a significantly higher FIM score improvement (discharge FIM-admission FIM) in nonanemic group (P=.042). FIM efficiency (FIM change/LOS) was also significantly higher in the nonanemic group (P=.027). Higher percentage of patients were discharged home in nonanemic group (94.3% versus 73.3%, P=.006). In addition, higher rateof complications was found in anemic group (60% versus 39%, P=.049). Anemia appears to have a significant effect on the functional improvement and discharge outcomes for patients who had an ischemic stroke. Anemia mayalso increase the complication rate and affect the efficiency of stroke rehabilitation for those patients.

The improvement of work efficiency in acute rehabilitation from a work volume survey

The improvement of work efficiency in acute rehabilitation from a work volume survey

Efficiency and safety of pulmonary rehabilitation in acute exacerbation of chronic obstructive pulmonary disease.

BackgroundPulmonary rehabilitation (PR) is able to improve dyspnea, endurance capacity, and health-related quality of life in chronic obstructive pulmonary disease (COPD) patients, but it is rarely used in China. This study aimed to assess the effectiveness and safety of PR after exacerbation of COPD.Material/MethodsPatients admitted to hospital due to an exacerbation of COPD were randomized to receive either PR or routine care (control group). The PR program was performed from the second day of admission until discharge. The pre-post changes in 6-minute walk distance (6MWD), self-reported quality of life (QOL) assessed by CAT score and CRQ-SAS score, and activity of daily life assessed by ADL-D score were determined. The perceived end-effort dyspnea (Borg scale) was measured throughout the study.ResultsA total of 101 patients were enrolled, of whom 7 withdrew after randomization, and 94 completed this study. There were 66 patients in the PR group and 28 in the control group. The 6MWD, resting SpO2, and exercise Borg dyspnea score were significantly improved in the PR group. In addition, the PR group had greater improvement in the total CRQ-SAS score and had a lower CAT score. Significant improvements were also found in the ADL-D and BODE index in the PR group. No adverse events were recorded during exercise.ConclusionsOur study provides evidence that it is safe and feasible to apply an early PR in patients with acute exacerbation of COPD.

Possibilities of using naftidrofuryl in the therapy of cerebrovascular diseases: Literature review and the authors’ observations

The efficacy of naftidrofuryl in treating cerebrovascular diseases is analyzed on the basis of a review of the Russian and foreign literature. Naftidrofuryl is a seroton 5-HT2 receptor antagonist and acts on brain energy metabolism mainly during hypoxia or ischemia. The results of preclinical studies proving the antispasmodic and neuroprotective properties of the drug and its capacity to normalize microcirculation in hypoxia are briefly considered. Experimental findings served as a basis for further studies of the efficacy of naftidrofuryl in patients with stroke, chronic cerebral ischemia, or vascular dementia. The use of naftidrofuryl (dusopharm) was demonstrated to statistically significantly enhance the efficiency of rehabilitation in post-stroke patients and to be followed by significant psychoemotional improvement. According to a Cochrane review, the naftidrofuryl-treated patients with vascular dementia showed a tendency towards better executive and cognitive functions, behavior, and mood. The drug was noted to have a positive effect on the health of patients with chronic cerebral ischemia. The authors provide the data of their trial of naftidrofuryl used in patients with dyscirculatory encephalopathy, which have confirmed its efficacy in this category of patients. The data available in the literature suggest that oral naftidrofuryl has a good tolerability and safety profile in patients with cerebrovascular diseases.

Hearing and music in unilateral spatial neglect neuro-rehabilitation.

Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients’ neuro-rehabilitation.

Spatial cognitive rehabilitation and motor recovery after stroke.

Stroke rehabilitation needs to take major steps forward to reduce functional disability for survivors. In this article, we suggest that spatial retraining might greatly increase the efficiency and efficacy of motor rehabilitation, directly addressing the burden and cost of paralysis after stroke. Combining motor and cognitive treatment may be practical, as well as addressing the needs after moderate-to-severe stroke. Spatial neglect could suppress motor recovery and reduce motor learning, even when patients receive appropriate rehabilitation to build strength, dexterity, and endurance. Spatial neglect rehabilitation acts to promote motor as well as visual-perceptual recovery. These findings, and the previous underemphasized studies, make a strong case for combining spatial neglect treatment with traditional exercise training. Spatial neglect therapies might also provide motor stimulation if people cannot participate in intensive movement therapies because of limited strength and endurance after stroke. Spatial retraining, currently used selectively after right-brain stroke, may be broadly useful after stroke to promote rapid motor recovery.

Functional outcomes and efficiency of rehabilitation in a national cohort of patients with Guillain-Barré syndrome and other inflammatory polyneuropathies.

ObjectivesTo describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies.Subjects and Setting186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8.1%) or critical illness neuropathy (n = 32 (17.2%)).MethodsCohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: ‘low’ (NPDS<10), ‘medium’ (NPDS 10–24) and ‘high’ (NPDS ≥25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community.ResultsThe mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat.ConclusionsPatients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients.

Патоморфоз возбудителей перфоративного перитонита у детей и возрастные особенности этиопатогенеза заболевания

Diffuse purulent perforating peritonitis was diagnosed in 41 children aged from 6 hours to 14 years old, including up to 1 year - 15 children (36,5%), 1-4 years old - 1 child, 4-7 years old in 8 children (19%%), 7-14 years old inl8 children (45%). Bowel perforations were caused by complications of diseases and malformations and acute purulent processes in the abdominal cavity. Perforating peritonitis has polymorphism of pyogenic flora, where the most dangerous are the following: Pseudomonas aeraginosae, fungi Candida (albicans, crasei, glabrata, tropicalis), Klebsiella pneumoniae, Enterococcus faecium, Enterobacter cloacae; E.Coli, Staphylococcus pyogenes, Staphylococcus aureus rarely revealed in the children after 4 years of age.&#x0D; &#x0D; The paper focuses on ineffective traditional treatment of children with diffuse perforating peritonitis due to insufficient knowledge of the pathogenesis of the disease and low efficiency of remedial measures. The authors&amp;#180; developments aimed at improving efficiency of the local rehabilitation of purulent perforating peritonitis continue to be implemented in practice. However, the methods of differentiated treatment of patients with purulent perforating peritonitis are missing in clinical practice.&#x0D; &#x0D; The use of new medical technologies in complex diagnostics and the modern antifungal and highly effective antibacterial drags in treatment of patients contributed to improve treatment outcomes and prevent mortality.

Optimal duration of therapy in the recovery period of vestibular diseases

Dizziness is a common symptom in neurological and general medical practice. In most cases it is caused by diseases of the central or peripheral vestibular system. The most common vestibular system diseases include benign paroxysmal postural vertigo, dizziness, Meniere's disease, vestibular neuronitis, and cerebrovascular diseases. One of the main treatments for the diseases accompanied by dizziness is vestibular rehabilitation that is a complex of exercises, the goal of which is to stimulate vestibular compensation. Adequate vestibular compensation allows a patient to get rid of dizziness and unsteadiness even though vestibular system injury is irreversible. Some medications are able to enhance the efficiency of vestibular rehabilitation. At the same time, the optimal duration of treatment for the most common vestibular disorders has not been adequately explored. The paper gives the results of an observational program, whose purpose was to determine the optimal duration of vestibular rehabilitation in combination with the use of tanakan in patients with non-progressive unilateral peripheral vestibular disorder. Patients and methods. Data on 46 patients aged 19 to 70 years who underwent vestibular rehabilitation and took tanakan for vertigo caused by vestibular neuronitis (n = 44), labyrinthitis (n =1), or Ramsay Hunt syndrome (n = 1) were analyzed. All the patients were examined four times. The symptoms were recorded and the histories of disease were considered. The degree of vestibular disorders, including vertigo, was assessed when collecting complaints. The symptoms of vertigo were objectivized using its vertigo rating scale and five-point subjective rating scale for vertigo. All the patients underwent standard somatic and neurological examinations and videonystagmography. During the first visit after diagnosis, vestibular exercises were chosen for the patients and tanakan was used in a dose of 40 mg thrice daily to accelerate vestibular compensation. During visits 2, 3, and 4, the symptoms of the disease were recorded in the patients and the time course of treatment-induced changes in their status was estimated. Results. The optimal duration of treatment was established to be at least 2 months. Vestibular exercises in combination with the intake of tanakan resulted in a reduction in the symptoms of vestibular dysfunction and in emotional improvement in the patients.

Applied-Information Technology in Design of Diabetic Rehabilitation Management System Based on the Technology of Mobile Internet

Today, since diabetes has become one of the killers that threat human health, the full use of advanced mobile Internet technology to achieve the real-time information exchanged between medical institutions, doctors and patients, improve the efficiency of rehabilitation is a priority task for the research workers. In view of this, the project focuses on analyzing the functional requirement of each link in the whole process which includes medical institutions, doctors, diabetes disease prevention, treatment, rehabilitation and management and so on. Based on the mobile Internet, we do some systematic design for diabetes rehabilitation, treatment and management and carry on the detailed design and program implementation code for mobile client reception, Web site, data acquisition and transmission, user rights management, and background database. The system can realize the functions of disease data collection, transmission, analysis, feedback, user privilege management, rights query and management, and some other features. This topic provides different platforms and services for different users and business requirements.

Прогнозирование эффективности экзистенциально-личностной реабилитации у больных с манифестным приступом шизофрении

Прогнозирование эффективности экзистенциально-личностной реабилитации у больных с манифестным приступом шизофрении

AB1124 The Importance of the Early Rehabilitation after Total Knee Replacement in Osteoarthritis and Rheumatoid Arthritis Patients

BackgroundTotal knee replacement (TKR) revolutionized management of patients with advanced knee osteoarthritis and rheumatoid arthritis, in order to help them overcome pain and functional limitation, with very good long-term results.ObjectivesOur...