Rehabilitation Experience Research Articles

Coronaviral Infection (COVID-19) in Children (Situation on June 2020)

Dear friends, colleagues! The number of cases of new coronaviral infection has begun to decrease over the past two months, whereas, the number of publications on the accumulated experience of diagnosis, management and rehabilitation is increasing. It allows us to share knowledge and enhance our tactics. We present updated data on SARS-CoV-19 coronavirus and the disease it causes in this review.

Developing a hand sizing system for a hand exoskeleton device based on the Kansei Engineering method

This study aimed to identify the customers’ requirements for a hand rehabilitation exoskeleton device using the Kansei Engineering approach and propose improvements. The Kansei Engineering approach was used to extract the design attributes for a hand rehabilitation exoskeleton device by conducting an in-depth interview with 3 physical therapists. The Kano questionnaire survey investigated 25 participants with hand rehabilitation experience. The Kano classification results found three attractive factors and corresponded it to the design attributes of the evaluation grid method results that were suitable (size), flexible (controllability), and light (weight). The principal component analysis results indicated three components can be considered as the improvement categories; functions, structure-texture, and appearance of the hand exoskeleton device. The new functional and structural designs were proposed in a previous study. This study collects 110 male participants’ hand anthropometric data to establish a hand sizing system as a design improvement (suitable attribute). The 3D and manual measurements were obtained for 63 hand dimensions with an open palm posture. The 14 dorsal length dimensions with three bent finger postures were also manually measured. The results showed that the $${\text{MAD}}_{\text{Precision}}$$ (mean absolute difference) of 3D measurement is smaller than that of manual measurement, indicating better reproducibility of 3D scanning. The $${\text{MAD}}_{\text{Accuracy}}$$ of all dimensions are within the 1 mm of the referenced ISO 20685 criteria. Significant differences were found in the 14 dorsal hand length, showing that databases should explicitly state the aspect (dorsal or palmar) where dimensions have been of measurement. The 77 hand dimensions were taken into consideration to develop a hand sizing system using the clustering results. The two-level self-organizing map method was performed and 3 handshape types and 8 sizes were extracted. The coverage rate of the sizing system was over 85%. These results provide useful information for designing and manufacturing for hand-related products.

Experiences and responses of nursing students as second victims of patient safety incidents in a clinical setting: A mixed‐methods study

To investigate the degree of second victim syndrome among nursing students in clinical practice and determine the rehabilitation process. Empirical evidence suggests that health care providers who are considered second victims suffer from various difficulties. Nursing students in a clinical setting could be potential second victims, but few studies have quantitatively investigated the experiences and explored their response processes. A mixed-methods design was used. A questionnaire was sent to nursing students via a link to an electronic survey, and a semi-structured interview was conducted to explore their response process as second victims. The quantitative results showed that nursing students in the clinical setting suffered second victim-related distress and that the most significant influences were psychological distress and professional efficacy. Four stages of rehabilitation experiences emerged from the qualitative data. Being a second victim for nursing students in a clinical setting is psychological suffering, and although they can be expected to recover, an impact on professional efficacy is inevitable. Nursing managers must be aware that nursing students in a clinical setting might experience difficult situations after patient safety incidents and that developing appropriate programmes to support at-risk students is important.

Measuring shared decision-making and collaborative goal setting in community rehabilitation: a focused ethnography using cross-sectional surveys in Canada

ObjectiveTo describe and measure the shared decision-making (SDM) experience, including goal-setting experiences, from the perspective of patients and providers in diverse community-rehabilitation settings.DesignProspective, longitudinal surveys.Setting13 primary level-of-care community-rehabilitation sites in...

Patient Experiences of Rehabilitation and the Potential for an mHealth System with Biofeedback After Breast Cancer Surgery: Qualitative Study.

BackgroundPhysiotherapy-led home rehabilitation after breast cancer surgery can protect against the development of upper limb dysfunction and other disabling consequences of surgery. A variety of barriers can limit physical rehabilitation outcomes, and patients may benefit from more support during this time. Mobile health (mHealth) systems can assist patients during rehabilitation by providing exercise support, biofeedback, and information. Before designing mHealth systems for a specific population, developers must first engage with users to understand their experiences and needs.ObjectiveThe aims of this study were to explore patients’ rehabilitation experiences and unmet needs during home rehabilitation after breast cancer surgery and to understand their experiences of mHealth technology and the requirements they desire from an mHealth system.MethodsThis was the first stage of a user-centered design process for an mHealth system. We interviewed 10 breast cancer survivors under the two main topics of “Rehabilitation” and “Technology” and performed a thematic analysis on the interview data.ResultsDiscussions regarding rehabilitation focused on the acute and long-term consequences of surgery; unmet needs and lack of support; self-driven rehabilitation; and visions for high-quality rehabilitation. Regarding technology, participants reported a lack of mHealth options for this clinical context and using non-cancer–specific applications and wearables. Participants requested an mHealth tool from a reliable source that provides exercise support.ConclusionsThere are unmet needs surrounding access to physiotherapy, information, and support during home rehabilitation after breast cancer surgery that could be addressed with an mHealth system. Breast cancer survivors are open to using an mHealth system and require that it comes from a reliable source and focuses on supporting exercise performance.

Access to Care for Persons With Brain Injury: Ethical Frameworks to Promote Health Systems Change.

The challenges of providing optimal healthcare for individuals with brain injuries are heightened by the unique complexity of the injury itself. Survivors with long-term needs often encounter precarious situations where they struggle to receive services in health systems focused on cost containment driven by medical necessity and managed care. This article draws inductively from the rehabilitation experiences of 2 survivors to highlight neuroethical considerations representing the person, the rehabilitation system, and the medical model. Drawing upon our experience studying the provision of care in the Commonwealth of Virginia, we seek to explicate the challenge of providing longitudinal services. Three diverse and intersecting ethical considerations are applied: (1) teleological implications within rehabilitation medicine; (2) a care ethics framework, nested in the scholarship of feminist and disability ethics; and (3) the literature on pragmatism and dehumanization. This article uses these frameworks to explore the challenge posed by current healthcare practices and the needs of individuals with chronic brain injury.

Surviving the “silent epidemic”: A qualitative exploration of the long-term journey after traumatic brain injury

ABSTRACT Previous studies examining life after traumatic brain injury (TBI) have taken a predominantly short-term and quantitative perspective, with generally narrow focus, and have not specifically investigated changes in experience over time post-injury to gain a uniquely long-term perspective. This study therefore aimed to qualitatively explore the broad long-term experience of living for 10 years or more with TBI. Thirty participants completed semi-structured interviews investigating the impact of TBI on various life domains, the rehabilitation experience and support received, and overall perspectives of the long-term journey after TBI. Results demonstrated that: (a) although some participants reported full recovery, several experienced persistent physical, cognitive and emotional problems that impacted their independence, employment and interpersonal relationships; (b) early rehabilitation was very helpful, but some participants experienced difficulties accessing ongoing services; (c) family and social support were important to recovery; (d) most participants drew upon inner strength to find positives in their experience. These findings have identified factors that facilitate and impede long-term recovery from TBI, which may inform better support and care for injured individuals over the years after injury to improve their quality of life.

Understanding the Rehabilitation Experience of Obese Patients After Bariatric Surgery in China: a Qualitative Study

Understanding the Rehabilitation Experience of Obese Patients After Bariatric Surgery in China: a Qualitative Study

Опыт многоэтапной хирургической реабилитации пациентки с лучевым пузырно-влагалищно-прямокишечным свищом: клинический случай

Опыт многоэтапной хирургической реабилитации пациентки с лучевым пузырно-влагалищно-прямокишечным свищом: клинический случай

Participant expectations and experiences of a tailored physiotherapy intervention for people with Parkinson’s and a history of falls

Purpose People with Parkinson’s are twice as likely to fall as older people within the general population. This longitudinal qualitative study was part of a larger programme of research including a randomised controlled trial to test the effectiveness of a tailored physiotherapy intervention. Specific qualitative aims focused on a subsample of trial participants in the intervention arm of the trial, and comprised the following: To explore the expectations of participants about the intervention. To investigate participants’ experiences of the intervention, and its perceived impacts. To understand the facilitators and barriers to engagement. Methods Two semi-structured interviews were completed with a theoretical sample of people with Parkinson’s from the intervention arm, initially after randomisation but before the intervention commenced, and then again six months later. Results Forty-two participants out of a large clinical trial were interviewed initially, with 37 agreeing to a second interview at six months. Prior experience of rehabilitation plus information accessed through the trial consent procedure informed participants’ realistic expectations. Most found the level of the intervention acceptable, and perceived a range of benefits. However, views about equipment provided were more equivocal. The biggest barriers to participation were time and motivation, whilst social support facilitated engagement with the intervention. Conclusions This study is the first to capture expectations about participation in a programme of exercises and strategies. It highlights that previous challenges to engagement in physical exercises and activities are not a barrier to future participation and provides new insights into the role of equipment and technology in programmes of physical activity for people with Parkinson’s. The challenge of ensuring that programmes of exercise and strategies become an embedded feature of everyday life is highlighted, particularly alongside busy social engagements and leisure pursuits. Implications for rehabilitation For people with Parkinsons, a programme of exercises and strategies has the potential to reduce the risk of falls amongst those with a history of falling. Adherence to such programmes can prove challenging for a variety of reasons, even when participants have realistic expectations about the commitment and effort needed. Clear explanations about the role of equipment and technology within such programmes could enhance adherence. In order to further individualise programmes of exercise for people with Parkinsons, choice regarding social support, reminders and integration into everyday activities should be explored.

Experience of enriched rehabilitation in the chronic phase of stroke

Purpose In this study, we explored the experiences of patients who participated in an enriched task-specific therapy (ETT) program in the chronic phase after stroke. Method Focus group interviews were conducted with twenty participants with a mean time since stroke of 30 months and mean age 61 years, who completed the ETT program including task-specific training and environmental enrichment. ETT was delivered 3.5–6 h per day, 5½ days per week for 3 weeks in a climate suitable for both indoor and outdoor activities. The training consisted of repetitive mass practice of gradually increasing difficulty. Directly after the intervention, qualitative interviews were conducted in six focus groups. The interviews were analysed with qualitative content analysis. Results Three main categories describing the informants’ experiences of the ETT program were identified. These categories were; 1. The program—different and hard – highlighting the participants view of the ETT as strenuous and different in nature; 2. My body and mind learn to know better – describing positive changes in participants’ body function and functional ability as well as behavioural changes experienced throughout the ETT; and 3. The need and trust from others – emphasizing the perceived importance of trust in rehabilitation clinicians and the support of family and other participants. From these categories, a main theme emerged: It’s hard but possible—but not alone! Conclusion A therapy program including task-specific training and environmental enrichment may provide late-phase stroke survivors with perceived improvements in functional ability, knowledge insights, perceptions of rehabilitation needs and enriching emotional impacts. Implications for rehabilitation ETT is feasible and may lead to perceived improvements in function and a change of mindset, even in the chronic phase after stroke. Trust in the competence of the rehabilitation staff is an important factor in compliance with the high-intensity training in the ETT program. Given the lack of stimulation and socialization among many individuals with chronic stroke, the social and physical environment are important components of the ETT program.

Social integration as a significant factor in the rehabilitation of people with disabilities in a neuropsychiatric boarding school

The article describes the experience of social rehabilitation of persons with mental disorders and central nervous system living in a neuropsychiatric boarding school. It has been established that modern rehabilitation practices aimed at developing or restoring lost skills of patients is not a program limited to a specific time period, but a long continuous process that requires constant monitoring and corrective measures. But mental diseases in the vast majority require large expenditures from the state budget, therefore, the implementation of systematic individual resocialization measures becomes extremely difficult, and subsequent work with the mentally ill is reduced to meeting the basic life needs of the disabled, assigning them the role of recipients of guardianship and care. It is justified that social rehabilitation programs aimed at developing or restoring the necessary skills, as well as activating compensatory mechanisms, do not fully fulfill the socializing function without forming the individual and social value of the wards. The novelty of the study is to justify the prospect of including in the process of existing practice of social rehabilitation a component that can to some extent change the social status of patients in a neuropsychiatric boarding school and allow them to master new social roles – the integration of the mentally ill and society.

Perceived barriers to evidence-based practice in stroke management among physiotherapists in a developing country.

Like most healthcare disciplines, the physiotherapy profession has embraced the concept of evidence-based practice (EBP) worldwide. However, there is a discrepancy between the amount of research evidence that exists and its use in clinical decision making. To investigate the barriers physiotherapists in Nigeria encounter in implementing EBP in stroke management. This was a cross-sectional survey involving consecutively recruited 170 physiotherapists (mean age = 29.92 ± 5.72 years) from conveniently sampled centres in the six geopolitical zones in Nigeria. The Practitioner and Organizational Barriers to Evidence-based Stroke Rehabilitation Questionnaire was used to collect data on EBP among the physiotherapists. Data was summarized using frequency, percentage, mean, and SD and analysed using Spearman rank order, Kruskal-Wallis and Mann-Whitney U tests at alpha level of 0.05. Insufficient time (47.6%), lack of information resources (42.9%), lack of organizational mandate (42.9%), lack of research skills (30.6%), and poor ability to critically appraise literature (29.4%) were the mostly reported barriers. Most participants had received formal training about EBP, had positive attitude and beliefs about EBP, were highly confident in their abilities to implement EBP, were aware of their roles in EBP, and were interested in acquiring and improving the skills necessary to implement EBP. There was unavailability of resources and support to promote evidence-based practice. EBP uptake was significantly facilitated by having more education on EBP, higher academic degree, less daily workload, more years of experience in stroke rehabilitation, more participation time in research and teaching, and belonging to professional association (P < .05). Insufficient time, lack of organizational mandates, lack of research skills, poor ability to critically appraise literature and unavailability of resources and organizational support are key barriers to EBP among Nigerian physiotherapists. Nigerian physiotherapists, their regulatory board, and Government need to work in tandem to improve EBP among Nigerian physiotherapists.

Reassessing Conditions of “Prison” in Jamaica

Jamaican maximum-security correctional facilities are largely identified by their extremely poor, anachronistic, and inhuman conditions of custody. This overriding identity shelves the positive influence of reforms that have taken place or are currently underway. By drawing on interviews conducted with 55 inmates and nine correctional staff, secondary analyses, and the International Covenant on Civil and Political Rights (ICCPR, 1966), this article examines the degree to which recommendations from the “Improving Prison Conditions in the Caribbean” Conference have been implemented in the Jamaican context. The results suggest that since the Conference, noticeable steps have been taken by the Jamaican state to improve the quality of the rehabilitation experience against the backdrop of challenges of size and competing priorities. However, such improvements are not necessarily the direct result of the implementation of the Conference recommendations. Despite the improvements evidenced, it is argued that more meaningful reforms are required if more inmates are to be enabled to lead crime-free and productive lives upon release. This article provides contemporary insights into the improved conditions of imprisonment in Jamaica and makes recommendations on how serious offenders in the care of Jamaica’s correctional service can be better enabled to experience effective (not successful) reintegration.

Patient perception of rehabilitation in the community following hip fracture surgery. A systematic review of qualitative research

Purpose: Hip fracture is one of the most common injuries in older people and the main cause of reduced mobility in adults over the age of 65. Hip fracture can be a life changing experience. Many patients are ill-prepared for the changes in daily living that occur once discharged from hospital. To date there are no systematic reviews that synthesised qualitative data with regard to this. The aim of this review was to understand the views and experiences of patients after hip fracture surgery, of their physiotherapy rehabilitation in the community. This will enable improvements to hip fracture rehabilitation services following hospital discharge to be identified, to enhance the patient experience of community rehabilitation and improve future clinical practice for this population.

Final year physiotherapy studentś experiences of early mobilisation and rehabilitation for the critically ill patient

Final year physiotherapy studentś experiences of early mobilisation and rehabilitation for the critically ill patient

Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial.

The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach’s main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.

COVID-19 and disabled people: perspectives from Iran

This is a Current Issue because, at the time of writing, COVID-19 has affected many countries and territories worldwide and Iran ranked early on as one of the most seriously affected countries. As a result, this pandemic crisis poses a considerable challenge to people with disabilities in Iran. In this short article we show the different challenges people with disabilities are facing during the COVID emergency in Iran. In addition, we provide several recommendations, based on our perspective and experience in Rehabilitation and Health Policy Centres, to improve the situation in the content of the COVID-19 breakout.

COVID-19-A Guide to Rapid Implementation of Telehealth Services: A Playbook for the Pediatric Gastroenterologist.

COVID-19-A Guide to Rapid Implementation of Telehealth Services: A Playbook for the Pediatric Gastroenterologist.

Mobile rehabilitation service as an innovative technology in the activity of the center for patients with consciousness (on the example of FNKC RR)

In the last decade, considerable attention has been paid to the development of medical and social services including rehabilitation services, for citizens at home. Particularly noteworthy are patients with impaired consciousness, high-quality rehabilitation and social work with which at home has not been carried out before. According to the research materials, the creation of the Mobile Rehabilitation Service (MRS) in the Federal State Budgetary Institution Federal Scientific and Clinical Center for Reanimatology and Rehabilitation has allowed to accumulate and actively practice the unique innovative experience of mobile rehabilitation of clients with impaired consciousness. The data on the served contingent and the indicators of the effectiveness of the rehabilitation, convincingly confirming the need and high medical and social significance of the innovative technology the mobile rehabilitation service. The experience of MRS FNKC RR seems appropriate to scale and replicate in the framework of medical rehabilitation institutions in the country.