Involvement In Rehabilitation Research Articles

Evaluating the Effectiveness of Geriatric-Specific Cancer Rehabilitation Programs on Patient Health Outcomes.

This study evaluated a specialized rehabilitation program's impact on senior cancer patients' quality of life. one hundred and thirty patients aged ≥65 years with various cancer types undergoing/recovering from treatment were enrolled in oncology clinics in Al-Ahsa, Saudi Arabia. The intervention arm (n=65) participated in a tailored geriatric cancer rehabilitation program. The control group (n=65) received standard oncology care. The Functional Assessment of Cancer Therapy-General (FACT-G) tool assessed the quality of life across physical, social, emotional, and functional domains. T-tests and multivariate regression analyses compared outcomes. Total FACT-G scores showed a significantly higher quality of life for the geriatric cancer rehabilitation group versus standard care. Rehabilitation patients also demonstrated meaningful improvements across physical, social, and functional subscales. Rehabilitation involvement was the most predictive factor for optimized outcomes. Specialized geriatric cancer rehabilitation meaningfully improved several quality of life domains in older patients over standard care. Despite persistent barriers, rehabilitation programming optimized older cancer patients' physical and psychosocial health. Oncology and geriatrics must collaborate to ensure evidence-based rehabilitation access meets older cohorts' unique needs.

A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers—a co-creative journey

BackgroundThe World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.MethodsThe aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.ResultsThe analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.ConclusionsThe staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.

Community Involvement in the Rehabilitation and Treatment of Persons Deprived of Liberty (PDL): A Case Study of the Iriga District Jail, Philippine

This study focuses on evaluating community involvement in rehabilitating and caring for Persons Deprived of Liberty (PDL) at the Iriga District Jail in Camarines Sur's Fifth District, Philippines. The research employed a quantitative-methods of survey questionnaire, utilizing purposive and random sampling techniques to select participants of total 100 however 89 respondents replied considered and data were analyzed using descriptive statistics. The findings revealed that community involvement activities were partially implemented, encompassing work and livelihood programs, moral and spiritual programs, education and training programs, sports and recreation programs, behavior modification programs, and health and welfare programs. Challenges identified included limited funds, inadequate physical facilities, limited government and community support, insufficient staff training, and organizational issues. To strengthen community involvement in prisoner rehabilitation, this study recommends psychological evaluations, job placement or referral, community service programs, client self-help organizations, environmental awareness programs, volunteer probation aides, and involving the client's family in the rehabilitation process. These findings offer insights into the current state of community involvement in prisoner rehabilitation and propose measures for improvement in Camarines Sur's Fifth District.

Parental Perception of Self- Efficacy for the Rehabilitation of Children with Cochlear Implantation.

Present study aimed to develop a questionnaire related to the self-efficacy for the rehabilitation of children using Cochlear Implantation (CI) and to administer the questionnaire on parents of children with cochlear implantation. 100 parents of children with Cochlear Implantation between the years 2010- 2020 were selected randomly to be participants for the present study.A questionnaire on Self- Efficacy was developed. Questionnaire consists of 17 questions related to self-efficacy of therapy and Goal related Strategies, Listening, language and Speech Development and also Parental Involvement in rehabilitation, family and emotional support, device maintenance and follow up, At school engagement. Responses were recorded on three-point rating scale as (2= Yes, 1=sometimes,No=1). In addition, there were 3 open ended questions. This questionnaire was administered on 100 parents of children with CI. Total scores under each domain were calculated. Responses of open-ended question were listed. It was found that majority (more than 90%) of parents were aware of the therapy goals given to their children and also able to join the therapy session. Most (more than 90%)of the parents reported an improvement in the child's auditory skills post rehabilitation. 80% of parents were able to bring their children for therapy consistently, other parents felt the distance and financial affordability was a main barrier to bring the child consistently for therapy. 27 parents have reported a regression in the child due to the Covid lockdown. Though most of the parents reported to be satisfied with their child's progress post rehabilitation, other concerns such as inability to spend adequate time and inability for the children to learn via tele-mode were highlighted. These concerns should be carefully considered while providing rehabilitation for the child with CI.

Supporting older patients in working on rehabilitation goals: Ascoping review of nursing interventions.

Nurses are consistently present throughout the rehabilitation of older patients but are apprehensive about performing goal-centred care in the multidisciplinary team. The aim of this review was to explore working interventions on setting goals and working with goals designed for nurses in geriatric rehabilitation, and to describe their distinctive features. We performed a scoping review. We searched MEDLINE and CINAHL through August 4, 2021. Search terms related to the following themes: nurses, rehabilitation, geriatric, goal and method. We used snowballing to find additional. From the selected studies, we systematically extracted data on means, materials and the nursing role and summarized them in a narrative synthesis, using intervention component analysis. The study includes 13 articles, describing 11 interventions which were developed for six different aims: improving multidisciplinary team care; increasing patient centredness; improving disease management by patients; improving the psychological, and emotional rehabilitation; increasing the nursing involvement in rehabilitation; or helping patients to achieve goals. The interventions appeal to four aspects of the nursing profession: assessing self-care skills incorporating patient's preferences; setting goals with patients, taking into account personal needs and what is medically advisable; linking the needs of the patient with multidisciplinary professional treatment and vice versa; and thus, playing an intermediate role and supporting goal achievement. The interventions show that in goal-centred care, the nurse might play an important unifying role between patients and the multidisciplinary team. With the support of nurses, the patient may become more aware of the rehabilitation process and transfer of ownership of treatment goals from the multidisciplinary team to the patient might be achieved. Not many interventions were found meant to support the nursing role. This may indicate a blind spot in the rehabilitation community to the additional value of its contribution.

Predictors of worsening condition before discharge in patients of the gerontopsychiatric hospital.

Introduction. Hospitalization of an elderly patient in some cases may be associated with such negative phenomena as social and psychological maladjustment, a decrease in the level of daily functioning, the formation of dependence on a hospital and hospitalism. Often in clinical practice there are patients whose condition suddenly worsens just before discharge from the hospital.
 The aim of this study was to analyze the dynamics of the patient's condition in the period preceding the planned discharge from the hospital, to identify various clinical options for worsening the condition, and to search for possible predictors of this adverse event.
 Materials and methods. Were examined 181 patients of the department of geriatric psychiatry NMIC PN. V.M. Bekhterev included by the continuous method in accordance with the criteria. The main research methods were clinical-psychopathological and clinical-anamnestic.
 Results. Deterioration of condition before discharge was observed in 44.8% of the examined patients and was represented by an exacerbation of the leading mental disorder syndrome, the appearance of new symptoms, somatic decompensation, or a combination of these phenomena. Patients whose condition worsened were characterized by longer hospital stays, more medications prescribed, a higher prevalence of hospitalism and compliance violations. Somatic decompensation developed in patients with a shorter duration of mental illness and was associated with a hidden refusal to take medications, for patients with an exacerbation of symptoms of a mental disorder, irregular drug intake and abuse were more typical.
 Conclusion. Elderly patients with a long history of hospitalizations and inpatient care options have an increased risk of deterioration before discharge from the hospital, as a result of which these patients need the earliest possible involvement in rehabilitation and psychotherapeutic measures and rational psychological support at the stage of preparation for discharge.

Family-centred service in paediatric acquired brain injury rehabilitation: perspectives of children and adolescents and their families

Purpose Family-centred service is considered best practice in paediatric acquired brain injury (ABI) rehabilitation. However, there is no universal model to guide clinicians and services in implementing this approach with a lack of research evidence informed by the lived experience of families. This study explored experiences of family-centred service during rehabilitation from the perspectives of parents/caregivers, siblings, and children/adolescents with ABI. Materials and methods Semi-structured interviews were conducted with participants from eight families, and included 10 parents/caregivers, five siblings, and four children/adolescents with moderate to severe ABI. Interview transcripts and additional data were analysed using constructivist grounded theory methods. Results Two themes and five sub-themes were developed: (1) Working together as a team: Valuing clinicians’ expert knowledge; Doing rehabilitation together; and Sharing family knowledge; and (2) Navigating rehabilitation as a family: Recognising family needs; Juggling family life; and Making rehabilitation work for the family. Participants reflected on the centrality of the child/adolescent with ABI during rehabilitation, and the ways that family needs, life, and involvement in rehabilitation change over time. Conclusions These findings highlight the importance of clinicians actively seeking to understand families’ unique contexts, needs, and priorities during rehabilitation through two-way information sharing with families. Through developing a greater understanding of families’ unique contexts, clinicians can be better placed to tailor rehabilitation according to their unique circumstances and needs. Implications for rehabilitation Rehabilitation involves active collaboration between families and clinicians that is responsive to changing needs over time. Family involvement in rehabilitation is shaped by family life, and families have unique needs following paediatric acquired brain injury. It is important that clinicians strive to develop an understanding of families’ unique needs, values, preferences, and lives to determine how to best support and involve them in rehabilitation.

Virtual visiting in intensive care during the COVID-19 pandemic: a qualitative descriptive study with ICU clinicians and non-ICU family team liaison members

ObjectiveTo understand the experiences and perceived benefits of virtual visiting from the perspectives of intensive care unit (ICU)-experienced clinicians and non-ICU-experienced family liaison team members.DesignQualitative descriptive study.SettingAdult intensive care setting...

Understanding the rehabilitation psychology specialty career pathway.

Little is known about how psychologists choose their specialty practice area, and rehabilitation psychology is no exception. Specialization and specialty certification in professional psychology have been controversial topics impacting the field during the training sequence and across the span of professional careers (Drum & Blom, 2001; Robiner & Fossum, 2017). The American Board of Rehabilitation Psychology (ABRP) has been providing specialty certification since 1995 and rehabilitation psychology was recognized as a unique specialty in 2015 by the APA's Council for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). There are limited established training programs and minimal information about the specialty in undergraduate course materials. The current survey is intended to provide information about how people are introduced to the field of rehabilitation psychology, specialty identification, and to identify opportunities for improvement. A survey of members of APA Division 22 and ABRP specialists was conducted to collect information about their exposure to and involvement in rehabilitation psychology. Results from 174 respondents suggest that personal relationships are the current key means of recruitment and confirms that rehabilitation psychology has limited presence in undergraduate training. Most professionals come to identify with rehabilitation psychology after training in clinical neuropsychology and health psychology. These preliminary results suggest that the current generalist training sequence does not provide sufficient exposure to, or preparation for the field of rehabilitation psychology. Recruitment opportunities should emphasize student leadership network activities and the identification of early and midcareer practitioners unaware of the rehabilitation specialty. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A systematic review of the qualitative literature on older individuals' experiences of care and well-being during physical rehabilitation for acquired brain injury.

AimsTo acquire an in‐depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well‐being and care when undergoing physical rehabilitation.DesignSystematic literature review.Data sourcesThe electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted.Review methodsA systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool.ResultsSeventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well‐being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well‐being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation.ConclusionOrganizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision‐making and goal‐setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well‐being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI.ImpactThere is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients’ concerns over their involvement in decision‐making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’ sense of well‐being.

Family composition and living arrangements-Cross-sectional study on family involvement to self-managed rehabilitation of people with coronary artery disease.

AimTo describe the family composition and living arrangements of persons diagnosed with coronary artery disease and those relationships to family involvement in self‐managed rehabilitation.DesignA cross‐sectional study.MethodsData were collected with postal questionnaire from persons diagnosed with coronary artery disease (CAD) by using the Family Involvement in Rehabilitation (FIRE) scale. It measures family members' promotion of patients' rehabilitation and issues encumbering rehabilitation in family. Statistical methods were used to analyse the data.ResultsPatients' gender and having children in the family were predictors of issues encumbering rehabilitation in the family. But when examining living arrangements, patients who lived with a spouse or underage children had a better environment for recovery than those who lived alone or with adult children. More attention should be paid to targeting appropriate support for persons with coronary artery disease and their family members during the rehabilitation phase.

Recursos públicos e a reabilitação da criança com implante coclear

Objetivo: Verificar a existência de recursos de apoio à reabilitação nas regiões de procedência dos pacientes em acompanhamento na Seção de Implante Coclear (IC) do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo, e se estes estavam contribuindo com o processo de reabilitação e com a efetivação das políticas públicas. Método: O estudo envolveu análise documental de 87 prontuários de crianças usuárias de IC, com idade entre 1 a 12 anos incompletos. A caracterização dos sujeitos considerou o perfil socioeconômico e os recursos públicos disponibilizados. Resultados: A Faixa etária predominante foi de 42,5% entre 7 a 12 anos incompletos; 67% procedentes da região sudeste e 69% pertenciam à classe social Baixa Superior. A participação dos responsáveis na reabilitação foi dada como boa, 71,2% dos casos. Quanto aos recursos públicos disponíveis notou-se que: apenas 12,6% tinham o acesso a benefícios assistenciais; a maioria estava inserida na rede pública de ensino; utilizando do Tratamento Fora do Domicílio de forma parcial para o acompanhamento no serviço e 58,7% realizavam terapias fonoaudiológicas via Sistema Único de Saúde. Conclusão: constatou-se a existência e acesso aos recursos públicos, no entanto sem contemplar qualitativamente as exigências da reabilitação para as crianças usuárias de IC.

Physical therapy intervention to improve Gait post stroke

Stroke therapy has progressed through both conventional and novel methods, with a special emphasis on gait restoration. After a stroke, gait abnormalities are prevalent and can negatively affect mobility and quality of life. Though they are still useful, traditional physical therapy techniques like task-specific gait training are frequently constrained by patient-specific issues and resource availability. New technologies that improve the intensity, accuracy, and involvement of rehabilitation, such as neuromodulation, virtual reality, and robotics, present interesting options. However, there are obstacles to the clinical practice integration of these advanced medicines, including cost, accessibility, and the requirement for additional validation through long-term studies. It has been demonstrated that individualised therapy, catered to each patient's deficits and objectives, improves adherence and results. Additionally, the utilisation of interactive and wearable technology supports patient motivation and involvement. Barriers including uneven progress measurement, inconsistent treatment outcomes, and unequal access to healthcare continue to exist despite these developments. Research to improve these treatments, comprehend the neuroplastic principles underpinning recovery, and address psychosocial aspects influencing rehabilitation success is becoming more and more necessary. The usage of cutting-edge technology will be improved, cost-effectiveness will be increased, and fair access to efficient treatments will be guaranteed. All things considered, increasing recovery and the quality of life for stroke survivors requires a multimodal, patient-centered approach to stroke rehabilitation that incorporates both established and cutting-edge therapies.

Nursing practice in stroke rehabilitation: Perspectives from multi-disciplinary healthcare professionals.

In this qualitative, descriptive study, we explored the status of and factors related to nursing practice for stroke rehabilitation in China, considering the perspectives of multi-disciplinary healthcare professionals. Fifteen participants were interviewed in depth, followed by field observations at three healthcare institutions. Data were analyzed using ethnographic data analysis methods. Current nursing practice for patients with stroke emerged as a cultural domain that included nine patterns: coordination of nursing, basic nursing following nursing procedures, limited rehabilitation nursing care with varied functions, therapeutic function in rehabilitation care, the importance of nurses' involvement in rehabilitation, environments making rehabilitation nursing possible, inadequate staffing for the numerous clinical nursing practices, lack of effective communication with other healthcare professionals, and lack of policies regarding rehabilitation nursing practice. Nurses' role in stroke rehabilitation must be addressed by updating nursing practice. Further, stroke team leaders must recognize the constraints faced by nurses in fulfilling their stroke-rehabilitation roles.

Family role in in-patient rehabilitation: the cases of England and Turkey

Purpose This article explores the differences between experiences of family role in in-patient rehabilitation in Turkey and England. Background The literature predominantly assumes family presence in rehabilitation as positive, because it draws upon Western cases, where care is delivered fully by professionals, and patients may feel isolated during hospital stays. Analyses of other contexts provide a more nuanced view. Method This qualitative research included in-depth interviews (Turkey: 42, England: 18) with people with disabilities (n = 39), their families (n = 8) and hospital staff (n = 13); hospital ethnography (Turkey), focus groups (England: 3 groups involving 4 doctors, 5 nurses, 6 therapists), and participant-observation (England: 5 families). Thematic analysis highlights experiences of family involvement across different contexts. Results Families are differently integrated in rehabilitation in England and Turkey. In England, where family presence is regulated and relatively limited, people with disabilities feel more isolated and see family as a major form of support. In Turkey, where family presence is unregulated and intense, they enjoy family as an agent of intra-hospital socialising, but find it disabling when it implies a loss of privacy and individuality. Conclusion Family involvement in rehabilitation should support social interaction but allow people with disabilities to remain independent. Implications for rehabilitation Family involvement in rehabilitation can be both enabling and disabling. Existing literature draws upon rehabilitation practices, where family presence is limited and perceived as positive. An analysis of cases, where families are integral to the health care system (e.g., Turkey), can provide a nuanced view of family integration, which can be both enabling and disabling. Rehabilitation processes and health professionals need to integrate families in ways that will enrich social interaction, but still allow people with disabilities to retain their independence.

Praćenje oporavka tokom rehabilitacije senzomotorne afazije - studija slučaja

Introduction: Rehabilitation of aphasia depends on the localization, severity and extent of brain damage, length and intensity of rehabilitation, patient age, motivation, family support and environment, material conditions and other factors. Aim: Aim of the paper was to determine the outcomes of speech-language rehabilitation of patient N.N. with sensory aphasia resulting from brain injury caused by a fall down the stairs. The methodology was based on follow up of theoutcomes of speech rehabilitation for more than four months. We used the Boston Aphasia Diagnostic Test (BDAE). Case reaport: During patient's rehabilitation, we relied mainly on partially preserved reading ability, which is not specific to this type of aphasia. The first assessment of speech and language skills is not fully credible due to the poor general condition of the patient, the blurring of consciousness and other circumstances that cause the rehabilitation to be interrupted. After improving the general condition, the patient was readmitted, and the speech therapist performed an assessment and the patient was found to have sensory aphasia, with specificities in the form of partially preserved reading ability, which was used during rehabilitation. The assessment was performed four times over a 4-month period. After the patient's re-arrival, a speech therapy was performed at the hospital for a month, and after discharge from the institution, treatment continued in the family, occasionally following the instructions of the speech therapist. At the beginning of rehabilitation in the BDAE speech subtest, the patient achieved minimal results, while at the end of rehabilitation he achieved significantly more successful results in all segments of auditory comprehension. Conclusion: Good assessment of language status, planning of rehabilitation, follow-up of course of rehabilitation, encouragement, patient motivation, and family involvement in rehabilitation lead to good results in rehabilitation of aphasia.

Asssesing the effectiveness and impact of agricultural water management interventions: the case of small reservoirs in northern Ghana

Agricultural water management, particularly management of multi-purpose small reservoirs (SRs) in drier savanna areas of the northern Ghana, is being promoted as a key solution to improve agricultural production, enhance food security and livelihoods of smallholder farm households. However, little empirical evidence exist on how effective these small water infrastructures are in terms of delivering multiple benefits and their impact on the livelihood of smallholder farmers. This study assessed the effectiveness and impact of the small reservoirs on smallholder vegetable farmers in northern Ghana. A participatory rating method using a 5-point Likert-scale was used to assess the effectiveness of SRs in delivering multiple livelihood benefits and an endogenous switching regression model was applied to assess the SRs’ impact using a primary data collected from 328 randomly sampled vegetable farmers. Results from the Likert scale analysis show that most of the SRs are either dysfunctional or underutilized and not effective in delivering multiple benefits. Results from the endogenous switching regression model show that there is only about 3% increase in the income of vegetable farmers participating in irrigated vegetable production using SRs against the counterfactual situation but this change is insignificant statistically. The current low level effectiveness and impact of SRs could be enhanced by improving their management, for example, through the provision of incentive mechanisms such as subsidies to the private sector involvement in rehabilitation, management and irrigation service provision and strengthening the capacity of existing water users associations. Furthermore, small reserviors should be recognized not only as water sources for small scale irrigation but also as providers of multiple livelihood benefits to local communities and consequently should attract due attention in public resource allocation in their rehabilitation and management/institutional capacity building.

Family involvement in rehabilitation: Coronary artery disease-patients' perspectives.

To describe coronary artery disease patients' perceptions of family involvement in rehabilitation and the connection between background factors and family involvement. Coronary artery disease patients' hospital stays can be very concise. Family members can support rehabilitation, but many challenges can emerge. There is a need to nurture patients and family members in an individual way and to recognise their concerns. More accurate patient education should be available for patients and their family members. This study is a descriptive cross-sectional study. Data were collected from patients with coronary artery disease at least 6weeks after discharge from hospital (n=169) with a postal questionnaire. The Family Involvement in Rehabilitation (FIRE) scale measures family members' promotion of patients' rehabilitation and issues encumbering rehabilitation in family. The data have been analysed with statistical methods. Both parametric and nonparametric tests were used to evaluate group differences. Patients with coronary artery disease perceived that family promotes their rehabilitation significantly. Respondents also perceived challenges at home. Family relations before hospitalisation were related to all subareas of family promoting rehabilitation and one subarea of issues encumbering rehabilitation in family. Patients with symptoms at rest also had more encumbrance on their rehabilitation. Patients who had undergone coronary artery bypass surgery perceived more challenges than percutaneous coronary intervention (PCI) patients in many subareas of issues encumbering rehabilitation in family. Family relations prior to illness and the rigour of heart symptoms are significantly relevant to challenges that can occur between patient and their family members. Healthcare staff need to pay attention to coronary artery disease patients' individual situation, and patient education should be more family-centred. In the future, it would be noteworthy to collect more data from family members of patients with coronary artery disease and to find out their perceptions of family involvement.

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care.

Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care. We conducted a prospective pairwise cluster randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care involving 20 primary care rehabilitation units with 1-year follow-up. Adult patients with acute/subacute neck and back pain, worked ≥4 weeks past year and not currently on sick leave or no more than 60 days of sick leave and considered at-risk of sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least 4 consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days past week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared with the reference group (127/171, 74%) (P = 0.02). The intervention increased the odds of having work ability at 1-year follow-up, also after adjustment for baseline health-related quality of life (odds ratio 1.85, confidence interval 1.01-3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.

Kinésithérapie des capsulites rétractiles de l’épaule (incluant la post-capsulodistension)

Shoulder adhesive capsulitis is a common condition with favourable outcome but very long. Although full resolution of symptoms does not always occur, persistent symptoms are commonly mild with stiffness and/or minimal pain with possible persistent sequelae. Therapeutic interventions aim to reduce pain, which are important at the initial stage, and improve joint mobility thus shorten disability. There are no official guidelines for optimum therapeutic management. Conservative interventions including pain-killers, NSAIDs, corticosteroid infiltration and physical therapy are recommended at first. Shoulder capsular distension plus mobilisation is second line. Indications of arthroscopic capsular release or mobilisation under anesthesia are sparse. Physical therapy (techniques, duration and frequency of sessions, modality of management) need to be adapted to patient abilities and symptoms and must consider and treat the full shoulder complex dysfunction. Patient's involvement in rehabilitation and education to repeated home exercises is of paramount importance.