Long-term Care Rehabilitation Research Articles

Evolution of rehabilitation services in response to a global pandemic: reflection on opportunities and challenges ahead.

The rapidly evolving COVID-19 public health emergency has disrupted and challenged traditional healthcare, rehabilitation services, and treatment delivery worldwide. This perspective paper aimed to unite experiences and perspectives from an international group of rehabilitation providers while reflecting on the lessons learned from the challenges and opportunities raised during the COVID-19 pandemic. We discuss the global appreciation for rehabilitation services and changes in access to healthcare, including virtual, home-based rehabilitation, and long-term care rehabilitation. We illustrate lessons learned by highlighting successful rehabilitation approaches from the US, Belgium, and Japan.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

Prevention Plan for COVID-19 in a Psychiatric Long-term Care Rehabilitation Facility: An Italian Experience.

Prevention Plan for COVID-19 in a Psychiatric Long-term Care Rehabilitation Facility: An Italian Experience.

COVID-19 Transmission in a Psychiatric Long-Term Care Rehabilitation Facility: An Observational Study.

To report the clinical characteristics and transmission rate of coronavirus disease 2019 (COVID-19) in a community inpatient long-term care psychiatric rehabilitation facility designed for persons with serious mental illness to provide insight into transmission and symptom patterns and emerging testing protocols, as well as medical complications and prognosis. This study examined a cohort of 54 residents of a long-term care psychiatric rehabilitation program from March to April 2020. Baseline demographics, clinical diagnoses, and vital signs were examined to look for statistical differences between positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) groups. During the early phase of the pandemic, the facility closely followed the local shelter-in-place order (starting March 19, 2020) and symptom-based testing. Of the residents, the primary psychiatric diagnoses were schizoaffective disorder: 28 (51.9%), schizophrenia: 21 (38.9%), bipolar I disorder: 3 (5.5%), and unspecified psychotic disorder: 2 (3.7%). Forty (74%) of 54 residents tested positive for SARS-COV-2, with a doubling time of 3.9 days. There were no statistical differences between the positive SARS-COV-2 versus negative groups for age or race/ethnicity. Psychiatric and medical conditions were not significantly associated with contracting SARS-COV-2, with the exception of obesity (n = 17 [43%] positive vs n = 12 [86%] negative, P = .01). Medical monitoring of vital signs and symptoms did not lead to earlier detection. All of the residents completely recovered, with the last resident no longer showing any symptoms 24 days from the index case. Research is needed to determine optimal strategies for long-term care mental health settings that incorporate frequent testing and personal protective equipment use to prevent rapid transmission of SARS-COV-2.

Effectiveness of a Serious Game for Cognitive Training in Chronic Stroke Survivors with Mild-to-Moderate Cognitive Impairment: A Pilot Randomized Controlled Trial

Previous cognitive training games for stroke survivors required the close supervision of therapists. We aim to demonstrate the preliminary therapeutic effectiveness of Neuro-World, serious mobile games for cognitive training, in chronic stroke survivors with mild-to-moderate cognitive impairment without therapist supervision. For that, we conducted a randomized, controlled clinical trial at a single long-term care rehabilitation center with 50 stroke survivors in the chronic stage with mild-to-moderate cognitive impairment. Participants were randomized to standard medical care (n = 25) or standard medical care plus administration of Neuro-World (n = 25) over 12 weeks. A two-way mixed model ANOVA and Tukey’s post hoc tests identified significant differences in outcomes between the experimental and the control groups at post-intervention but not at baseline. Within the experimental group, there were statistically significant improvements in all the outcomes except for the language category of the Mini-Mental State Examination and Digit Forward Span. The improvements were clinically significant for the total Mini-Mental State Examination, Digit Forward Span, and Digit Backward Span. Within the control group, there were no improvements in any of the outcomes. The practice of Neuro-World led to significant improvements in cognitive function and marginal mitigation of depressive symptoms in chronic stroke survivors with mild-to-moderate cognitive impairment.

Jonathan Shaatal: Practicing in a long-term care rehabilitation center.

Jonathan Shaatal: Practicing in a long-term care rehabilitation center.