National Rehabilitation Hospital Research Articles

Epidemiology of Pediatric Traumatic and Acquired Nontraumatic Spinal Cord Injury in Ireland.

Objective: To examine the epidemiology of pediatric traumatic (TSCI) and acquired nontraumatic spinal cord injury (NTSCI) in Ireland. There are few studies reporting pediatric TSCI incidence and fewer of pediatric NTSCI incidence, although there are several case reports. As there is a single specialist rehabilitation facility for these children, complete population-level data can be obtained. Method: Retrospective review of prospectively gathered data in the Patient Administration System of the National Rehabilitation Hospital of patients age 15 years or younger at the time of SCI onset. Information was retrieved on gender, age, etiology, level of injury/AIS. Population denominator was census results from 1996, 2002, 2006, and 2011, rolled forward. Results: Since 2000, 22 children have sustained TSCI and 26 have sustained NTSCI. Median (IQR) age at TSCI onset was 6.3 (4.4) years, and at NTSCI onset it was 7.3 (8.1) years. Most common TSCI etiology was transportation (n = 10; 45.5%), followed by surgical complications (n = 8; 36.4%); most common injury type was complete paraplegia (n = 12; 54.5%) followed by incomplete paraplegia (n = 5; 22.7%). Most common NTSCI etiology was transverse myelitis (n = 11; 42.3%) followed by vascular (n = 5; 20%); most common injury type was incomplete paraplegia (n = 17; 65.4%) followed by incomplete tetraplegia (n = 6; 24%). Incidence of TSCI ranged from 0 to 3.1 per million per year; incidence of NTSCI ranged from 0 to 6.5 per million per year. Conclusion: Incidence of SCI in Ireland seems similar to or slightly lower than other developed countries. Injury patterns are also similar, considering variations in reporting methods.

Self-reported inner speech in aphasia is related to phonological retrieval

Self-reported inner speech in aphasia is related to phonological retrieval

Successful Self-Monitoring of Speech Errors Depends on Frontal White Matter Tracts

Successful Self-Monitoring of Speech Errors Depends on Frontal White Matter Tracts

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy.

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy.

Redefining Recovery from Aphasia

[email protected] Department of Neurology Georgetown University Medical Center Research Division MedStar National Rehabilitation Hospital Washington, District of Columbia Supported by the National Center for Advancing Translational Sciences via the Georgetown-Howard Universities Center for Clinical and Translational Science (KL2TR000102), the Doris Duke Charitable Foundation (2012062), and the Vernon Family Trust. The reviewer declares no conflicts of interest.

Thermal dose t43 measured for commercial moxas

Sook-Hyun Lee1, Go Eun Lee2, Jung Sup Lee3, Kuem Ju Lee1, Sung Min Lim1, Hyun Choi1, Dong-A Kim4, Wan Ho Kim4, Chi Hyoung Son2 1 Department of Clinical Research for Rehabilitation, National Rehabilitation Research Institute 2 Department of Korean Traditional Rehabilitation Medicine, National Rehabilitation Hospital 3 Department of Korean Traditional Internal Medicine, National Rehabilitation Hospital 4 Department of Rehabilitation Medicine, Korean National Rehabilitation Hospital

Acupuncture therapy for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials

Sook-Hyun Lee1, Go Eun Lee2, Jung Sup Lee3, Kuem Ju Lee1, Sung Min Lim1, Hyun Choi1, Dong-A Kim4, Wan Ho Kim4, Chi Hyoung Son2 1 Department of Clinical Research for Rehabilitation, National Rehabilitation Research Institute 2 Department of Korean Traditional Rehabilitation Medicine, National Rehabilitation Hospital 3 Department of Korean Traditional Internal Medicine, National Rehabilitation Hospital 4 Department of Rehabilitation Medicine, Korean National Rehabilitation Hospital

An Evidence-Based Review of Hemiplegic Shoulder Pain

Sook-Hyun Lee1, Go Eun Lee2, Jung Sup Lee3, Kuem Ju Lee1, Sung Min Lim1, Hyun Choi1, Dong-A Kim4, Wan Ho Kim4, Chi Hyoung Son2 1 Department of Clinical Research for Rehabilitation, National Rehabilitation Research Institute 2 Department of Korean Traditional Rehabilitation Medicine, National Rehabilitation Hospital 3 Department of Korean Traditional Internal Medicine, National Rehabilitation Hospital 4 Department of Rehabilitation Medicine, Korean National Rehabilitation Hospital

Stroke rehabilitation in Fiji: are patients receiving services?

The national hospital and stroke rehabilitation services of the Fiji Ministry of Health. To describe patients admitted with stroke to the Fiji Colonial War Memorial Hospital (CWMH) from January 2010 to December 2012, and to report on rehabilitation services accessed during and after admission. Retrospective descriptive study using patient records. Of the 328 patients admitted with stroke, 54% were male, 55% i-Taukei and 16% aged <50 years; 75% had hypertension, 41% diabetes and 37% both; 23% (n = 76) died. Of the survivors, 58% (146) received rehabilitation therapy during admission at the CWMH. After discharge, 10% (n = 26) received therapy at the National Rehabilitation Hospital; six accessed the services of the community rehabilitation assistants. Just over half of stroke survivors (52%) remained in CWMH for <1 week (median stay 6 days, IQR 4-11). The length of stay and access to rehabilitation was inadequate for over half of the stroke survivors. After discharge, very few accessed the available rehabilitation services of the Ministry of Health. It will be crucial to review procedures for tracking patient use of rehabilitation services and to explore why patients are not accessing these services, which are vital to recovery and restoration of function.

All in the Family

All in the Family

“I know it but I can’t say it”: Clarifying the subjective experience of inner speech in aphasia

“I know it but I can’t say it”: Clarifying the subjective experience of inner speech in aphasia

USE OF PLATELET RICH PLASMA FOR THE TREATMENT OF BICIPITAL TENDINOPATHY IN SPINAL CORD INJURY: A PILOT STUDY

IntroductionShoulder pain remains one of the most common complaints in the spinal cord injury (SCI) population. Several studies suggest that approximately 30–70% of people with SCI in the USA suffer...

뇌졸중 환자의 낮병원 프로그램이 도구적·일상생활활동 수행 능력과 삶의 만족도에 미치는 영향

This study was to evaluate the effects how to have an influence on activities daily living and quality of life in day hospital program for the stroke patient. 41 experimental groups and 41 control groups in National rehabilitation hospital selected and examined K-ADL, K-IADL and quality of life. The result of this study indicated that experimental group was higher than control group in activity daily living performance and instrumental activity daily living performance. also experimental group was higher than control group all of total items in quality of life. age and economic state of general characteristic had an effect on K-ADL, K-IADL and quality of life and economic state, scholarship, marriage, job, helper had effect on quality of life. pain, social function, mental health, physical role in item of quality of life had effect on K-ADL and limit of physical role had best effect on K-IADL. Consequently we found that it needs to continuous rehabilitation to maintain body function, to prevent secondary disability, to improve social integration and quality of life for stroke patient actually.

ASHA Joins Forces to Help Wounded Warriors

You have accessThe ASHA LeaderASHA News1 Oct 2012ASHA Joins Forces to Help Wounded Warriors Carol Polovoy Carol Polovoy Google Scholar More articles by this author https://doi.org/10.1044/leader.AN3.17132012.8 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Characterizing the human brain as a “magical, awesome, but fragile organ,” ASHA Past President Paul Rao pitched the importance of rehabilitation services after traumatic brain injury (TBI) to a room full of congressional staffers at a Sept. 18 briefing hosted by ASHA, the American Occupational Therapy Association, and the American Physical Therapy Association. When the brain is “damaged by a bullet or a football injury or a fall, the patient needs rehab to become more independent, to resume participating in his or her community, and to seek an improved quality of life post-trauma,” said Rao, vice president of inpatient operations and compliance at Medstar National Rehabilitation Hospital in Washington, D.C. The briefing was part of the three organizations’ efforts to help address the health care needs of returning U.S. troops through Joining Forces, a White House initiative to serve America’s military families. As a member of the initiative, ASHA unites with other nonmilitary medical organizations to increase members’ awareness of the unique medical needs of troops returning home from overseas deployments. Rep. Mike Michaud (D-Maine), ranking member on the House Veterans Affairs Subcommittee on Health, sponsored the briefing—“Therapy and Traumatic Brain Injury”—to educate congressional staffers about how physical therapy, occupational therapy, and speech-language pathology are helping wounded warriors and veterans recover, rehabilitate, and reintegrate. Rao and other presenters emphasized the cost savings of preventing TBI and providing treatment in the acute and post-acute TBI periods to avoid the long-term costs of institutionalization or dependency. At the briefing, Rao cited statistics from the Centers for Disease Control and Prevention indicating that 5.3 million Americans—approximately 2% of the U.S. population—have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI. “TBI can also have a devastating impact on communication, cognition, and swallowing that can result in a staggering impact on one’s emotional, vocational, and/or social well-being,” he said. “It is sometimes said the TBI is a silent epidemic...there are often no outward signs, and a victim may possess his or her physical abilities but still have a drastic reduction in the ability to perform some of life’s most basic daily living skills.” Joining Forces was created specifically to emphasize the conditions that may not be evident when the service member first returns from overseas: mild TBI, post-traumatic stress disorder (PTSD), and depression. Joining Forces’ series of four 30-minute videos is designed to help health care providers understand the experiences of overseas troops and their families and to provide guidance on discussing those experiences with them. The videos focus on the general experience of overseas deployment, returning home, and reintegration into civilian life; an overview of the health-related issues of soldiers and their families; PTSD; and mild TBI. The initiative includes more than 30 organizations, representing physicians, nurses, social workers, counselors, physician assistants, medical schools, dentists, psychologists, physical therapists, surgeons, and other health-related groups. Members have committed to: Educate members on how to recognize PTSD, TBI, and post-combat depression. Partner with other public and private organizations to share educational and training resources. Focus on veteran care at annual conferences. Develop or highlight existing educational and referral resources. Use technology to connect experienced professionals with those who have not been trained or educated on PTSD/TBI or post-combat depression recognition/treatment regimens. A speaker from the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury will present a session on TBI, PTSD, and depression in returning soldiers at ASHA’s 2013 Health Care/Business Institute, scheduled for April 27–28 in Orlando. For more information, contact Janet Brown, MA, CCC-SLP, director of health care services in speech-language pathology, at [email protected]. Author Notes Carol Polovoy, assistant managing editor of The ASHA Leader, can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 17Issue 13October 2012 Get Permissions Add to your Mendeley library History Published in print: Oct 1, 2012 Metrics Downloaded 70 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2012 American Speech-Language-Hearing AssociationLoading ...

Back to Their Old Selves

Back to Their Old Selves

ASHA Asks for Education, Hearing Screening Funding

You have accessThe ASHA LeaderASHA News1 May 2012ASHA Asks for Education, Hearing Screening Funding Neil Snyder Neil Snyder Google Scholar More articles by this author https://doi.org/10.1044/leader.AN5.17062012.np SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In In testimony before a House subcommittee, 2011 ASHA President Paul Rao called attention to three issues important to audiologists and speech-language pathologists: funding for Individuals With Disabilities Education Act (IDEA) and early hearing detection and intervention (EHDI programs), and the role of audiologists and SLPs in federally funded literacy programs. Rao, chief operating officer for inpatient services at the National Rehabilitation Hospital in Washington, D.C., testified on behalf of ASHA at the March 29 hearing before the Labor–Health and Human Services–Education Appropriations Subcommittee. This subcommittee will develop a fiscal year 2013 funding proposal for federal education and health and human service programs, and other programs that affect services for individuals with communication disorders. IDEA Rao emphasized that federal funding of IDEA is authorized to be 40% of the funds required to administer the regulations of the act, but that federal funding has never reached that level. The administration’s 2013 budget proposal (see The ASHA Leader, April 3) “would freeze funding for the program and decrease the federal contribution from 16.2% to 15.8% of the national per pupil average expenditure for FY2013, well below the original target of 40%,” he said. Rao also indicated that the effects of “sequestration,” as called for under deficit-reduction efforts, will cut IDEA Part B funds by at least $903 million. “Limiting funding for IDEA places school-based speech-language pathologists, audiologists, schools, and school districts in an unsustainable position,” Rao said. “If this request is enacted, they will face serious struggles to meet their obligations” to serve children and youth with disabilities. “I ask for this committee to provide the maximum funding available to IDEA,” Rao said, “to revitalize what has become one of our nation’s core educational programs for students.” EHDI EHDI programs have significantly increased the number of infants screened for hearing loss at birth, but substantial work remains to ensure that infants diagnosed with hearing loss receive timely and appropriate services. The national figure for those infants who did not receive follow-up services or whose follow-up was not documented was 38% in 2010, with wide variation in individual state rates. Rao indicated ASHA’s support for appropriate funding for EHDI screening programs and for state programs to link screening programs with diagnosis and early intervention supports. Literacy and Reading Under current law, school-based SLPs and audiologists are omitted from initiatives designed to improve literacy. Rao noted that young children at risk of failure in acquiring literacy skills often have a speech, language, processing, or hearing disorder, and that failure to identify these disorders early can interfere with academic success. “SLPs and audiologists play important roles in ensuring that all children gain access to appropriate instruction in reading, writing, and spelling,” Rao said, but administrators often don’t use the expertise of these professionals when implementing their literacy programs. Rao urged the committee to avoid limiting the reach of SLPs and audiologists to children already identified with a disability, and to allow states and school districts that receive federal funds to allow—not mandate—school-based SLPs and audiologists on school literacy teams and state advisory boards. Author Notes Neil Snyder, director of federal advocacy, can be reached at[email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 17Issue 6May 2012 Get Permissions Add to your Mendeley library History Published in print: May 1, 2012 Metrics Downloaded 53 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2012 American Speech-Language-Hearing AssociationLoading ...

Characterization of Compensatory Trunk Movements During Prosthetic Upper Limb Reaching Tasks

Metzger AJ, Dromerick AW, Holley RJ, Lum PS. Characterization of compensatory trunk movements during prosthetic upper limb reaching tasks. ObjectiveTo characterize the compensatory movements of the trunk during functional reaching tasks performed by upper limb prosthesis users. DesignSurvey. SettingClinical laboratory at a national rehabilitation hospital. ParticipantsTranshumeral and transradial prosthesis users (n=10) and uninjured control subjects (n=10). InterventionsNot applicable. Main Outcome MeasuresThree-dimensional motion analysis data were collected during simulated reaching tasks, such as donning a cap, placing a nut, and sorting clothes. The metrics were range of motion of the trunk in the 3 anatomical directions and elbow and shoulder path distance. ResultsProsthesis users had significantly larger truncal movements than controls during all 3 reaching tasks in all 3 directions (P≤.03). Shoulder path distance in persons with amputation was larger than in controls in all 3 tasks (P<.01). Elbow path distance in persons with amputation was larger than in controls in the nut and clothes tasks (P≤.02). The subgroup of transradial prosthesis users displayed these abnormal movements despite the presence of an intact elbow. ConclusionsThe altered physiologic structure of the arm caused the individuals to develop a different motor control strategy than an intact arm. Functional limitations, such as the loss of distal degrees of freedom, required persons with amputation to use trunk displacement in place of arm/hand movement. These compensatory movements during reaching tasks may be a cause of prosthesis rejection and, in some cases, may be resolved with proper rehabilitative training. Analysis of compensatory trunk movements may also provide a useful endpoint for evaluating new prosthesis designs.

Mentorship: The Price of Membership

Mentorship: The Price of Membership

A Blueprint for Telerehabilitation Guidelines—October 2010

Committee Members Co-Chairs David Brennan, M.B.E., Senior Research Engineer, National Rehabilitation Hospital, Washington, District of Columbia. Lyn Tindall, Ph.D., Speech-Language Pathologist, Department of Veterans Affairs Medical Center, Lexington, Kentucky. Writing Committee Janet Brown, M.A., CCC-SLP, Director, Health Care Services, American Speech-Language-Hearing Association, Rockville, Maryland. Mike Campbell, M.S., M.B.A., CCC-SLP, Director of the Speech and Hearing Program, The University of North Carolina at Greensboro, Browns Summit, North Carolina. Jana Cason, D.H.S., OTR/L, Assistant Professor, Auerbach School of Occupational Therapy, Louisville, Kentucky. Diana Christiana, M.A.T., CCC-SLP, President/CEO, Clinical Communications, Sugar Land, TX. Alan Lee, Ph.D., P.T., D.P.T., C.W.S., G.C.S., Associate Professor, Mount St. Mary's College, Doctor of Physical Therapy Program, Los Angeles, California. David R. Smith, Director, Telehealth Resource Center, Marquette General Hospital, Marquette, Michigan. Deborah Theodoros, Ph.D., Associate Professor and Head, Division of Speech Pathology, School of Health and Rehabilitative Sciences, The University of Queensland, Queensland, Australia. Contributors Working Group Members [WG], Consultants [C], Reviewers [R], Telerehabilitation Special Interest Group Chair [TR], ATA Standards and Guidelines Committee Member [SG], and ATA Staff [S] Nina Antoniotti, R.N., M.B.A., Ph.D., Chair of SG, Director of Telehealth, Marshfield Clinic, Marshfield, Wisconsin. Jordana Bernard, M.B.A., S, Senior Director, Program Services, American Telemedicine Association, Washington, District of Columbia. Anne Burdick, M.D., M.P.H., SG, Associate Dean for Telemedicine and Clinical Outreach, Professor of Dermatology, Director, Leprosy Program, University of Miami Miller School of Medicine, Miami, Florida. Jerry Cavallerano, Ph.D., OD, SG, Staff Optometrist, Assistant to the Director, Joslin Diabetes Center, Beetham Eye Institute, Boston, Massachusetts. Ellen Cohn, Ph.D., CCC-SLP, TR, WG, Associate Dean for Instructional Development, School of Health and Rehabilitative Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania. Paul Cox, MSEE, WG, President, PERL Research, Huntsville, Alabama. Mary Fran Delaune, P.T., MPT, R, Director, Practice Department, American Physical Therapy Association, Alexandria, Virginia. Matt Elrod, P.T., D.P.T., M.Ed., N.S.C., R, Associate Director, Practice Department, American Physical Therapy Association, Alexandria, Virginia. Brian Grady, M.D., [SG], VISN5 TMH Lead and Director, TeleMental Health, School of Medicine, University of Maryland, Baltimore, Maryland. Elizabeth Krupinski, Ph.D., Vice Chair of SG, Associate Director, Program Evaluation, University of Arizona, Arizona Telemedicine Program, Department of Radiology, Research Professor, Department of Radiology Research, Tucson, Arizona. Jonathan D. Linkous, MPA, S, Chief Executive Director, American Telemedicine Association, Washington, District of Columbia. Michael Pramuka, Ph.D., CRC, WG, Rehabilitation Counselor, Walter Reed Medical Center, Washington, District of Columbia. Richard Schein, Ph.D., WG, Postdoctoral Associate, Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania. Lou Theurer, SG, Grant Administrator, Burn Telemedicine Program, University of Utah Health Sciences Center, Salt Lake City, Utah. Jill Winters, Ph.D., R.N., WG, SG, Dean and Professor, Columbia College of Nursing, Milwaukee, Wisconsin.

Applying the Principles of Peer Mentorship in Persons with Aphasia

The concept of peer mentorship can be applied to a variety of populations. In this article, literature will be reviewed discussing the principles of mentorship and how they have been applied to persons living with aphasia through the development and implementation of an Aphasia Mentorship Program. The protocol of this program (created at the National Rehabilitation Hospital [NRH] in Washington, DC), a case report of a successful mentorship experience, and conclusions regarding the success of the program and future directions will be discussed.