Rehab Centres Research Articles

New guidance on AI for wildlife rehab centres.

New guidance on AI for wildlife rehab centres.

Architecture and Societal Problems: Development of Rehab Facility for Drug Addicts Reintegration

Drug abuse problems in recent times have become an issue of grave concern and worrisome globally, with similar consequences for society. The paper emphasized the role of architecture in facilitating a therapeutic process for drug addicts in rehabilitation centre design as one of the solutions to this problem. Architectural spaces undoubtedly affect and influence the actions and attitudes of users. The study aims to integrate therapeutic techniques in rehabilitation centre design with enhanced spatial efficiency for holistic patient treatment to integrate them back into society. The methodology of the study is both theoretical and practical, involving a literature review, appraisal of case studies; observations, use of interviews and architectural design principles to formulate and produce a design model for a rehab centre in Calabar, Nigeria. Findings revealed that there are no known well-designed centres to rehabilitate victims of drug addiction in Calabar, Nigeria. The few centres available function as detention and discriminating spaces. The study concludes that rehab centres that focus on the therapeutic healing principles approach, which deals with patients’ mental, psychological, social and spiritual needs, should be developed in Calabar and other cities in Nigeria for swift rehabilitation of addicts.

A Rapid Review on matrix rhythm therapy

This brief study focuses on the effectiveness of Matrix rhythm therapy which exist as new development in the stream of physiotherapy used for the purpose of relieving pain, improves microcirculation, relaxation and increases oxygen supply of blood. A non-invasive method for gently releasing muscular tension and obtaining quick pain relief that can be used in conjunction with other forms of manual therapy or on its alone. A frequency range of 8-12 hz to stimulates the body’s natural self-healing powers storing good tissue resonance using a device by vibromassage method. The vibrating magneting field goes deep into the tissues via a reasonating head sending a phase synchronised mechanical vibration. It is used in conditions like chronic back pain, frozen shoulder, stroke, plantar fasciitis and lymphedema. In rehabilitation facilitate and compensatory education, clubs of sports, and neurological, orthopaedic, physiotherapy, and rehab centres, a new vibromassage application is being implemented.

What is therapeutic? Analysis of the narratives available on Italian Addiction Rehab Centres' Sites to present the therapeutic programme.

In recent years, the use of the adjective "therapeutic" has expanded to encompass a great variety of experiences, blurring the line between what is effectively therapeutic and what is not. Proceeding from the idea that a word's meaning is linked to its use in a particular linguistic game, we will analyse the etymons "therapy" and "psychotherapy" and the change in their meanings over time. This background will guide us in the qualitative analysis of the so-called "therapeutic activities" available on the websites of 14 Italian therapeutic communities for treating addiction. Four main master narratives emerge from our investigation. These are characterised by biomedical assumptions, pedagogical principles, religious precepts, and moral values, respectively. Activities are considered therapeutic per se rather than based on theoretical assumptions regarding change. In the light of our results, the adjective "therapeutic" has become a domain of common sense, which poses the threat of undue reification of the linguistic game that expresses it.

Participation in cardiac telerehabilitation

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EIT Health Campus Rationale Cardiac rehabilitation (CR) programmes are successful in educating patients and lowering their cardiovascular (CV) risk. However attendance before COVID was between 8 and 50%. Because of short duration of CR programmes sustainability in behaviour change is often suboptimal. The COVID pandemic has shown us the need for high quality remote CR. Mobile guided CR (mCR) has proven to be equally effective as centre-based CR and has the potential to increase participation rates. It also provides possibilities to extend the CR programme. Extending CR programmes with ehealth solutions have shown mixed results on sustainable behaviour change. It is still unknown what type of patients prefer mCR above regular CR when offered as standard care. REHAB+ Rehab+ is a mobile CR program, offered for one year to patients after myocardial infarction as an alternative to the regular CR program. It offers an optimised digital platform and regular interaction with the healthcare team. Patients are able to measure and register physical activity, heart frequency and intensity (BORG scale) and can monitor progress. A care professional (coach) also has access to a portal to monitor progress of different patients, advice on rehabilitation approach and stimulate compliance. Rehab+ is co-created with patients and rehab centres. In 2022, it will conclude its pilot and evaluation in 4 centres (Spain and the Netherlands), and scaled to more in the EU. Objectives 1. To assess whether mCR programmes result in better sustained effects, as compared to the regular CR programme. 2. To explore what type of patients prefer mCR above a regular CR programme. Study population 900 Post myocardial infarction patients (300 mCR, 600 regular CR) who are indicated for CR. (See figure 1) Patients not able or willing to participate will be registered in an exclusion log. mCR patients will be coached for 12 months with decreasing amounts of touchpoints. Regular CR patients receive no coaching after the end of the regular CR program. Study design Prospective, matched control observational trial Follow-up Patients will be monitored at (see table 1): - T0: baseline characteristics, exercise test, laboratory tests, Fägerstrom test, IPAQ questionnaire, SF-36 questionnaire - T1 (3 months): Physical exam, medication, ECG, laboratory tests, adherence and compliance (mCR only),Fägerstrom test, IPAQ questionnaire, SF-36 questionnaire, eHIQ questionnaire - T2 (12 months): Physical exam, medication, ECG, laboratory tests, exercise test, adherence and compliance (mCR only),Fägerstrom test, IPAQ questionnaire, SF-36 questionnaire, eHIQ questionnaire Conclusion Inclusion will start in November 2021. The results of this study will give insight in what type of patients choose to participate in mCR. With this information mCR programmes can be further optimised and adjusted. It may help to further increase participation rates in CR.

The development of a specific database for rehabilitation centres in Madagascar

The service provision of PRM was dramatically improved by the establishment of a trained cohort of PRM doctors in 2013 following training in 2011–2013 for a Diplome Universitaire and the immediate establishment of the Association of Physical and Rehabilitation Medicine of Madagascar (AMPR Madagascar). The Ministry of Health database then used was not helpful to the development and planning of rehabilitation services having little about disabilities and rehabilitation. During training those doctors developed and refined e a data -base built on their knowledge of their patients. Data included demographic, diagnostic and treatment information. This database was then used systematically in all major Rehab centres where participants worked, nationwide. Data were then sent monthly to the author, the vice chair of AMPR, and the Ministry of Health, presented regularly at AMPR meetings and made available for the up-dating of the national Rehab plan for Madagascar. Initially in 2012, in the first month, 351 patients were seen in six centres, numbers increasing thereafter with 6148 persons being entered in 2014. Data for 2015 were incomplete. By 2016 data collection was complete, 5373 patients being entered, 1568 of these referred by other hospital departments; 51.2% were female, 46,8% were under the age of 15. The total numbers of patients seen yearly has increased substantially from 2012. Five main diagnoses were common to all centres, for children: cerebral palsy, clubfoot, acute respiratory disease; for adult lumbo-sacral pain and hemiplegia. The database has helped in the planning of rehabilitation services at national level where it is increasingly recognised that databases are of great importance for planning, surveillance and acquiring epidemiological data. It has informed the regular national teaching of AMPR which now concentrates on major pathologies.

Demographic Profile and Substance Abuse Patterns in Women Stationed at Detoxification and Rehabilitation Centres in Tehran

Objective: Throughout recent years, wide spread substance abuse in both genders, especially in women, has been increasingly on the rise in Iran. This is a serious matter. There are no solid and accurate statistics on female drug abusers yet. According to the World Drug Report (2014), the highest amount of methamphetamine consumption has been observed in Mexico, the USA, China, Thailand, and Iran. Despite global concerns in the matter, it is difficult to estimate the exact number of amphetamine consumers. Method: This descriptive cross-sectional study aimed to examine the socio-demographic profile and substance abuse patterns in woman stationed at three Detox and Rehab Centres in Tehran. The statistical society at this centre includes 112 female patients. In this study, a questionnaire designed by the team of SOS-Enterprise.

Akzeptanz und Praktikabilität der Reha-Therapiestandards für Kinder und Jugendliche: Ergebnisse der Anwenderbefragung

The introduction of evidence-based therapy standards in child and adolescent rehabilitation of the German statutory pension insurance scheme (Deutsche Rentenversicherung Bund, 2011) was accompanied by a user survey that gave the participating rehabilitation centres the opportunity to comment on the new therapy standards and to suggest modifications.The survey questionnaire encompassed various topics related to the therapy standards, amongst them quality, comprehensibility, and acceptance, evaluation of feedback, and reasons for noncompliance with therapy standard requirements. For each of the 3 indications, a separate questionnaire was applied to assess modification suggestions regarding KTL therapy elements, the minimum percentage of patients to be treated accordingly, and the minimum duration of therapeutic procedures for each evidence-based treatment module. Responses from 14 rehab centres (return rate 54%) were obtained and analyzed.According to the majority of the responding rehabilitation centres, the therapy standards for child and adolescent rehabilitation fulfilled the quality features of topicality, multidisciplinarity, and relevance for routine rehabilitative practice. The degree of empirical grounding was evaluated more inconsistently. Difficulties with coding of KTL therapy elements were cited as the primary reasons for failing to comply with requirements in 2008.Exemplarily, the results of the user survey regarding the rehabilitative treatment of children and adolescents with obesity (age group: 8 years and older) are presented in detail.Concluding, the modifications to the therapy standards in child and adolescent rehabilitation introduced on the basis of the user survey are set out.

Die Entwicklung von Praxisempfehlungen für psychologische Interventionen in der Rehabilitation von Patienten mit koronarer Herzkrankheit: Methoden und Ergebnisse

Available guidelines and treatment standards are not sufficiently detailed to give practical guidance for psychological interventions in the rehabilitation of patients with coronary heart disease. We therefore aimed at developing evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of individual patients with coronary heart disease. The following steps were taken: (1) A systematic search for guidelines and reviews, and a survey of rehabilitation centres concerning present structures and the practice of psychological services, (2) development of a first draft of the practice guidelines in an expert workshop, (3) a survey of all senior psychologists and chief physicians of the rehab centres for their approval, as well as focus groups with rehab patients, and (4) revision of the recommendations and final consensus development in an expert workshop. Significant aspects of the guidelines that go beyond present practice are routine screening for psychological comorbidity, neuropsychological screening for cognitive dysfunction in particular patients, and employment of defined psychologically grounded interventions by the entire rehab team. So far, the practice guidelines have been widely accepted by professionals in the field of rehabilitation.

Strukturen und Praxis der Psychologischen Abteilungen in der orthopädischen und kardiologischen Rehabilitation: Vergleich zwischen ambulanten und stationären Einrichtungen in Deutschland

We aimed at comparing the present structural quality and practice of psychological services in ambulatory (outpatient) and inpatient rehabilitation in Germany.A nationwide survey of psychological services in orthopaedic and cardiac outpatient rehab centres was carried out. Results were compared to those of an identical study of inpatient services that was conducted simultaneously.Data were obtained from 81 ambulatory centres (return rate: 44%). Structures and practice (e. g., diagnostic procedures, psychological interventions) in ambulatory and inpatient rehabilitation only differed marginally. Differences concern the staff/patient ratio which is slightly better in ambulatory centres and some aspects of working conditions (e. g., less assisting staff or supervision).From its beginning, ambulatory rehabilitation in Germany has followed the standards of the inpatient model as far as structural quality and processes are concerned. Psychological practice in the ambulatory setting reflects that too. It is discussed whether the uniformity of ambulatory and inpatient rehabilitation services really is appropriate, or whether a more flexible model (e. g., regarding treatment duration) is needed in the German rehabilitation system.

Akzeptanz und Praktikabilität der Reha-Therapiestandards für die Rehabilitation nach Hüft- und Kniegelenks-Totalendoprothese (TEP) - Ergebnisse einer Anwenderbefragung zur Pilotversion

Implementation of the pilot version of the rehab therapy standards for rehabilitation following total hip or knee replacement was accompanied by a user survey. This survey allowed rehab centres to comment on the standards and suggest changes.Early 2010 a total of 160 rehab centres that had treated at least 50 German Pension Fund insurees following total hip or knee replacement in 2008 received a written survey together with an overview of performance data according to KTL (Classification of Therapeutic Procedures), data that reflect the degree to which the centres had complied with the requirements of the therapy standards.69% of the centres returned the questionnaire. The centres included predominantly agreed that the rehab standards fulfil the quality attributes "scientific foundation (evidence)", "relevance for day-to-day work", "up-to-dateness", and "inter- and multidisciplinary development". There were no statistically significant differences between centres with previously high or low compliance with the requirements of the standards relative to the ratings given for these global quality criteria. Almost all responders considered comprehensiveness and structure of the standards adequate. Between 55 and 94% found that therapeutic procedures were sufficiently represented by the treatment modules. Minimum percentages of patients requiring the respective treatment were considered adequate for 8 out of 13 modules. Responders suggested restricting continuous passive motion to knee replacement. Psychological interventions were considered less important. Among the main reasons for non-adherence to therapy standards in 2008 were: coding problems, too high demands, contraindications, and shortage of staff. Implementation of the standards was associated with both positive and negative expectations on the part of the rehab centres; an issue raised in addition was the effort involved in internal restructuring.The results of the user survey show that the concept of the rehab standards and its implementation basically are accepted. Criticism had mainly concerned continuous passive motion and the need for psychological interventions. Coding problems should not be overrated since the underlying performance data referred to a period of time before the standards were implemented. General appraisal of the rehab standards was independent of previous performance. This emphasizes the weight of user feedback. The rehab standards already have been revised in light of the results of the user survey.

Entwicklung, Implementierung und Umsetzung einer Intervention zur bedarfsgerechten Patienteninformation für Rehabilitandinnen und Rehabilitanden

Patients have a great need for information that is often not satisfied by providing "standard" information. In order to reach the patients better, it is increasingly necessary to tailor patient information to the individual needs of patients and make stronger use of patients' "common sense" models. This article reports on the development and implementation of an intervention procedure for providing needs-based patient information as well as on initial results of its use. Both the intervention concept and the operationalization of its contents are based on the common sense self-regulation model (CSM). The intervention aims to link the information given to patients to the existing illness beliefs and treatment beliefs of the rehabilitation patients. To do this, the illness and treatment representations held by the patients before rehabilitation are assessed, automatically analyzed using a computer programme, and aggregated in a "response questionnaire". This feedback is then passed on to the information-providing therapists well in advance of admission of the rehab patients. The contents and key organizational data of the intervention procedure were discussed with the treatment providers in a feasibility analysis before implementation. In addition, intervention training was also conducted before the start of the intervention. Since August 2009 the procedure has been implemented and evaluated in 9 cooperating rehab centres. Process documentation provides criteria relative to the feasibility of the intervention. The results on implementation of the intervention as well as on its feasibility have thus far been relatively encouraging. The treatment providers ascribe high relevance to the contents of the intervention and assess the major components to be generally feasible. From the treatment provider viewpoint, the rehabilitation patients benefit from the intervention, and it is also considered to be helpful for planning further treatment. The intervention procedure for needs-based patient information presents an option for making information available to patients as needed. It is based on theory and accepted by treatment providers. The strengths and weaknesses of the intervention are discussed.

Qualitätssicherung in der ambulanten medizinischen Rehabilitation: Konzeption und Ergebnisse eines Pilotprojekts zur Entwicklung eines Qualitätssicherungsprogramms für die Indikationsbereiche muskuloskeletale und kardiologische Erkrankungen

The concept and results of a pilot project to develop a quality assurance programme for outpatient medical rehabilitation in musculoskeletal and cardiac diseases are discussed. The processes developed and the results that were achieved using the instruments in 24 pilot institutions are described. The quality of structure was assessed by defining and applying basic and detailed criteria; a version of peer review for outpatient treatment was developed to test the quality of process. The quality of results was determined by means of a prospective study with two or three measurement times and implementation of generic and disease-specific measurement instruments. The process was tested on n=1475 patients with musculoskeletal diseases and n=843 patients with cardiac diseases. The level of the quality of structure in the participating centres is quite high; 89-93% of the structure features required were fulfilled. The peer review indicated that the process had 25-40% serious shortcomings in cardiology and 15-20% for musculoskeletal diseases. The quality of results measurements show that the participating outpatient rehab centres achieved medium effects for the majority of the core rehab dimensions for the respective indications, but the findings also showed that at the time the follow-up reports were made there was often a reduction of positive effects and high effects were quite rare. While there were marked differences in quality of structure and process among the various institutions, there were only slight differences among the outpatient centres regarding quality of results. A scientifically sound quality assurance programme was developed that covers specific aspects of outpatient rehabilitation, to a great extent using the same structures that have been implemented in the quality assurance programmes for inpatient treatment. To implement the results presented here, the scientific findings will need to be evaluated in the respective committees of the cost-carriers. The tests of the programme in 24 pilot institutions showed an overall high level of quality, but also revealed potential for improvement in some areas.

Weiterentwicklung und Validierung eines Verfahrens zur Visitation von Rehabilitationseinrichtungen

Visitations (audits) are considered an instrument of external quality assurance by which the structural and organizational set-up of health facilities can be assessed on site by external experts. The Deutsche Rentenversicherung Bund (including the former Bundesversicherungsanstalt für Angestellte, BfA, the statutory pension insurance agency for white collar employees) is the largest body responsible for rehabilitation in Germany, and it regularly carries out visitations in the approximately 650 rehab centres it sends its patients to. The project presented in this article aimed at developing a manual with detailed descriptions of the procedures and criteria of the assessment, as well as at checking the inter-rater-reliability of the assessment. The manual was developed in cooperation with experts of the Deutsche Rentenversicherung Bund. It contains a description of the areas to be assessed during a visitation as well as leading questions and criteria for the evaluation of single features. The manual was examined in "test visitations" in 10 centres, each of which was visited by three visitation teams (1 medical and 1 administrative expert) simultaneously. When the resulting 30 assessments were compared, the criterion "overall quality of the centre" (which was assessed on a 10-point scale) showed precise agreement in 47 %, and a deviation by 1 point in 33 % of the cases. Single features assessed on a three-point scale (no improvement needed/improvement recommended/immediate improvement obligatory) resulted in precise agreement in between 80 % ("medical and therapeutic processes") and 86 % ("structural features") of the cases. Two-point scales (condition fulfilled or not fulfilled) showed an agreement between 89 % ("internal quality management") and 97 % ("single structural features"). In order to maintain and further develop this good inter-rater-reliability, the visitors of Deutsche Rentenversicherung Bund are continually trained in applying the visitation manual. In addition to transferring knowledge, these internal training courses are aimed at exchanging views and experience in order to enhance consensus among the visitors. This approach of Deutsche Rentenversicherung Bund could be regarded as "internal quality assurance" of its visitation procedure.