Rehabilitation Administration Research Articles

Effectiveness of telerehabilitation versus face-to-face pulmonary rehabilitation on physical function and quality of life in people with post COVID-19 condition: a systematic review and network meta-analysis.

Post COVID-19 condition (PCC) is characterized by the persistence of symptoms associated with COVID-19 infection for more than 12 weeks, with worsening quality of life and physical function deconditioning being among the most commonly reported persistent symptoms. Pulmonary rehabilitation has emerged as a safe and viable option for these patients. Administered either face-to-face (FTF) or telemedicine (TL), it has been shown to improve symptoms associated with PCC. However, little is known about which approach is best for this population. Therefore, we conducted a systematic review and network meta-analysis on the efficacy of FTF versus TL compared to usual care in improving physical function and quality of life (physical and mental) in patients with PCC. A systematic search of PubMed, Cochrane Library, and Web of Science was performed from 2020 to January 5th, 2024. Two independent reviewers performed study selection, data extraction, and risk of bias assessment; this selection included only randomized controlled trials. A network meta-analysis was performed to compare the effects of FTF and TL with usual care. Multivariate and univariate analysis were performed to evaluate the best intervention. Data were extracted from 10 studies, five of which were treated with FTF and five of which were TL, involving 765 adults with PCC, ranging in age from 22 to 66 years. Interventions consisted of isolated or combined exercises (aerobic, resistance, breathing) and lasted between three and ten weeks in most of the included studies. Multivariate analysis found that FTF produced significant differences compared to TL or usual care with moderate quality of evidence. Univariate analysis found that significant differences were only found for physical function and mental domain of quality of life for TL vs. usual care, with moderate quality of evidence. This study supports the use of FTF as a therapy to improve physical function and quality of life in patients with PCC. However, in the absence of differences between FTF and TL in the univariate model for any of the outcomes studied, the choice of the form of pulmonary rehabilitation administration should be individualized. Future studies should compare FTF with TL directly to clarify which is the best approach.

Healthcare professionals' knowledge and perceptions of post-stroke rehabilitation in the peripandemic period: an online cross-sectional survey.

The COVID-19 pandemic has profoundly affected healthcare systems, particularly post-stroke rehabilitation centers. The elevated severity of strokes and delayed hospital admissions caused numerous hurdles to rehabilitation administration during the peri-pandemic period. This study surveyed healthcare professionals' knowledge and perceptions of post-stroke rehabilitation during this period. An online cross-sectional survey was administered from September 17, 2023 to February 23, 2024, utilizing the SurveyMonkey platform. The questionnaire included 30 questions addressing participant baseline characteristics, knowledge of definitions and experiences, post-stroke rehabilitation procedures, obstacles encountered during the peri-pandemic period, and the utilization of telerehabilitation. Only complete responses from health professionals were considered. This report utilized convenience sampling. Data were analyzed via descriptive statistics and chi-square tests, with a significance threshold of p < 0.05. A total of 79 health professionals, predominantly physiatrists, neurologists, and physiotherapists, from eight countries participated in the study. Over half of the participants (64.6%) indicated the existence of a dedicated department for post-stroke rehabilitation. Significant obstacles comprised an absence of advanced rehabilitative treatments (60.8%), inadequately skilled workers (50.6%), and restricted space for rehabilitation (46.8%). Telerehabilitation was regarded as a feasible option by 45.6% of participants; nonetheless, obstacles, including patients' telecommunication proficiency and the possibility of diagnostic inaccuracies, were acknowledged. Complementary therapies, such as music and dance therapy, received favorable evaluations from 67.1% to 63.3% of respondents, respectively. The pandemic reduced rehabilitation admissions due to infection concerns (75.9%) and increased multimorbidity cases among patients (48.1%). The study underscores the pandemic's negative effect on post-stroke rehabilitation, emphasizing the necessity for multidisciplinary, customized therapy and enhanced integration of telerehabilitation to overcome access barriers. Addressing obstacles regarding infrastructure, training, and access to advanced approaches, particularly in a post-pandemic context, is essential to improving rehabilitation outcomes.

Women’s Garden Work, Agricultural Rehabilitation, and Gendered Knowledge from Below on the Canadian Prairies, 1930–46

This article considers the gardening work of prairie women in the context of farming difficulties and agricultural rehabilitation on the Canadian Prairies in the 1930s and 1940s. It is based on analysis of gardening coverage in the Western Producer (a prairie periodical aimed at English-speaking farm families) and engagement with the records of federal government officials involved in the Prairie Farm Rehabilitation Administration and the Experimental Farms Service. The article establishes the significance of women’s gardening work and its important role in agricultural rehabilitation. In doing so, the article makes clear the ambition underlying agricultural rehabilitation, a federal government project intended to help protect permanent homes for settler families on the Canadian Prairies. Contributing to the understudied topics of rural experiences in women’s history and of women’s experiences in environmental history and the history of knowledge, the article illustrates the importance of considering gendered knowledge from below in grappling with the consolidation of agricultural colonization on the Canadian Prairies.

Developing excellent plantar pressure sensors for monitoring human motions by using highly compressible and resilient PMMA conductive iongels

Based on real-time detection of plantar pressure, gait recognition could provide important health information for rehabilitation administration, fatigue prevention, and sports training assessment. So far, such researches are extremely limited due to lacking of reliable, stable and comfortable plantar pressure sensors. Herein, a strategy for preparing high compression strength and resilience conductive iongels has been proposed by implanting physically entangled polymer chains with covalently cross-linked networks. The resulting iongels have excellent mechanical properties including nice compliance (young’s modulus < 300 kPa), high compression strength (>10 MPa at a strain of 90 %), and good resilience (self-recovery within seconds). And capacitive pressure sensor composed by them possesses excellent sensitivity, good linear response even under very small stress (∼kPa), and long-term durability (cycles > 100,000) under high-stress conditions (133 kPa). Then, capacitive pressure sensor arrays have been prepared for high-precision detection of plantar pressure spatial distribution, which also exhibit excellent sensing performances and long-term stability. Further, an extremely sensitive and fast response plantar pressure monitoring system has been designed for monitoring plantar pressure of foot at different postures including upright, forward and backward. The system achieves real-time tracking and monitoring of changes of plantar pressure during different static and dynamic posture processes. And the characteristics of plantar pressure information can be digitally and photography displayed. Finally, we propose an intelligent framework for real-time detection of plantar pressure by combining electronic insoles with data analysis system, which presents excellent applications in sport trainings and safety precautions.

Women in child search: a gendered view of post-World War II reconstruction

ABSTRACT One of the most crucial sections of the International Tracing Service, centralized and established in 1948, was the Child Search Branch (CSB), which had the emotionally and ethically complex task of assisting ‘unaccompanied children’ who were discovered in far larger numbers after 1945 than anyone had expected. This article examines the role of three women relief workers who ran the CSB in the post-war period: Eileen Blackey, Cornelia Heise and Eileen Davidson. Focusing mainly on these exemplary cases, the authors evaluate and centre the women’s leadership and decisions, showing how women who worked for the CSB played roles that subverted the general rule in the United Nations Relief and Rehabilitation Administration (UNRRA) and its successor organization, the International Refugee Organization (IRO), which was that women were directed into ‘feminine’ posts. Women who ran the CSB played senior roles in child search and welfare and the decisions they took had significant and crucial outcomes for children, although gendered assessments of ‘carer’ and ‘feminine’ roles in UNRRA/IRO more widely have thus far hidden their activities as a subject worthy of analysis. This article shows how gender affected the spheres of influence the women carved out as they contributed to post-war reconstruction and humanitarian aid.

Reclaiming the History of the Maritime Marshland Rehabilitation Administration

Reclaiming the History of the Maritime Marshland Rehabilitation Administration

Exhibiting the Missing: The World Jewish Congress’ London Exhibition of 1947, ‘Search for the Scattered’

ABSTRACT In June 1947, the World Jewish Congress (WJC) launched an exhibition in London titled ‘Search for the Scattered.’ Some of the materials on display were loaned to the WJC by the United Nations Relief and Rehabilitation Administration (UNRRA)’s Central Tracing Bureau (CTB), the predecessor to the International Tracing Service (ITS). The exhibition presented a detailed accounting of the vital work of both the CTB and the WJC. This paper argues, on the basis of the limited documentation that remains, that the ‘Search for the Scattered’ exhibition was a site of postwar knowledge production and transnational exchange that served a practical purpose: facilitating searching by addressing visitors as potential enquirers and reproducing the material culture of the search for visitors to view, read, handle, and understand. Like lists of names that were posted in DP camps, the exhibition can also be read as an early marker of the emotive power of name lists; in Leora Auslander’s words, commemorative markers of ‘a shared fate and common tragedy.’ Although tracing work has been infrequently a focus in the historiography of the Holocaust, the staging of this exhibition demonstrates early recognition of the significance of the WJC’s and CTB’s tracing work and the need for its wider acknowledgement, and suggests the reconstructive and restorative nature of the search itself.

The Race for Rehabilitation: Sign-Mime, the National Theatre of the Deaf, and Cold War Internationalism

In 1967, the US Vocational Rehabilitation Administration (VRA) awarded $331,000 to the Eugene O'Neill Memorial Theatre Foundation to fund a new company, the National Theatre of the Deaf. Endowing such an enterprise was bold, but not entirely unprecedented for this federal agency tasked with restoring disabled Americans to productive employment. Founded in 1920, the federal–state vocational rehabilitation program, or VR, ascended to institutional and ideological prominence during World War II and maintained this position well into the 1960s and beyond. VR distinguished itself not only through positing competitive employment as the solution to disabled Americans’ dependence on the state, but the specific means through which it would restore the disabled to productivity: the multidisciplinary expertise of physicians, psychologists, physical therapists, and rehabilitation counselors who collectively sought to render rehabilitants employable through a series of therapeutic interventions. Whereas disability activists focused on combatting the structural barriers disabled workers experienced in the labor market, “rehabilitationists” emphasized the imperative for disabled people to acclimate to existing work environments through individual physical and psychological transformation.

UNRRA in North Africa: A late colonial history of refugee encampment

Abstract This article tells the story of two long-forgotten United Nations Relief and Rehabilitation Administration (UNRRA) camps in wartime French North Africa, using their history as a lens through which to view the emergence of a modern global regime of refugee encampment. It examines these camps’ entanglements with the mechanisms of late colonial rule; their resonances with the systems of detention articulated by the Third Reich and its Vichy collaborationists; their rehabilitation of the practice of encampment for post-war colonial ‘development’ schemes like French Algeria’s centres de regroupement; and their eventual clearing of the way for the Cold War–era extension of an internationalist, American-dominated regime of refugee internment, first into Tunisia and Morocco and later across much of the Global South. Through its attempt to present its North African refugee camps as a new, modern, humanitarian form of encampment, UNRRA managed to rehabilitate the old colonial strategy of migrant internment as fundamentally humanitarian rather than punitive, successfully eliding its relationships with Nazi and Vichy practices in the process and establishing encampment as a central strategy of the modern internationalist refugee regime for the era of decolonization.

Forced Migration and Refugee Resettlement in the Long 1940s: An Introduction to Its Connected and Global History

AbstractWhen considering the wave of forced migrations during the Second World War in Europe and Asia, and the international and institutional responses thereof, we can speak about the 1940s as witnessing the birth of a global refugee resettlement regime. Organisations including the United Nations Relief and Rehabilitation Administration (UNRRA), the International Refugee Organization (IRO), and eventually the United Nations High Commissioner for Refugees (UNHCR) placed refugee resettlement at the heart of constructing the postwar world order. This volume adopts a global optic to investigate the formation of this international resettlement regime in Europe and Asia, while also studying refugee camps and movements, agency of refugees and migrants, decision factors for resettlement, and the intellectual production of people on the move. A historicisation of the global resettlement regime of the long 1940s may well carry important political and ethical lessons for us today, if only to remind us of the connected fates of our common humanity, and the responsibilities we therefore bear towards our fellow human beings.

From POW to Cold War DP: A Global Microhistory of Former Yugoslav Soldiers in Occupied Germany, 1946–48

AbstractThere are still many historical blind spots in research on Europe's displaced persons (DPs) after the Second World War. In particular, there are relatively few studies that link microhistorical perspectives on repatriation and resettlement with global contexts. This essay addresses this gap, in empirical as well as methodological terms, by focusing on a group of DPs that hitherto has received little attention from scholars: former members of the Royal Yugoslav Army, whom the Nazis had taken to Germany as prisoners of war (POWs). Classified as DPs after 1945, they lived in camps administered by the United Nations Relief and Rehabilitation Administration (UNRRA) and the International Refugee Organization (IRO). Under the circumstances, they continued to maintain military-like routines and fiercely refused repatriation. This was partly an expression of loyalty to the exiled Yugoslav king, Peter II. But it also mirrored the fears of DPs about—and resistance to the idea of—being returned to their homeland in the context of the early Cold War. Using the example of a DP camp in Bad Aibling (Upper Bavaria), this article connects Yugoslav DPs, Allied DP politics, and the interests of Tito's government, as well as the interventions of international relief agencies. It shows how some DPs adroitly subverted the international logic of DP self-governance as promoted by UNRRA. A global microhistory approach thus reveals how local actors and sites are shaped by, but also foundationally constitutive of, global regimes of migrational self-governance.

A low-cost virtual coach for 2D video-based compensation assessment of upper extremity rehabilitation exercises

BackgroundThe increasing demands concerning stroke rehabilitation and in-home exercise promotion grew the need for affordable and accessible assistive systems to promote patients’ compliance in therapy. These assistive systems require quantitative methods to assess patients’ quality of movement and provide feedback on their performance. However, state-of-the-art quantitative assessment approaches require expensive motion-capture devices, which might be a barrier to the development of low-cost systems.MethodsIn this work, we develop a low-cost virtual coach (VC) that requires only a laptop with a webcam to monitor three upper extremity rehabilitation exercises and provide real-time visual and audio feedback on compensatory motion patterns exclusively from image 2D positional data analysis. To assess compensation patterns quantitatively, we propose a Rule-based (RB) and a Neural Network (NN) based approaches. Using the dataset of 15 post-stroke patients, we evaluated these methods with Leave-One-Subject-Out (LOSO) and Leave-One-Exercise-Out (LOEO) cross-validation and the F_1 score that measures the accuracy (geometric mean of precision and recall) of a model to assess compensation motions. In addition, we conducted a pilot study with seven volunteers to evaluate system performance and usability.ResultsFor exercise 1, the RB approach assessed four compensation patterns with a F_1 score of 76.69 %. For exercises 2 and 3, the NN-based approach achieved a F_1 score of 72.56 % and 79.87 %, respectively. Concerning the user study, they found that the system is enjoyable (hedonic value of 4.54/5) and relevant (utilitarian value of 4.86/5) for rehabilitation administration. Additionally, volunteers’ enjoyment and interest (Hedonic value perception) were correlated with their perceived VC performance (rho = 0.53).ConclusionsThe VC performs analysis on 2D videos from a built-in webcam of a laptop and accurately identifies compensatory movement patterns to provide corrective feedback. In addition, we discuss some findings concerning system performance and usability.

Ernest Weissmann’s Architectural and Planning Practices

Architect Ernest Weissmann (1903-1985) dedicated his career to improving the living conditions of the deprived population - before and immediately after World War II in Europe and the United States and, starting from the 1950s and owing to senior positions he held at the United Nations Department of Social Affairs [UN DESA], also in underdeveloped countries in Asia, Africa, and Latin America. The means by which he tried to achieve it were type projects flexible enough to respond to each individual case, education, teamwork, and self-help approach. The latter was thought to strengthen the local communities, their experts, resources, and production. Relying on the research on Weissmann’s pre-UN DESA career, this paper argues that Weissmann formulated most of his ideas, in particular self-help, and the above-mentioned methods, and put them into practice and an international perspective, before 1951 thanks, to his collaboration with Le Corbusier, the School of Public Health in Zagreb, the International Congress of Modern Architecture [CIAM], New York-based Structural Study Associates [SSA] group, Board of Warfare, and United Nations Relief and Rehabilitation Administration [UNRRA].

Picturing Displaced Persons (DPs), Exhibiting French Prestige?

This article explores how photography documenting humanitarian aid in French-occupied Germany was mobilized to enhance France’s image, against the backdrop of increasing anxieties about its international standing. It draws on images found in the archives of the United Nations Relief and Rehabilitation Administration and the French occupation zone , which sat between the ‘official’ and the ‘private’. In doing so, it calls for a recognition of the role of amateur and relief workers photographers in sustaining post-war visual discourses of internationalism and national-self fashioning. Although largely overlooked today, these images play a role in wider debates about what it meant to be ‘French’ in the aftermath of the Nazi occupation. Relief workers and amateur photographers built on and reproduced aspects of the widely disseminated narrative about the universalism of resistance to disrupt images of the zone as a refuge for wartime collaborators. This neglected aspect of humanitarian imagery offers fresh insights into the contribution of these photographers to post-war diplomatic strategies.

Anglo-Jewish Humanitarianism and the Jewish Relief Unit, 1943–1950

Abstract The Jewish Relief Unit (JRU) was an Anglo-Jewish humanitarian agency of 213 members that operated across Europe during 1945/50, particularly in the British Zone of Occupation in Germany. JRU staff cared for the hundreds of thousands of Jewish Displaced Persons (DPs) who lingered in United Nations Relief and Rehabilitation Administration (UNRRA) assembly centres such as Belsen before their eventual departure for the United States or the new state of Israel. The JRU has remained a somewhat understudied body relative to other Jewish organizations active in DP camps and this article, based on personnel files and field reports archived at London’s Wiener Library and the London Metropolitan Archives, centres JRU aid workers as valuable objects of study in their own right, in line with increased historiographical interest in the backgrounds and world-views of postwar UNRRA operatives. Through an emphasis on materials related to and produced by individual JRU staff members and on the intimate and everyday character of their work, this article suggests that the JRU work among Jewish DPs in Germany was more substantive and consequential than has often been appreciated. More broadly, the work of the JRU is suggestive of the significance of humanitarian relief and reconstruction to postwar Jewish revival in Germany.

Whither the Refugees? International Organisations and “Solutions” to Displacement, 1921–1960

Abstract Achieving “durable solutions” is a central goal of the contemporary refugee regime. Durable solutions are often equated with three routes to resolving displacement—voluntary repatriation, local integration or resettlement—and the concept is closely tied to ideas about permanency, protection, and the rectification of refugees’ legal limbo. Despite its contemporary prominence, the genealogy of the concept of durable solutions has not been fully considered. Accordingly, this article traces the origins of the concept of durable solutions for refugees from 1921 to 1960, examining how such solutions have been framed in international law and through the work of a key set of international organisations: the League of Nations, the UN Relief and Rehabilitation Administration, the International Refugee Organization, the UN Conciliation Commission for Palestine, the UN Relief and Works Agency for Palestine Refugees in the Near East, and the Office of the UN High Commissioner for Refugees. By historicising durable solutions discourse as it evolved in the inter-war, immediate post-Second World War and early Cold War eras, and analysing how different international organisations have understood the “refugee problem” and solutions to it, this article promotes critical (re)engagement with the very notion of durable solutions, and demonstrates how the contemporary trinity of voluntary repatriation, local integration, and resettlement emerged from earlier approaches shaped by geo-political and legal considerations tied to particular groups of refugees.

International Food and Medical Relief. UNRRA (1943-47) and the New Global Order

During the Second World War several initiatives in Britain and the US carried out a prospective analysis of famine and nutritional relief in occupied countries. The results were devastating. Food aid programmes were launched, refugee camps opened for displaced people and health services established. With contributions from the countries involved, the United Nations Relief and Rehabilitation Administration (UNRRA) was approved in Washington (November 1943)by the United Nations’ forty-four members and associated countries afteran initial agreement between the British and the US administrations. This article aims to discuss the political tensions around UNRRA and its technical work, especially in international food relief.

ДЕЯТЕЛЬНОСТЬ ЮНРРА В ПОЛЬШЕ 1945-1947 гг.: УСПЕХИ И ПРОВАЛЫ МЕЖДУНАРОДНОЙ ГУМАНИТАРНОЙ МИССИИ

The article is devoted to the activities of the mission of the United Nations Relief and Rehabilitation Administration (UNRRA) in Poland. The history of UNRRA characterizes the development of humanitarian activity on truly international basis, it also allows us to trace the tasks and priorities of post-war planning and reconstruction process. The main efforts of the organization were concentrated on the situation at the European continent. Providing assistance to Poland as one of the hardest-hit countries in the war whose fate has also caused political controversy, was a serious test for the UNRRA. The article is based on American and Soviet diplomatic documents, as well as materials from the UN archive; sources give us reason to conclude that the main difficulties of the organization included agreement on the deployment of the mission, as well as planning supplies. The authors characterize the main directions of the mission's activities in 1945-1947, present information on the volume and structure of humanitarian aid supplies to Poland. Archival documents of UNRRA provided a basis for studying the activities of the organization aimed at stimulating the process of repatriation to Poland. Humanitarian aid and funding of programs through the organization made it possible to stabilize the situation and minimize the negative consequences of war in Poland. UNRRA's international approach has been both a strength and a weakness of the organization. On the one hand, the international approach contributed to an effective response to political challenges and logistical problems. On the other hand, the interaction of the USSR and the USA in one organization inevitably led to an aggravation of political contradictions regarding the goals and objectives of the organization's activities in a particular region.

Defining the ‘best interests’ of children during the post-1945 transformations in Europe

After World War II, the welfare workers of the United Nations Relief and Rehabilitation Administration and International Refugee Organization took care of refugee children in post-war Germany and assisted them in returning to their home countries. This article analyses the changes in welfare workers’ decisions about the future of unaccompanied displaced children of presumably Ukrainian origin in the light of the post-1945 transformations. It explores the relationship of transformations in the humanitarian approach to child resettlement with geopolitical ruptures between the former Allies after 1945. It aims to demonstrate that by 1947, welfare workers’ preconceived notion that the ‘best interests’ of Ukrainian children were served by reconnecting them with family and homeland, wherever possible, had given way in the face of political transformations that welfare workers confronted on the ground during the transition from war to peace. Despite their deep commitment to restoring children to their national and familial roots, they soon began to consider that allowing Ukrainian refugee children to emigrate was better for them than their repatriation to Soviet Ukraine.

The "Penicillin Project" of the he United Nations Relief and Rehabilitation Administration as a factor of aggravation of the Soviet American relations

The analysis of the declassified documents of the Russian State Archive of Economics and the State Archive of the Russian Federation made it possible to establish that the project of the United Nations Relief and Reconstruction Administration was not a priority in the USSR for supplying equipment for penicillin factories to the two Soviet republics. Of greater interest was the acquisition in the United States of expensive high-performance plant equipped with the latest machinery, albeit for cash payment. This prioritization affected time-frame and implementation progress of the UNRRA penicillin project and facilitated manipulation on part of the United States. In aggregate with distrust of the USSR in quality of the supplied equipment and the hope for alternative sources of obtaining necessary scientific and technical information, this resulted in loss of interest to this project. The turned out situation affected correspondingly on the attitude of the Soviet Government to the UNRRA missions operating on the territory of the Soviet Republics and to the leadership of the organization itself and contributed to the further exacerbation the of Soviet-American relations.