Rehabilitation Hospital For Patients Research Articles

Effect of in-patient cardiac rehabilitation at rehabilitation hospital for cardiology patients: two-center trial.

The effectiveness of cardiac rehabilitation (CR) in patients with cardiovascular disease requiring continuous CR from an acute care hospital to a convalescent rehabilitation hospital is unknown. Therefore, we compared the effect of CR in a rehabilitation hospital for patients with cardiovascular disease with that of those who underwent cardiovascular surgery. Sixty-nine consecutive patients were admitted to two rehabilitation hospitals for CR. Patients were classified by primary disease into two groups: patients with cardiovascular disease (cardiology group, 26 patients) and patients who underwent cardiovascular surgery (surgery group, 43 patients). Clinical information, physical function, cognitive function, activities of daily living (ADL), quality of life (QOL), amount of CR, and length of hospital stay were compared between the two groups. Compared with clinical features, age was significantly higher in the cardiology group (P < 0.001), and the preadmission Barthel index was significantly lower in the cardiology group (P = 0.025). Physical function at the time of transfer was significantly lower in the cardiology group than in the surgery group for the short physical performance battery (P < 0.001), gait speed (P = 0.005), and 6-min walking distance (P = 0.042). No significant difference was found in the amount of CR performed or the length of hospital stay, and no interaction effects were observed in improvements in physical function, exercise tolerance, or QOL. In conclusion, in rehabilitation hospitals, patients with cardiovascular disease were older, had lower preadmission ADL, and had lower a physical function at transfer than those who underwent cardiovascular surgery, but CR improved physical function and QOL to the same extent. The results suggest that the recovery of patients with cardiovascular disease may be similar to those who undergo cardiovascular surgery.

The Factors Influencing Selection for Rehabilitation Hospital After Stroke

Objectives: The purpose of this study was to investigate the factors influencing selection for rehabilitation hospital in patients who have been diagnosed with stroke.Methods: This study included 169 stroke patients who were admitted to the top 5 hospitals with the highest recovery rate among 13 hospitals where the rehabilitation medicine is operated as the main medical department in Daegu Metropolitan City. The data was collected from 10 February, 2020 to 17 March, 2020, and the survey was conducted by the head of the hospital administration in each hospital for about a month through face to face.Results: Among the factors influencing selection for rehabilitation hospital after stroke, image factors were at the highest mean and standard deviation (3.83 ± 0.74), following human factors (3.75 ± 0.77), physical factors (3.57 ± 0.89), efficiency factors (3.35 ± 0.69), accessibility factors (3.11 ± 1.00). In the demographic characteristics, human factors were considered important when selecting hospital in aged people over 70 years old (p&lt; 0.01). Efficiency factors and human factors were considered important if patients living outside Daegu (p&lt; 0.05), but accessibility factors were more important if patients living in Daegu (p&lt; 0.01). In the stroke related characteristics, the human factors were considered important in the shorter the disease period, and in the case of having swallowing disorders (p&lt; 0.05). When paralysis was affected on both sides (bilateral paralysis), physical factors were considered important (p&lt; 0.05), and efficiency factor was also considered important as the disease periods gets shorter (p&lt; 0.05). Efficiency factors and accessibility were important in the case of not having respiratory disorders compared to those with the respiratory disorders (p&lt; 0.05). The results of the factors for choosing a hospital according to the stroke diseases-related characteristics showed that human factors, physical factors, and hospital image factors were considered important in case of putting much of the efforts to gather hospital information (p&lt; 0.01). When the patients who had rehabilitation in the tertiary hospital prior to the current hospital admission, the physical factors were considered important (p&lt; 0.05).Conclusions: This study found that various factors were considered in patients who have been diagnosed with stroke, when selecting rehabilitation hospital after stroke. Therefore, it should be warranted to provide reliable and objective hospital information for stroke patients through establishing national level health system and sharing rehabilitation data so that the people can get effective rehabilitation at the right time.

Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients

BackgroundThe Canadian Occupational Performance Measure (COPM) is an individualized patient-reported outcome designed to evaluate the self-perceptions of a patient’s occupational performance. Our study aimed to examine the minimal important change (MIC) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using the three different anchor-based analyses with the transition index as an external criterion; the mean change method (MICMeanChange), the receiver operating characteristic (MICROC) analysis, and the predictive modeling method adjusted for the proportion of improved patients (MICadjust). In this study, the MICadjust value was considered as the most valid statistical method. We recruited 100 inpatients with various health conditions from subacute rehabilitation hospitals. Data were collected twice: an initial assessment and a reassessment one month later. The systematic interview format (Five Ws and How) was used for both the initial and second assessments to prevent information bias (response shift).ResultsThree patients who indicated deterioration on the transition index were excluded from all analyses, and 97 patients were analyzed in this study. The MICadjust values were 2.20 points (95% confidence interval 1.80–2.59) for the COPM performance score and 2.06 points (95% confidence interval 1.73–2.39) for the COPM satisfaction score. The MICMeanChange and MICROC values were considered less reasonable to interpret because the proportions of the improved patients subgroup were more than 50% (82.5%).ConclusionsThe MICadjust value estimates from this study can help detect whether the patients’ perceived occupational performance improved or did not change. The results support the multidisciplinary use of COPM in clinical practice and research on subacute rehabilitation inpatients.

Suitability of food in a rehabilitation hospital for patients with neurologic dysphagia.

Texture-modified food is a common strategy in dysphagia management for increasing safety of swallowing. It is essential for the patient to receive the prescribed diet based on clinical and instrumental examination of swallowing in order to be able to benefit from rehabilitation and avoid complications. Variations in terminology and definitions regarding texture-modified food and liquids demonstrate the need for international standardized terminology. We aimed to assess suitability of texture-modified diets used at a rehabilitation hospital in terms of the International Dysphagia Diet Standardization Initiative guidelines. A texture-modified main dish was analyzed for 5 days (15 samples of pureed and 10 samples of minced texture) at lunch time by 2 trained assessors using International Dysphagia Diet Standardization Initiative-recommended testing methods. The majority of pureed and minced food samples did not suit the comparable International Dysphagia Diet Standardization Initiative levels. The results underline the need for implementing the International Dysphagia Diet Standardization Initiative guidelines in order to provide an appropriate texture-modified diet for patients with neurogenic dysphagia and support dysphagia management within inpatient rehabilitation.

大腿骨近位部骨折術後患者における骨折前の外出状況と回復期リハビリテーション病院退院時の身体機能の回復との関連

大腿骨近位部骨折術後患者における骨折前の外出状況と回復期リハビリテーション病院退院時の身体機能の回復との関連

Immediate Effect of Denture Wearing on Swallowing in Rehabilitation Hospital Inpatients

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Poster 87: Frontal Plane Balance Control With Rollators: Perturbed Stance and Walking

Objective: To investigate whether balance control shifts from the feet to the hands with the use of a rollator (wheeled walker). Design: Repeated-measures randomized block design. Setting: Gait laboratory. Participants: 10 healthy young controls and 10 rehabilitation hospital inpatients who use a rollator for independent ambulation. Interventions: Participants were assessed in 2 tasks: (1) perturbation-evoked balance reactions (2 amplitudes: low, high) and (2) walking at a preferred speed (2 stance widths: preferred, zero step width).

Feasibility of swallowing interventions for tracheostomized individuals with severely disordered consciousness following traumatic brain injury

Primary objective : To report the ability of 12 tracheostomized acute rehabilitation hospital inpatients with severely disordered consciousness post-traumatic brain injury (TBI) to participate in an objective swallowing assessment. Research design : Post hoc analysis of data from a larger, prospective blinded comparison study. Methods and procedures : Subjects completed a modified barium swallow (MBS) study. Food/drink and tracheostomy tube management recommendations were made. Main outcomes and results : All subjects participated successfully during an MBS. Post-MBS, 10 subjects began receiving small amounts of food and/or drink. Prior to hospital discharge, all subjects received some food and/or drink and were extubated. Subjects were deemed representative of this patient population and, from a swallowing perspective, other tracheostomized patient populations at the same facility. Conclusions : Clinicians should routinely consider tracheostomized, acute rehabilitation hospital inpatients with severely disordered consciousness post-TBI potential MBS candidates. Implications and continued research needs are discussed.

Analgesic effectiveness of subcutaneous carbon-dioxide insufflations as an adjunct treatment in patients with non-specific neck or low back pain

Objectives: To evaluate the analgesic effectiveness of subcutaneous carbon-dioxide insufflations in addition to standard physical treatment in patients with non-specific neck or low back pain. Design: A pragmatic, randomized controlled trial. Setting: Rehabilitation hospital inpatients. Interventions: Patients received either subcutaneous carbon-dioxide insufflations (10 treatments) and standard physical treatment or standard physical treatment only. Outcome measures: Affective pain perception (42-point scale), sensory pain perception (30-point scale), pain intensity (100 mm visual analogue scale). Results: Between-groups differences were –2.2 [95% CI –5.2; +0.9] (affective pain perception), –1.2 [–3, 0; + 0.7] (sensory pain perception), and –6.5 [–14; +1.0] (pain intensity) respectively in favour of subcutaneous carbon-dioxide insufflations. Conclusions: Subcutaneous carbon-dioxide insufflations do not seem to be a worthwile adjunct in the given setting of inpatient rehabilitation. Trials in a monotherapeutic setting, which aim more at the efficacy of subcutaneous carbon-dioxide insufflations, might help to solve this issue.

Clostridium difficile-related disease: evaluation and prevalence among inpatients with diarrhea in two freestanding rehabilitation hospitals.

Clostridium difficile has been associated with diarrhea in hospitalized patients receiving antibiotic therapy, and may be nosocomially acquired. Rehabilitation hospital inpatients may require frequent antibiotic intervention and are thus at risk, though few reports of epidemics at such centers have been published. This study describes the evaluation and prevalence of C difficile-related disease, among rehabilitation hospital inpatients. A retrospective review was conducted of all diarrhea evaluations performed among inpatients in two freestanding rehabilitation hospitals over a two-year period. A total of 303 laboratory tests were performed among the 115 patients evaluated. C difficile was determined to be the etiologic agent of diarrhea in 25% of patients undergoing enteric evaluation, and in 39% of patients specifically assayed for C difficile toxin B. Giardiasis was detected in one patient, and no evidence of Salmonella, Shigella, Campylobacter, or Yersinia infection was found. The estimated prevalences for diarrhea and C difficile-related disease were 3.7% and 1.1%, respectively. Thus, C difficile is an important cause of diarrhea among rehabilitation hospital inpatients, though its true prevalence may be underestimated due to inadequate diagnostic evaluation. Enteric bacterial pathogens such as Campylobacter, Salmonella, Shigella, Yersinia, and Giardia are insignificant causes of diarrhea among these patients. Elimination of routine testing for these pathogens would reduce costs without compromising diagnostic utility. Diagnostic evaluation should include C difficile toxin assay, and if positive, appropriate therapy instituted.

Diarrhea in hospitalized patients.

Clostridium difficle has been associated with diarrhea in hospitalized patients receiving antibiotic therapy and may be nosocomially acquired. Rehabilitation hospital inpatients may require frequent antibiotic intervention and are thus at risk, although few reports of epidemics at such centers have been published. This study describes the impact of C. difficle-related disease among rehabilitation hospital inpatients. A retrospective review was conducted of all inpatients evaluated for diarrhea in two freestanding rehabilitation hospitals over a 13-month period. Clostridium difficle was determined to be the etiologic agent of diarrhea in 36% of the 33 patients, and no other etiologies were identified. Four patients were transferred to acute care because of the severity of symptoms. A total of 120 altered or canceled therapy sessions were observed to occur during the rehabilitative hospital course among studied patients, of which 90% (108) occurred during periods when patients were documented to have been symptomatic for diarrhea. Diarrhea and C. difficile-related disease thus appear to exert an important and adverse impact on the hospital course of these patients, both in terms of medical complications and therapy attendance. Physicians should therefore possess a heightened index of suspicion for C. difficile infection when evaluating patients with diarrhea in this setting. Diagnostic evaluation of rehabilitation hospital inpatients with diarrhea should include C. difficile toxin assay. If the results of the toxin assay are positive, appropriate therapy, including initiation of oral vancomycin or metronidazole and avoidance of antimotility drugs, should be instituted promptly to minimize risk of potential sequelae.