Rehabilitation Of Adult Patients Research Articles

Applying quantitative methods to the prediction of full functional recovery in adult rehabilitation patients

The purpose of this project was to construct a pilot prognostic index for use in research and clinical practice that would predict functional recovery in adult rehabilitation patients at discharge using clinical characteristics at admission to rehabilitation (independent performance of seven activities of daily living and three basic mobility tasks). We constructed the index from retrospectively collected data on 1,020 adult rehabilitation patients who underwent rehabilitation between 1980 and 1986. Adjusting for patient characteristics, the odds of recovering independent function doubled for each ten-point increase in the 100-point functional status score measured at admission to rehabilitation (odds ratio = 2.1, 95% confidence interval [CI] = 1.9 to 2.4). The odds increased by a factor of 1.9 (95% CI = 1.1 to 3.2) in patients with an impairment considered more functionally reversible and by a factor of 2.1 (95% CI = 1.3 to 3.4) in patients transferred from an acute hospital. The odds of functional recovery decreased in those over 79 years of age, in those who were unemployed before hospitalization, and as the number of comorbid conditions increased. Our findings demonstrate the feasibility of developing quantitative estimates of functional prognosis. Prior to use, the index should be externally validated in different rehabilitation facilities.

Clinical experiences with communication instruments in adults with sensorineural hearing loss.

Progress in the field of auditory rehabilitation of adult patients with sensorineural hearing loss has been made possible by combined contributions from technology, successively manufacturing better hearing aids and additional communication instruments, institutional arrangements and the achievements within clinical audiology, successively resulting in better knowledge of several basic diagnostic and therapeutic factors. Hearing aid fitting, as is well known, is still a controversial area because of many unknown factors. The same holds true for auditory training and speech reading, which have in practice been shown to be useful as a therapeutic complement to hearing aid fitting in many adult patients with sensorineural hearing loss. It was thus shown to be possible to fit the great majority of the patients with head-worn instruments. The variety of available alternatives within the communication instruments (vented molds, output-limiting devices, special microphones, CROS hearing aids) has increased the number of appropriately fitted patients. Special communications devices in addition to hearing aids for patients with difficulties to listen to signals, TV, etc., and complementary speech-reading treatment to severely hearing-impaired patients, have improved the listening situation of many patients. However, too much of clinical audiology is still based merely on clinical experience. To make progress in this field further research in clinical audiology is necessary in order to further clarify several diagnostic and therapeutic factors.

Assessment, Treatment and Rehabilitation of Adult Patients with Brain Damage

Brain damage has become an enormous social and economical load all over the world. There is an urgent need for research on prevention of brain damage. Accepted possibilities of prevention should be used more consciously in clinical practise. Full assessment of all functional disturbances caused by cerebrovascular accidents and brain injury is the first step to successful treatment and rehabilitation. The management in the early stage, the neurophysiology of regeneration after brain damage and therapeutic techniques used are discussed. The advantages of a combination of formal rehabilitation with a sound informal net-work of reliable persons around the patient are emphasized. Results concerning independence in daily living of a formal rehabilitation program as compaired to a group of patients who had only been treated in the acute hospital are presented. Also the possible value of a standardized neuropsychological assessment and a specifically designed neuropsychological training in addition to the allroun...