Rehabilitation Literature Research Articles

The Principles of Effective Correctional Treatment Also Apply To Sexual Offenders

The effectiveness of treatment for sexual offenders remains controversial, even though it is widely agreed that certain forms of human service interventions reduce the recidivism rates of general offenders. The current review examined whether the principles associated with effective treatments for general offenders (risk-need-responsivity; RNR) also apply to sexual offender treatment. Based on a meta-analysis of 23 recidivism outcome studies meeting basic criteria for study quality, the unweighted sexual and general recidivism rates for the treated sexual offenders were lower than the rates observed for the comparison groups (10.9%, n = 3,121 vs. 19.2%, n = 3,625 for sexual recidivism; 31.8%, n = 1,979 vs. 48.3%, n = 2,822 for any recidivism). Programs that adhered to the RNR principles showed the largest reductions in sexual and general recidivism. Given the consistency of the current findings with the general offender rehabilitation literature, the authors believe that the RNR principles should be a major consideration in the design and implementation of treatment programs for sexual offenders.

And they shall walk: ideal <i>versus</i> reality in polio rehabilitation in the United States

This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

Reference accuracy in four rehabilitation journals

Objective: To investigate the incidence of reference errors in major peer-reviewed general physical therapy and rehabilitation journals (American Journal of Physical Medicine and Rehabilitation (AJPMR), Archives of Physical Medicine and Rehabilitation (APMR), Clinical Rehabilitation (CR) and Physical Therapy (PT)). Design: Descriptive, comparative. Main outcome measures: All issues of the AJPMR, APMR, CR and PT between 2003 and 2007 were studied. For each journal, references from articles were consecutively numbered, and using a random number generator, 100 references were selected from each journal. For each reference, ease of retrieval on MEDLINE and the presence of citation errors were noted. If discrepancies were identified, the reference was compared with the original publication. Two observers independently evaluated each reference for citation errors. Results: The total number of citations with errors among all published journals was 123 (30.7%). The reference error rates by journal ranged from 23% to 44%. Most errors (48.0%) occurred in the author element, followed by the title (31.7%), journal (8.9%), page (5.7%), year (4.1%), and volume (1.6%). Only 8 (2%) were likely to make retrieval of the reference difficult. Conclusions: Errors in references still appear in current physical therapy and rehabilitation literature, but most are not severe.

The Value of “Traditional” Reviews in the Era of Systematic Reviewing

Reviews offer examinations of published material on a topic, and are becoming indispensable in keeping up with an exponentially growing rehabilitation literature. Adherents of the systematic reviews that support evidence-based practice have been quite dismissive of narrative (traditional, qualitative, and nonsystematic) reviews. However, the types of problems that plague the latter may also be found in systematic reviews, which, in addition, have problems of their own. It is argued here that reviews play a number of roles in scientific research and professional practice such as answering specific clinical questions, pooling data, comparing research, synthesizing complementary studies, offering guidance in uncharted fields, and "translating" research between disciplinary traditions. For some of these purposes, systematic reviews are better; for others, a narrative review is more suitable. Both types can be improved to serve the reader better in keeping up with the literature.

Identifying and applying psychological theory to setting and achieving rehabilitation goals

Background: Goal setting is considered to be a fundamental part of rehabilitation; however, theories of behaviour change relevant to goal-setting practice have not been comprehensively reviewed. Objectives: (i) To identify and discuss specific theories of behaviour change relevant to goal-setting practice in the rehabilitation setting. (ii) To identify `candidate' theories that that offer most potential to inform clinical practice. Methods: The rehabilitation and self-management literature was systematically searched to identify review papers or empirical studies that proposed a specific theory of behaviour change relevant to setting and/or achieving goals in a clinical context. Data from included papers were extracted under the headings of: key constructs, clinical application and empirical support. Results: Twenty-four papers were included in the review which proposed a total of five theories: (i) social cognitive theory, (ii) goal setting theory, (iii) health action process approach, (iv) proactive coping theory, and (v) the self-regulatory model of illness behaviour. The first three of these theories demonstrated most potential to inform clinical practice, on the basis of their capacity to inform interventions that resulted in improved patient outcomes. Conclusions: Social cognitive theory, goal setting theory and the health action process approach are theories of behaviour change that can inform clinicians in the process of setting and achieving goals in the rehabilitation setting. Overlapping constructs within these theories have been identified, and can be applied in clinical practice through the development and evaluation of a goal-setting practice framework.

Autonomic dysreflexia and associated acute neurogenic pulmonary edema in a patient with spinal cord injury: a case report and review of the literature

A case report of a patient with spinal cord injury with autonomic dysreflexia and associated acute neurogenic pulmonary edema. To further describe autonomic dysreflexia as a potential cause of acute neurogenic pulmonary edema; specifically in a population with spinal cord injury. James A Haley Veterans Hospital, Tampa, FL, USA. A patient with a prior history of C5 AIS (ASIA impairment scale) B spinal cord injury was admitted for bowel preparation before a screening colonoscopy. During the 2-day bowel preparation, the patient developed severe autonomic dysreflexia. Due to persistent hypertension and acute onset respiratory failure, he required transfer to the intensive care setting. Following a complicated course, the patient expired without a definitive cause of death. Autopsy findings showed gross and microscopic evidence of pulmonary edema. To date, the association between autonomic dysreflexia and acute neurogenic pulmonary edema is not described in the spinal cord or rehabilitation literature. The purpose of this case report is to further describe the overlooked and/or under reported incidence of acute neurogenic pulmonary edema associated with episodes of dysreflexia in a population with spinal cord injury.

When is a case-control study not a case-control study?

There is confusion in the rehabilitation literature about case-control studies because terms such as "cases" and "controls", used to refer to the subjects in the study, are confused with the design of the study. The aim of this study was to estimate the extent to which the label "case-control study" is misused in the rehabilitation literature and in the literature of other health disciplines. A structured review revealed 7 rehabilitation journals, which, during the period 2000-2006, published 86 research articles in which the key word "case-control" or "case control" appeared in the title or abstract. For comparison purposes, other English language journals whose titles began with "Archives of" were also searched. The proportion of mislabeled case-control studies in rehabilitation journals was 97% (83 of 86 studies were mislabeled). In contrast, 34% (76 of 221) of case-control studies published in the sample of non-rehabilitation journals were found to be mislabeled. The most frequent type of rehabilitation study misclassified as case-control was a cross-sectional study (56/86) followed by intervention studies (13/86). The extent of mislabeling indicates that the case-control design is poorly understood by the rehabilitation community. This is not solely an issue of semantics; mislabeling led to misinterpretation of findings. In rehabilitation, the research questions answered by case-control studies, regarding the etiology of health events, are rarely posed. Rehabilitation researchers must be attentive to issues of design and report correctly on design in publications.

The Canadian Occupational Performance Measure: A tool for recovery-based practice.

This paper discusses the Canadian Occupational Performance Measure (COPM) which is a tool that supports goal setting and the assessment of change with an individual participating in daily activity. The purpose of the paper is to examine the Canadian Occupational Performance Measure as a potential tool for use in psychiatric rehabilitation and recovery-oriented services. The paper considers the theoretical orientation of the Canadian Occupational Performance Measure and describes the instrument's structure and properties. In addition, there is a delineation of the instrument's utility in mental health and an examination of its relationship to psychiatric rehabilitation and recovery principles. The paper uses existing research on the instrument, examines psychosocial rehabilitation literature, and reflects on consultation with local and international researchers/practitioners. The Canadian Occupational Performance Measure is designed to foster partnership between clients and practitioners and it encourages identification of occupationally-focused issues and goals. This instrument promotes an agenda of participation, resumption of life roles, and inclusion in environments of choice.

Effectiveness of cognitive rehabilitation following acquired brain injury: A meta-analytic re-examination of Cicerone et al.'s (2000, 2005) systematic reviews.

The present study provides a meta-analysis of cognitive rehabilitation literature (K = 115, N = 2,014) that was originally reviewed by K. D. Cicerone et al. (2000, 2005) for the purpose of providing evidence-based practice guidelines for persons with acquired brain injury. The analysis yielded a small treatment effect size (ES = .30, d(+) statistic) directly attributable to cognitive rehabilitation. A larger treatment effect (ES = .71) was found for single-group pretest to posttest outcomes; however, modest improvement was observed for nontreatment control groups as well (ES = .41). Correction for this effect, which was not attributable to cognitive treatments, resulted in the small, but significant, overall estimate. Treatment effects were moderated by cognitive domain treated, time postinjury, type of brain injury, and age. The meta-analysis revealed sufficient evidence for the effectiveness of attention training after traumatic brain injury and of language and visuospatial training for aphasia and neglect syndromes after stroke. Results provide important quantitative documentation of effective treatments, complementing recent systematic reviews. Findings also highlight gaps in the scientific evidence supporting cognitive rehabilitation, thereby indicating future research directions.

Introduction to the use of Rasch analysis to assess patient performance

Background: Rasch analysis is a statistical model used to develop assessment tools to effectively measure change in human attributes. It has a number of advantages compared to other statistical approaches; the most important of these is that it enables the development of assessments that more accurately quantify patient performance. Content: This article will discuss issues of measurement in rehabilitation, describe the advantages of Rasch analysis and illustrate these with examples from the rehabilitation literature. Discussion and conclusions: An understanding of Rasch analysis will assist clinicians to make informed decisions about selection of assessment tools that will provide the most accurate measurement of their patient’s performance and better support decision making regarding patient eligibility, progress and discharge. This information will also assist clinicians in critically analysing research evidence where assessment tools are used to generate data for comparative analysis.

White Privilege: A Primer for the Vocational Rehabilitation Counselor

Vocational rehabilitation outcome discrepancy studies point to a lingering disparity in outcomes between Northern European- Americans (white) and racial minority groups in the United States. Despite the history of the study of white privilege and its impact in many fields and disciplines, the possible connection between vocational rehabilitation outcome discrepancies and the values and attitudes engendered by white privilege are rarely discussed in rehabilitation literature. This paper explores the possible role of white privilege in disparities between vocational rehabilitation outcomes experienced by racial minorities and those experienced by whites.

Recent Advances and Future Directions in Aphasia Therapy

AbstractThis article reviews literature in aphasia rehabilitation in the English-speaking world. Although attempts have been made to incorporate literature from other continents, the major bias is toward North America. Four themes are emphasised. They are (1) advances in neuroscience that have already realised influences in language rehabilitation and some that have potential influence for the near future; (2) effects on language rehabilitation that have resulted from the worldwide acknowledgment and acceptance of the International Classification of Functioning, Disability, and Health (ICF); (3) the growing emergence of psychosocial concerns in the management of aphasia; and (4) present and future applications of technology to aphasia rehabilitation. For the sake of manageability, the review is largely limited to the rehabilitation literature of the decade from 1998, and to published or in-press work that is programmatic in the sense that it represents more than a single publication.

Approaching in the right spirit: Spirituality and hope in recovery from mental health problems

Aims Research indicates that having an active spiritual or religious life and sense of hope is highly protective against a wide range of problems throughout the life cycle. However, the two important domains of spirituality and hope have received limited coverage in mental health rehabilitation literature. Therefore the authors sought to discuss the role of spirituality and hope for people with mental health problems, and propose a process for practice which uses these concepts. Methods A discussion on the role of spirituality and hope in mental health rehabilitation is presented. The authors explore how spirituality has been defi ned in the literature, and its role in recovery from illness. The concept of hope in relation to spirituality and mental illness is discussed. Finally the authors propose how rehabilitation practitioners can apply these concepts in practice, in both assessment and interventions. Findings and conclusions This article highlights the importance of including spirituality and hope in assessment and treatment in order to move towards a recovery-orientated health-care service. The role of hope in assisting practitioners to be sensitive to the spiritual needs of clients is demonstrated.

Vitamin-D-Mangel und seine Folgen für die Rehabilitation

Ziel: Ein Vitamin-D-Mangel, der durch zu wenig Kontakt mit Sonnenstrahlen, ungenügende Aufnahme durch die Ernährung oder Absorptionsschwierigkeiten entstehen kann, ist in der publizierten Literatur aus dem Bereiche der Rehabilitation nur spärlich erwähnt. Der Vitamin-D-Mangel wird in der Rehabilitationsmedizin selten bedacht. Dies ist problematisch, denn ein Vitamin-D-Mangel kann sich in Form von Schmerzen am Bewegungsapparat manifestieren; solche Schmerzen kommen sowohl bei ambulanten als auch bei stationären Rehabilitationspatienten häufig vor. Die Bevölkerungen mit dem höchsten Risiko sind häuslich gebundene ältere Menschen; Menschen mit pigmentierter Haut; Menschen, die aus kulturellen oder gesellschaftlichen Gründen die Sonne meiden; in winterlichem Klima über oder unter dem Breitengrad von 35° leben, sowie Menschen mit schlechter gastrointestinaler Absorption.

Participation Following Traumatic Spinal Cord Injury: An Evidence-Based Review for Research

Background/Objective: To report an evidence-based review of participation instruments that have been used in spinal cord injury (SCI) clinical practice and research.Methods: Rehabilitation literature was searched for instruments used by at least 2 independent SCI researchers since 2000. Each instrument was reviewed by 2 committee members. One person reviewed the scale and documented the level of use and psychometric properties. The second committee member verified the values and made suggestions for changes.Results: Three instruments met the review criteria: Craig Handicap Assessment and Reporting Technique (CHART), Assessment of Life Habits (LIFE-H), and the Impact on Participation and Autonomy (IPA). Each instrument incorporates different perspectives in the measurement of participation. The LIFE-H uses a qualitative approach, whereas the CHART adopts a quantitative approach; both are based on societal norms of participation. In contrast, the IPA integrates individual choice and control in defining participation. CHART is the most widely used instrument, although its development predates the development of the ICF. The IPA is a relatively new instrument, and its psychometric properties have only recently published.Conclusions: Continuing research is needed to develop conceptually and psychometric valid measures of participation for use with people with SCI. Priorities include understanding the relationship between objective and subjective indicators of participation, describing the dimensions of participation, and identifying appropriate measurement models and psychometric approaches to evaluate the nonhierarchical character of participation. Researchers and clinicians should be aware of the strengths and limitations of existing measures to make informed decisions about appropriate instruments.

The empowerment of people with disabilities through qualitative research

The purpose of this article is to explore the use of qualitative research in vocational rehabilitation as a means of empowering people with disabilities to (a) take greater control of their lives and (b) directly inform public policy and vocational rehabilitation service delivery. After exploring various definitions of the construct empowerment, we provide a rationale for the use of qualitative research as an empowerment mechanism based on (a) philosophies espoused by leaders of the independent living movement, (b) disability legislation, and (c) a multi-constituency call for more consumer involvement in research. We then describe empirical properties of various qualitative methodologies that lend themselves to consumer empowerment. The article concludes with several examples of qualitative approaches to scientific inquiry from the rehabilitation literature that include many of the empowerment aspects described herein.

Recognizing and Responding to Early Psychosis: A Qualitative Analysis of Individual Narratives

Recognizing and Responding to Early Psychosis: A Qualitative Analysis of Individual Narratives

Clinical Utility of Predictors of Return-to-work Outcome Following Work-related Musculoskeletal Injury

Clinical expertise is one source of evidence that is generally under-utilised in the development of an evidence-base in rehabilitation. The current study aimed to incorporate this valuable clinical expertise in determining the utility of multiple predictors of return-to-work outcome following injury. Following systematic review of the rehabilitation literature and review, a total of 85 predictors were evaluated for clinical relevance by an expert panel of rehabilitation practitioners (n = 12). Each predictor was rated according the importance of the predictor in rehabilitation, its potential for modification and its classification into one of seven broad areas. In addition, practitioners were asked to provide a rationale as to why the predictor was important to rehabilitation. Analyses were conducted using inter-rater agreement statistics and text analysis. Predictors that were most commonly reviewed in the literature were not considered to be of greatest clinical utility, according to the current sample. From the total predictor set, only nine predictors were identified as clinically useful (i.e., both highly important and highly modifiable). Text analysis of the qualitative data revealed that these nine predictors highlighted the significance of time, context and engagement in rehabilitation practice. In the current study, predictors that were considered most clinically relevant were those that generally described workplace related processes. The findings confirmed the underlying supportive and collaborative processes that integrate predictors and account for their influence on outcome. Future rehabilitation efforts and indeed, individual outcomes, could benefit by incorporating these key predictors in targeted programs.

Interventions to Improve Employment Outcomes for Workers Who Experience Mental Illness

To review employment interventions for individuals who experience mental illness. I reviewed employment interventions described in the mental health, disability, and rehabilitation literature for the period 1990 to 2005 and organized these interventions into a framework. The framework develops 7 distinct individual-level employment interventions as well as interventions directed at the employer and at workplace organization. It also considers factors that will affect access to these interventions. Although there is a sense of optimism about the potential of these interventions, research in the area is limited. Physicians who are knowledgeable about the nature and scope of employment interventions for individuals with mental illness are in a good position to effect positive change in the work lives of the individuals they serve.

Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines

Pulmonary rehabilitation has become a standard of care for patients with chronic lung diseases. This document provides a systematic, evidence-based review of the pulmonary rehabilitation literature that updates the 1997 guidelines published by the American College of Chest Physicians (ACCP) and the American Association of Cardiovascular and Pulmonary Rehabilitation. The guideline panel reviewed evidence tables, which were prepared by the ACCP Clinical Research Analyst, that were based on a systematic review of published literature from 1996 to 2004. This guideline updates the previous recommendations and also examines new areas of research relevant to pulmonary rehabilitation. Recommendations were developed by consensus and rated according to the ACCP guideline grading system. The new evidence strengthens the previous recommendations supporting the benefits of lower and upper extremity exercise training and improvements in dyspnea and health-related quality-of-life outcomes of pulmonary rehabilitation. Additional evidence supports improvements in health-care utilization and psychosocial outcomes. There are few additional data about survival. Some new evidence indicates that longer term rehabilitation, maintenance strategies following rehabilitation, and the incorporation of education and strength training in pulmonary rehabilitation are beneficial. Current evidence does not support the routine use of inspiratory muscle training, anabolic drugs, or nutritional supplementation in pulmonary rehabilitation. Evidence does support the use of supplemental oxygen therapy for patients with severe hypoxemia at rest or with exercise. Noninvasive ventilation may be helpful for selected patients with advanced COPD. Finally, pulmonary rehabilitation appears to benefit patients with chronic lung diseases other than COPD. There is substantial new evidence that pulmonary rehabilitation is beneficial for patients with COPD and other chronic lung diseases. Several areas of research provide opportunities for future research that can advance the field and make rehabilitative treatment available to many more eligible patients in need.