Rehabilitation Management Of Patients Research Articles

QOL-20. A REVIEW OF THE LITERATURE ON THE REHABILITATION OF PATIENTS WITH POSTERIOR FOSSA SYNDROME

Abstract BACKGROUND Posterior fossa syndrome (also recently described as pediatric postoperative cerebellar mutism syndrome) is a well described phenomenon, in which a patient develops a spectrum of speech and motor/coordination deficits generally in the acute stage after posterior fossa tumor resection. While most patients recover well, some patients evidence significant deficits years after diagnosis, and there is some evidence that minor long-term deficits may remain. While its frequency of occurrence is relatively low, and efforts have been made to identify strategies to decrease the rate of Posterior Fossa Syndrome, the fundamental interventions for functional optimization and rehabilitation of patients are still being discussed and researched. METHODS Along with reviewing the most up-to-date literature on the rehabilitation management of patients with posterior fossa syndrome, we will discuss current a survey based study designed by a group of representatives from the American Academy of Physical Medicine and Rehabilitation (AAPM&R) Pediatric Cancer Rehabilitation subcommittee, to better understand the standards of how the syndrome is managed by physiatrists in the US. This survey distributed via email, posting on an AAPM&R online community, as well as social media sites. RESULTS While literature is limited, there is evidence for the practice of therapy services, bracing, and in admission for acute inpatient rehabilitation to guide treatment for patients with posterior fossa syndrome. Results from the above survey study will be discussed, which preliminarily shows a consistent reliance on therapy services and a broader heterogeneity to frequency and treatment preferences among physicians in the US. CONCLUSION Posterior Fossa Syndrome can be a challenging and debilitating disorder for pediatric brain tumor patients. Further research into treatment options and outcomes is necessary to guide future management.

Rehabilitation management of patients with spinal tuberculosis (Review)

Rehabilitation management of patients with spinal tuberculosis (Review)

Application of E-coach chronic disease management model in rehabilitation management of patients with arteriosclerosis obliterans

ObjectiveTo explore the effect of a health (E)-coach chronic disease management model on the rehabilitation behaviour management of patients with arteriosclerosis obliterans (ASO).MethodsThe E-coach chronic disease management model was constructed based on a literature review and expert interviews. The effect of the E-coach model on patients with ASO during hospitalisation was analysed by comparing the compliance rates of blood glucose control, blood pressure control, drug compliance, ankle-brachial index, 6-min walking test (6MWT) and pain-free walking distance (PFWD) scores between the E-coach and control groups.ResultsIn total, 212 patients with ASO were included in this study. After the intervention, the blood pressure compliance rate (44.8% vs. 65.7%) and blood glucose compliance rate (48.6% vs. 66.8%) were higher in the E-coach group than in the control group (p < 0.05). After intervention, compared with the control group, the patients in the E-coach group had better drug compliance (6.8 ± 1.9 vs. 7.9 ± 1.0), and the difference was statistically significant (p < 0.05). The scores for the 6MWT (329.19 ± 5.58 vs. 353.00 ± 9.76; 412.65 ± 12.59 vs. 499.16 ± 18.43) and PFWD (219.15 ± 11.96 vs. 225.36 ± 16.13; 331.62 ± 51.36 vs. 369.42 ± 75.71) tests were significantly higher in the E-coach group than in the control group at 1 and 6 months after intervention (p < 0.05).ConclusionThe E-coach chronic disease management model can effectively improve the control rates of blood glucose and blood pressure and the behaviour management of patients with ASO and is thus worthy of clinical reference.

Identification of Follow-Up Markers for Rehabilitation Management in Patients with Vestibular Schwannoma.

This study delves into the absence of prognostic or predictive markers to guide rehabilitation in patients afflicted with vestibular schwannomas. The objective is to analyze the reweighting of subjective and instrumental indicators following surgery, at 7 days and 1 month postoperatively. This retrospective cohort encompasses 32 patients who underwent unilateral vestibular schwannoma surgery at the Marseille University Hospital between 2014 and 2019. Variations in 54 indicators and their adherence to available norms are calculated. After 1 month, one-third of patients do not regain the norm for all indicators. However, the rates of variation unveil specific responses linked to a preoperative error signal, stemming from years of tumor adaptation. This adaptation is reflected in a postoperative visual or proprioceptive preference for certain patients. Further studies are needed to clarify error signals according to lesion types. The approach based on variations in normative indicators appears relevant for post-surgical monitoring and physiotherapy.

The effect of proprioceptive neuromuscular facilitation stretching exercises on pain and postural balance in patients with knee osteoarthritis

Background: Osteoarthritis is a degenerative disease that can cause pain, stiffness, and reduce balance function, thus interfering with daily activities. Proprioceptive Neuromuscular Facilitation Stretching (PNFS) can increase proprioceptive stimulation and activate muscles, reducing pain and improving postural balance in the OA knee. This study aimed to determine the effect of PNFS on reducing pain and increasing postural balance in patients with knee OA.&#x0D; Methods: This type of research was an experimental study with a quick experimental approach without a control group. Nineteen respondents with knee OA were taken by purposive sampling and met the inclusion and exclusion criteria. PNFS was done with the hamstring and quadriceps muscles twice a week for four weeks. The pain was evaluated using a numeric rating scale (NRS), while the dynamic balance was assessed by the timed up and go test (TUG), and static balance was examined by the one-leg stance (OLS) as well as Functional Reach Test (FRT).&#x0D; Results: There was a significant positive effect of PNFS to reduce pain and improve TUG, OLS, and FRT with p-values &lt;0,05, respectively.&#x0D; Conclusion: Pain is the main problem in OA knee and reduced balance. However, PNFS exercises were recommended for rehabilitation management in patients with knee OA.

Expert consensus on multi-disciplinary treatment, whole-course pulmonary rehabilitation management in patients with lung cancer and chronic obstructive lung disease.

Comorbidity of lung cancer and chronic obstructive pulmonary disease (COPD) is very common. Surgical operation is the initial treatment of lung cancer. But surgery operation will aggravate the symptoms of COPD, such as shortness of breath, chest tightness. On the other side, the COPD also increase the perioperative complications. Besides, the COPD may also influence the anti-cancer treatment and long-term survival of lung cancer patients. At present, there are guidelines for pulmonary rehabilitation (PR) of COPD or lung cancer respectively, but there is no reference expert consensus on the PR of patients with lung cancer who are comorbidity of COPD. Primary care has to satisfy the patient's complex needs holistically, and single-disease guidelines are unsuitable. In view of this, we organized experts from respiratory department, thoracic surgery department, oncology department, nursing department, etc., to write the expert consensus. We discussed the contents of the expert consensus through literature review, expert correspondence, expert meeting and discussion. This expert consensus contain five parts: introduction, respiratory assessment, timing of PR, PR strategies, perioperative PR management strategies in lung cancer patients with COPD. This expert consensus focuses on patients with COPD comorbid lung cancer and undergoing surgery operation, highlighting the concept of whole process management. For clinical medical staff, this expert consensus will promote the practice of PR in and out the hospital for this specific patient; for patients, this expert consensus is helpful to better understand PR and improve the enthusiasm of participating in PR in the whole process.

Efficacy of virtual reality-based interventions for patients with breast cancer symptom and rehabilitation management: a systematic review and meta-analysis

ObjectivesTo determine the effectiveness of virtual reality (VR)-based intervention on the symptoms and rehabilitation management in patients with breast cancer.DesignSystematic review and meta-analysis.Study selectionWe included all eligible randomised controlled trials...

Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability

BACKGROUND CONTEXTPositive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care. PURPOSETo examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery. STUDY DESIGN/SETTINGPooled secondary analysis of prospectively collected trial data from two academic medical centers. PATIENT SAMPLETwo hundred and forty-eight patients who underwent laminectomy with or without fusion for a degenerative lumbar condition. OUTCOME MEASURESPhysical function, pain inference, and social participation (ability to participate in social roles and activities) were measured using the Patient Reported Outcomes Measurement Information System. The Oswestry Disability Index, Numeric Rating Scale, and accelerometer activity counts were used to measure disability, pain intensity, and physical activity, respectively. METHODSParticipants completed validated outcome questionnaires at 6 weeks (baseline) and 12 months after surgery. Baseline positive psychosocial factors included resilience (Brief Resilience Scale) and self-efficacy (Pain Self-Efficacy Questionnaire). Multivariable linear regression analyses were used to assess the associations between early postoperative psychosocial factors and 12-month outcomes adjusting for age, sex, study site, randomized group, fusion status, fear of movement (Tampa Scale for Kinesiophobia), and outcome score at baseline. This study was funded by Patient-Centered Outcomes Research Institute and Foundation for Physical Therapy Research. There are no conflicts of interest. RESULTSResilience at 6 weeks after surgery was associated with 12-month physical function (unstandardized beta=1.85 [95% confidence interval [CI]: 0.29; 3.40]), pain interference (unstandardized beta=−1.80 [95% CI: −3.48; −0.12]), social participation (unstandardized beta=2.69 [95% CI: 0.97; 4.41]), and disability (unstandardized beta=−3.03 [95% CI: −6.04; −0.02]). Self-efficacy was associated with 12-month disability (unstandardized beta=−0.21 [95% CI: −0.37; −0.04]. CONCLUSIONSPostoperative resilience and pain self-efficacy were associated with improved 12-month patient-reported outcomes after spine surgery. Future work should consider how early postoperative screening for positive psychosocial characteristics can enhance risk stratification and targeted rehabilitation management in patients undergoing spine surgery.

Rehabilitation management of patients with COVID-19: lessons learned from the first experience in China.

Corona virus disease 2019 (COVID-19) is a new disease characterized by lung damage and involvement in multiple tissues and organs in the whole body. Some of the patients may have long-term impairment and dysfunctions, including pulmonary fibrosis, heart, liver, kidney, nerve and immune system. Rehabilitation has certain beneficial effect in the acute stage, and especially in the recovery stage, including improving respiratory function, exercise endurance, self-care in daily living activities, as well as psychological support, etc. Rehabilitation is not offside or absent. A reasonable rehabilitation program needs scientific research to avoid arbitrary conclusions.

Rehabilitative of COVID-19 patients with acute lower extremity Ischemia and amputation

To evaluate the clinical characteristics and rehabilitation management of patients who undergo amputation for COVID-19-associated coagulopathy. Clinical and laboratory data for 3 patients were analysed and their rehabilitative management discussed. The medical records of 3 patients who had undergone amputation due to acute lower extremity ischaemia and who were provided with rehabilitation in our COVID-19 unit were reviewed. Coagulation changes related to SARS-CoV-2 may complicate recovery from this devastating disease. The rehabilitation management of amputated patients for COVID-19 acute lower extremity ischaemia is based on a multilevel approach for clinical, functional, nutritional and neuropsychological needs. Based on this limited experience, a dedicated programme for this specific group of patients seems advantageous to warrant the best functional outcome and quality of life.

Development and Validation of Ambulosono: A Wearable Sensor for Bio-Feedback Rehabilitation Training.

Wearable technology-based measurement systems hold potential for the therapeutic and rehabilitation management of patients with various chronic diseases. The purpose of this study was to assess the accuracy and test–retest reliability of a new-generation wearable sensor-based system, dubbed Ambulosono, for bio-feedback training. The Ambulosono sensor system was cross-validated by comparing its functionality with the iPod touch (4th generation) sensor system. Fifteen participants underwent a gait test to measure various gait parameters while wearing both the iPod-based and Ambulosono sensors simultaneously. The physically measured values (i.e., the true values) of step length, distance traveled, velocity, and cadence were then compared to those obtained via the two-sensor systems using the same calculation algorithms. While the mean percentage error was <10% for all measured parameters, and the intra-class correlation coefficient revealed a high level of agreement between trials for both sensor systems, it was found that the Ambulosono sensor system outperformed the iPod-based system in some respects. The Ambulosono sensor system possessed both reliability and accuracy in obtaining gait parameter measurements, which suggests it can serve as an economical alternative to the iPod-based system that is currently used in various clinical rehabilitation programs.

Added Value of Isolated Core Postural Control Training on Knee Pain and Function in Women With Patellofemoral Pain Syndrome: A Randomized Controlled Trial

ObjectivesTo evaluate the added value of isolated core postural control training on knee pain and function in women with patellofemoral pain syndrome (PFPS). DesignRandomized controlled trial. SettingRehabilitation sciences research center. ParticipantsWomen (N=33) between 18 and 30 years of age with PFPS were randomly assigned to a control group (n=16) or the experimental group (n=17). InterventionsParticipants in both groups received the same stretching and strengthening exercises during 4 weeks (12 sessions 3 days per week). The experimental group also received isolated core postural training with an unstable seat apparatus. Main Outcome MeasuresCenter of pressure (CoP) trajectories in sitting postural control, pain intensity, and function were recorded before and after the 4-week intervention period. Functional capacity and pain intensity were reassessed 3 months after the intervention. ResultsAfter treatment, both groups had significant improvements in pain, function (P<.001), and CoP trajectories in sitting postural control (control group P<.05, experimental group P<.001). Between-group comparisons demonstrated greater improvements in pain, function, and CoP trajectories in the experimental group (P<.001). This group also had significantly greater improvements in pain and Kujala Anterior Knee Pain Scale score at 3-month follow-up compared to the control group (P<.001). ConclusionsAdding isolated core postural control training to physiotherapy exercises was associated with significantly greater improvements in pain, function, and CoP trajectories than physiotherapy exercises alone. Therefore, unstable sitting postural control training is potentially useful to enhance rehabilitation management in patients with PFPS.

Stroke and neurodegenerative disorders. 4. neurodegenerative disorders

Bryant PR, Geis CC, Moroz A, O’Neill BJ, Bogey RA. Stroke and neurodegenerative disorders. 4. Neurodegenerative disorders. 2004;85(3 Suppl 1):S21–33. This self-directed learning module highlights diagnosis, treatment, and rehabilitation issues in patients with neurodegenerative disorders, including multiple sclerosis (MS), Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the differential diagnosis, diagnostic evaluation, medical management, and rehabilitation issues in MS. Similarly, the differential diagnosis treatment and rehabilitation in Parkinson’s disease is discussed. Electrodiagnosis, pharmacologic treatment, and rehabilitation options for ALS are also discussed. Overall article objective To review the differential diagnosis, evaluation, medical treatment, and rehabilitation management of patients with MS, Parkinson’s disease, and ALS.

Subacute brain injury rehabilitation: an opportunity for medical education and training.

Changes in the delivery of health care have resulted in new sites for rehabilitation of patients with severe brain injury (BI). Adjustments in the training of resident physicians in physical medicine and rehabilitation are likely to ensue. We utilized Likert scales and open-ended questions to survey residents who were assigned over a 2(1/2)-year period to a subacute BI rehabilitation unit (SRU). Residents were surveyed about their desire to participate in a SRU training site, and the usefulness of such a rotation, and compared the rotation to traditional settings in which patients with similar diagnoses were treated. The results indicated that significant positive changes in residents' attitudes towards this type of training site occurred (p = 0.01). The rotation was felt to be useful (p = 0.008) despite initial misgivings. Positive educational aspects were exposure to the unique problems of patients with severe BI (e.g. spasticity and agitation) and a sense of independence and competence in leadership roles. Problematic aspects included the management of medically unstable patients without supportive resources, and a lack of nurses trained in rehabilitation principles. Training of residents in the rehabilitation management of patients with severe BI can be perceived as a valuable educational experience by trainees.

Surgical and Biomechanical Considerations in Rehabilitation of Patients with Intra-Articular ACL Reconstructions

The surgical and rehabilitation management of patients with anterior cruciate ligament (ACL) injuries has evolved rapidly over the past few decades. The purpose of this review is to present a rehabilitation strategy for intra-articular anterior cruciate ligament (ACL) reconstruction based on current surgical and biomechanical factors. Advances in basic science research and surgical procedures have led to aggressive rehabilitation programs for which guidelines may need to be considered. The literature presents a variety of protocols that do not address the biomechanical differences between varying surgeries that may affect the rehabilitation process. This review will present the surgical variables and biomechanical factors associated with intra-articular ACL reconstruction that need to be considered by physical therapists when planning a rehabilitation program. J Orthop Sports Phys Ther 1992;15(6):317-322.