Rehabilitation Perspective Research Articles

Allocating municipal services to individuals with complex rehabilitation needs – a discourse analysis of individual administrative decision letters

BackgroundRehabilitation is considered paramount for enhancing quality of life and reducing healthcare costs. As a result of healthcare reforms, Norwegian municipalities have been given greater responsibility for allocating rehabilitation services following discharge from hospital. Individual decision letters serve as the basis for implementing services and they have been described as information labels on the services provided by the municipality. They play an important role in planning and implementing the services in collaboration with the individual applicants. Research indicates that the implementation of policies may lead to unintended consequences, as individuals receiving municipal services perceive them as fragmented. This perception is characterised by limited user involvement and a high focus on body functions. The aim of this study was to examine how municipal decision letters about service allocation incorporate the recommendations made in the official national guideline and reflect a holistic approach to rehabilitation, coordination and user involvement for individuals with comprehensive needs.MethodsThe decision letters of ten individuals with moderate to severe brain injury allocating rehabilitation services in two municipalities were examined. It was assessed whether the content was in accordance with the authorities’ recommendations, and a discourse analysis was conducted using four tools adapted from an established integrated approach.ResultsThe letters primarily contained standard texts concerning legal and administrative regulations. They were predominantly in line with the official guideline to municipal service allocation. From a rehabilitation perspective, the focus was mainly on medically oriented care, scarcely referring to psychosocial needs, activity, and participation. The intended user involvement seemed to vary between active and passive status, while the coordination of services was given limited attention.ConclusionsThe written decision letters did fulfil legal and administrative recommendations for service allocation. However, they did not fulfil their potential to serve as a means of conveying rehabilitation issues, such as specification of the allocated services, a holistic approach to health, coordination, or the involvement of users in decision processes. These elements must be incorporated throughout the allocation process if the policies are to be implemented as intended. Findings can have international relevance for discussions between clinicians and policy makers.

Azolla cultivation enables phosphate extraction from inundated former agricultural soils

To combat the global loss of wetlands and their essential functions, the restoration and creation of wetlands is imperative. However, wetland development is challenging when soils have been in prolonged agricultural use, often resulting in a substantial nutrient legacy, especially of phosphorous (P). Inundating these soils typically leads to P mobilization, resulting in poor water quality and low biodiversity recovery. As a potential novel means to overcome this challenge, we tested whether cultivation of the floating fern Azolla filiculoides could simultaneously extract and recycle P, and provide a commercial product. Azolla has high growth rates due to the nitrogen fixing capacity of its microbiome and is capable of luxury consumption of P. Azolla cultivation may also accelerate soil P mobilization and subsequent extraction by causing surface water anoxia and the release of iron-bound P. To test this approach, we cultivated Azolla on 15 P-rich former agricultural soils in an indoor mesocosm experiment. Soils were inundated and either left unvegetated or inoculated with A. filiculoides during two 8-week cultivation periods. Biomass was harvested at different intervals (weekly/monthly/bimonthly) to investigate the effect of harvesting frequency on oxygen (O2) and nutrient dynamics. We found that Azolla attained high growth rates only on soils with high mobilization of labile P, as plant cover did not reduce surface water O2 concentrations in the first phase after inundation. This concurred with low porewater iron to P ratios (<10) and high porewater P concentrations. A. filiculoides cultivation substantially reduced surface water nutrient concentrations and extracted P at rates up to 122 kg ha−1 yr−1. We conclude that rapid P extraction by A. filiculoides cultivation is possible on soils rich in labile P, offering new perspectives for wetland rehabilitation. Additional field trials are recommended to investigate long-term feasibility, seasonal variations, and the influence of potential grazers and pathogens.

Modification of rain and run-off erosivity to predict erosion hazard level on The Manguan Sub-watershed’s Upper Slope

To protect natural resources and maintain the normal functioning of hydrological processes, the upper slope of the Manguan Sub-watershed should be designated as a conservation area. However, agricultural activities in the upstream have disrupted the watershed’s hydrological function, triggering high rates of erosion, sedimentation, and flooding. The aim of this research was to estimate the level of erosion hazard on Manguan Sub-watershed’s Upper Slope and its conservation directives to mitigate it. This study adopted a land unit approach to flow occurrence land units with the prediction of MUSLE (Modified Universal Soil Loss Equation) by integrating rainfall and run-off erosivity. The direction of land conservation will be evaluated through the perspectives of land rehabilitation and soil conservation. Based on the result, the prediction of erosion hazard levels is classified into four groups: Low, Moderate, High, and Extremely High. The Manguan Sub-Watershed’s Upper Slope has a significantly high level of erosion and necessitates soil conservation improvement measures on approximately 79% of its area.

Current Role and Future Perspectives of Cardiac Rehabilitation in Heart Disease.

As a comprehensive secondary prevention program, cardiac rehabilitation (CR) is a beneficial and cost-effective intervention for patients with heart disease, but the participation rate of patients in CR is low globally. In recent years, due to the COVID-19 pandemic and scientific and technological advances, an increasing number of alternative CR modes have been developed, such as remote CR, home-based CR, hybrid CR and virtual CR. These alternative CR modes represent changes and new opportunities for patients with heart disease. In this review, we will discuss in detail the impact of CR on patients with different types of heart disease, review the various alternative CR models, and explore some prospects for the future of CR in the field of heart disease.

Are triage tools effective for detecting cervical spine injury in paediatric trauma patients? - A Cochrane Review summary with commentary.

Pediatric cervical spine injuries (CSIs) from blunt trauma carry a high risk of neurological damage. Accurate diagnosis is vital for preventing harm and aiding recovery, yet the diagnostic accuracy of clinical decision rules (CDRs) remains unclear. To assess the effectiveness of triage tools for detecting CSI in pediatric trauma patients. A summary of the Cochrane Review by Tavender et al. (2024), with comments from a rehabilitation perspective. Five studies with 21,379 participants assessed seven CDRs. Direct comparisons showed high sensitivity but low specificity across different CDRs. Indirect comparison studies also demonstrated varying sensitivities and specificities. Insufficient evidence exists to determine the best tools for deciding if imaging is necessary for diagnosing potential CSI in children. Better quality studies are needed to assess the accuracy of CDRs for cervical spine clearance in this population.

Toward Culturally Responsive Qualitative Research Methods in the Design of Health Technologies: Learnings in Applying an Indigenous Māori-Centred Approach

There is a growing call for health researchers to address the inequities in healthcare experienced by indigenous populations by focusing on the development of culturally responsive research approaches. This article presents a contextual example from Aotearoa New Zealand (NZ) of how indigenous (Māori) knowledge and practices helped reimagine and enhance an existing qualitative descriptive research protocol exploring clinicians’ perspectives of robotic rehabilitation for people with stroke. The intent was to develop a research design that upheld and valued mātauranga Māori (indigenous knowledge systems) alongside Western clinical sciences knowledge. To achieve this, a collaboration of non-indigenous (tauiwi) and indigenous researchers with experience in Qualitative and Kaupapa Māori (indigenous) methodologies, and clinical practice was formed. The researchers undertook a cyclical process of relationship building, engagement with mātauranga Māori, discussion and exploration of how indigenous knowledge and practices could inform and shape the existing study design. Key influences in adapting the research design were drawn from Māori ethical principles, Māori frameworks of health and wellbeing, and Māori cultural practices for clinical engagement. Drawing on indigenous knowledge and practices to develop a Māori-centred research method resulted in significant changes to the study design, methods, and interview approach. Focused development of a culturally responsive approach enabled the researchers to engage indigenous participants in a research process that was safe, respectful, and culturally appropriate. Transformation occurred within the researcher-participant relationship from one often characterised as transactional, to one of deeper connection and reciprocity, which facilitated a richer and more in-depth inquiry. The explicit valuing and integration of indigenous knowledge and practices in adapting the research method strengthened the cultural responsivity of the research. Central to the process was prioritising working in relational partnership. Non-indigenous researchers’ self-reflection on their own culture, alongside being attuned to the influence of historical, political, and social contexts of the participants experiences proved essential.

The Future Perspectives of Rehabilitation for Children on the Pediatric Heart Transplant Waiting List

The Future Perspectives of Rehabilitation for Children on the Pediatric Heart Transplant Waiting List

Is trunk training effective at improving ability in activities of daily living and function of people who have had a stroke? ACochrane Review summary with commentary.

Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation. To evaluate the effectiveness of trunk training interventions in people with stroke. A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective. 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low. Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence.

Research trends and hotspots in exercise rehabilitation for coronary heart disease: A bibliometric analysis.

Exercise rehabilitation can improve the prognosis of patients with coronary heart disease. However, a bibliometric analysis of the global exercise rehabilitation for coronary heart disease (CHD) research topic is lacking. This study investigated the development trends and research hotspots in the field of coronary heart disease and exercise rehabilitation. CiteSpace software was used to analyze the literature on exercise therapy for CHD in the Web of Science Core Collection database. We analyzed the data of countries/institutions, journals, authors, keywords, and cited references. A total of 3485 peer-reviewed papers were found, and the number of publications on the topic has steadily increased. The most productive country is the USA (1125), followed by China (477) and England (399). The top 3 active academic institutions are Research Libraries UK (RLUK) (236), Harvard University (152), and the University of California System (118). The most commonly cited journals are Circulation (2596), The most commonly cited references are "Exercise-based cardiac rehabilitation for coronary heart disease" (75), Lavie CJ had published the most papers (48). World Health Organization was the most influential author (334 citations). The research frontier trends in this field are body composition, participation, and function. Research on the effects of physical activity or exercise on patients with CHD is a focus of continuous exploration in this field. This study provides a new scientific perspective for exercise rehabilitation and CHD research and gives researchers valuable information for detecting the current research status, hotspots, and emerging trends for further research.

Personality construct as a biomarker in fibromyalgia: A narrative review from an autonomic rehabilitation perspective.

The heterogeneity of symptoms and ineffective treatment raise questions about the current diagnostic criteria of fibromyalgia (FM). Misdiagnosis of FM often leads to less than efficacious treatment and poor quality of life. This article reviews relevant evidence-based literature on personality traits in FM patients with an autonomic dysfunction perspective based on a hierarchical model to explain the utility of considering the personality trait in FM diagnosis. A narrative review of articles concerning chronic pain, FM, and personality traits with respect to autonomic dysfunction in FM was conducted after extensive relevant literature searches. Reports discussing the predisposing factors, including coping styles, anger, suicide risk, a lack of physical activity and social support, in maintaining persistent pain in FM exist. Relationships between pain duration and severity and personality traits like neuroticism and extraversion have been reported. Coexisting clinical manifestations of FM like sleep disorders, anxiety, and intestinal irritability indicate autonomic dysfunction. This article lays out a constructive framework for individualized and personalized medicine for the effective rehabilitation of FM patients. The quest to find a definitive diagnosis of FM should include personality biomarkers that might translate into personalized medicine. An individualistic approach may bank upon artificial intelligence algorithms for both diagnostic as well as prognostic purposes in FM.

Should we add antiplatelet agents to current deep venous thrombosis treatments? A Cochrane Review summary with commentary.

Venous thromboembolism (VTE) is an important complication in rehabilitation practice despite preventive measures. The management can be complicated because patients may have co-existing cardiovascular comorbidities. To assess the effects of antiplatelet agents in addition to current best medical practice (BMP) compared to current BMP (with or without placebo) for the treatment of deep venous thrombosis (DVT). A summary of the Cochrane Review by Flumignan et al. (2022), with comments from a rehabilitation perspective. The review included six studies with 1625 eligible participants, with data up to 37.2 months of follow-up. When used after standard initial treatment with anticoagulants, antiplatelet agents such as aspirin in addition to BMP, may reduce recurrence of DVT or pulmonary embolism, when compared to BMP plus placebo in a chronic DVT setting and there may be a lower risk for post-thrombotic syndrome in patients with acute DVT. There is no clear difference in side effects, major bleeding, or pulmonary embolism (PE) with the use of antiplatelet agents. Adding antiplatelet agents to standard anticoagulation treatment in patients with VTE could provide benefit without increasing risks in selected patient groups. However, high quality studies with a long-term follow up are needed, including patients in rehabilitation settings.

462P Cognitive function of survivors with non-central nervous system cancer and its correlates: A community rehabilitation perspective

462P Cognitive function of survivors with non-central nervous system cancer and its correlates: A community rehabilitation perspective

Movement Asymmetries: From Their Molecular Origin to the Analysis of Movement Asymmetries in Athletes.

Asymmetry plays a major role in biology at all scales. This can be seen in the helix of DNA, the fact that the human heart is on the left side, or that most people use their right hand. A single protein such as Myosin 1D can induce helical motion in another molecule. This causes cells, organs, and even entire bodies to twist in a domino effect, causing left-right behaviour. More generally, athlete movements are often asymmetric and, during the physical rehabilitation after injury, the asymmetry is visually discernible. Herein, we review the molecular basis of the movement asymmetries and report on the available knowledge on the few therapeutics investigated so far such as meloxicam. From a more rehabilitative perspective, it is very important to use effective methods to control the process of resolving the injury-related movement asymmetry through the complex use of specialised exercises, measurements, and gait analysis, which can all provide useful information on the effectiveness of the rehabilitation plans. If for each athlete, the normal range of asymmetry is known, the asymmetry can be individually treated and the evolution can be monitored over time. Appropriate measures should be taken if the movement asymmetry is outside this range. In addition, genetic, physiological, and psychological factors relevant to athlete health should be considered in the process of assessing and improving exercise asymmetry, which we also discuss in this review. The main proposal of this work is that the movement asymmetries in athletes should be individually treated, while taking into account the athlete's genetics, physical condition, and previous injuries.

Volkmanns ischemic contracture with impaired vascularity managed by minimally invasive soft tissue release and capsulotomy A rehabilitation perspective

Volkmanns ischemic leg contracture is severe and debilitating, arising from prolonged ischemia of the lower limb musculature.

Acute Intermittent Porphyria: A Review and Rehabilitation Perspective.

Acute intermittent porphyria (AIP) is an uncommon metabolic disease that impacts multiple organs and can manifest in many ways. It is often misdiagnosed due to its nonspecific symptoms. Neurovisceral signs and symptoms should alert physicians to consider AIP in the differential after excluding more common causes. Identifying the underlying cause is critical in preventing acute attacks, and trigger avoidance is the optimal approach to managing AIP. Medications that are contraindicated should be reviewed thoroughly. Prompt intravenous hematin administration is the primary treatment for acute attacks, and additional pharmacological therapies may be necessary to treat concurrent symptoms. A severe neurological manifestation of AIP is flaccid paralysis or severe motor weakness, which can develop into total quadriplegia and respiratory insufficiency. A comprehensive rehabilitation program is an integral aspect of the treatment plan. Since the incidence of this disease is low, functional prognosis is not well-known. As a result, it is challenging to determine the most appropriate structure, intensity, and duration of rehabilitation therapy. By extending the treatment plan, individuals with tetraplegia due to AIP can continue to make functional gains years after the onset of weakness. Understanding the disease's functional prognosis will aid in coordinating resources and improving healthcare expenditures.

What are the benefits and harms of physical activity on irritable bowel syndrome? - A Cochrane Review summary with commentary.

The aim of this commentary is to discuss from a rehabilitation perspective the Cochrane Review "Physical activity for treatment of irritable bowel syndrome"(1) by Nunan D.[1], published by Cochrane Gut Group. This Cochrane Corner is produced in agreement with Journal of Rehabilitation Medicine by Cochrane Rehabilitation with views* of the review summary author in the "implications for practice" section. [1] This summary is based on a Cochrane Review previously published in the Cochrane Database of Systematic Reviews 2022, Issue 6, Art. No.: CD011497, DOI: 10.1002/14651858.CD011497.pub2 (see www.cochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review. * The views expressed in the summary with commentary are those of the Cochrane Corner author (different than the original Cochrane Review authors) and do not represent the Cochrane Library or Medical Journals Sweden or Journal of Rehabilitation Medicine.

Child Care Institutions in Manipur: A Rehabilitation Perspective

Child Care Institutions in Manipur: A Rehabilitation Perspective

Corporate Criminal Liability in the Perspective of Rehabilitation: The Bewilderment of Walking without a Map

Corporate Criminal Liability in the Perspective of Rehabilitation: The Bewilderment of Walking without a Map

Perspectives of cardiac rehabilitation in patients who had a stroke: a protocol for a qualitative study review

IntroductionStroke has a high incidence and disability rate, and its recurrence and readmission rates are rising, making it the second-leading cause of mortality in the globe. Cardiac rehabilitation is a...

Development of Children's Islamic Book Business Based on Dental Health Education and Medical Rehabilitation

Interest in children's Islamic books is still lacking and needs to be increased in society, especially parents, because many children prefer story books with fairy tale nuances. In Medical Rehabilitation, reading books needs to be a habit from an early age because it can stimulate the brain and increase knowledge. Knowledge about dental health, especially preventing cavities, is still lacking so it needs to be improved. The aim of this activity is to increase interest in children's Islamic books, it is necessary to include education about children's Dental Health and Medical Rehabilitation so that knowledge increases along with interest in children's Islamic books. The method used in this activity is collaboration with children's Islamic book business partners, followed by an educational program through counseling about Dental Health and the importance of reading from a Medical Rehabilitation perspective at the Experimental 2 State Elementary School in Yogyakarta. In this activity, education is carried out through counseling, practice of preventing cavities, education about the importance of reading, especially Islamic children's books. The activity ended with a post test in the form of a quiz and a demonstration of putting the educational results into practice as an assessment of the success of the program. As a result of this activity, all participants were very happy and enthusiastic about reading Islamic children's books because many did not know that there were interesting Islamic children's books. Knowledge about dental health and medical rehabilitation increased from the results of the post test which included knowledge about dental health and the importance of reading, and participants were able to demonstrate how to prevent cavities. Conclusion, this activity was successful because knowledge about dental health and medical rehabilitation increased along with the increasing interest of children in children's Islamic books.