Rehabilitation Therapy Interventions Research Articles

The Integration of Physical Therapists and Occupational Therapists into Burn Wound Care Increases Therapist Productivity, Job Satisfaction, and Multidisciplinary Collaboration.

When attempting to deliver specialized rehabilitation therapy interventions, physical therapists (PTs) and occupational therapists (OTs) must account for dynamic and logistical patient factors such as: daily wound care, pain, difficultly progressing range of motion with dressings donned, and ongoing surgical interventions. Additionally, they must attain institution-specific productivity standards. Given burn patients often require considerable multidisciplinary interventions, efficiently planning and delivering rehabilitation therapy interventions within productivity expectations may prove difficult. The purpose of this study was to assess the feasibility of integrating rehabilitation therapists, PTs and OTs, into daily burn wound care by investigating therapist productivity and multidisciplinary perceptions of this practice change. The quality improvement project involved six rehabilitation therapists (three PTs and three OTs) practicing exclusively in the burn unit within an American Burn Association (ABA) verified burn center at an urban, tertiary care academic medical center. One rehabilitation therapist was responsible for providing interventions within the burn wound care team five days a week. General duties included wound assessment, functional wound dressings, and skilled therapeutic interventions such as manual therapy, therapeutic exercise, and compression interventions. The primary outcome was changes in group productivity and individual therapist productivity, as measured by total billed CPT codes per hour worked, which were tracked 22 weeks pre- and 28 weeks post-implementation. Program feasibility and general perceptions were assessed by a qualitative questionnaire. For both the entire group of therapists and each individual rehabilitation therapist, billed CPT codes per hour increased post implementation, 1.81 versus 1.54 (p=0.005) and a matched increase of 0.27/hr (p=0.003). Of the 23 survey respondents, 96% had a favorable impression of the program and reported it eased staffing demands. All respondents reported improved unit workflow and multidisciplinary communication. The majority of multidisciplinary burn team members actively supported the pilot program and commented on improvements in patient care. Full-time rehabilitation therapy participation in wound care increases therapist productivity and job satisfaction. Future efforts, however, should focus on measuring specific patient outcomes and cost as a result of therapist integration into daily wound care practice.

Rehabilitation Therapy In Older Patients Hospitalized With Acute Heart Failure And Comorbid Diabetes: Insights From Rehab-hf

<h3>Introduction</h3> Prior studies showed an attenuated response to exercise training among patients with heart failure (HF) and concomitant type 2 diabetes mellitus (DM). We explored the interaction between DM status and a novel, transitional, tailored, progressive, multi-domain rehabilitation therapy intervention that improved physical function compared with usual care in the REHAB-HF trial. <h3>Methods</h3> REHAB-HF was a randomized controlled trial testing the effect of a novel multi-domain physical rehabilitation intervention initiated with patients with acute HF (regardless of EF) and continued in the outpatient setting for 36 in-person sessions. Demographics, QOL scores, and baseline physical function were compared between the patients with and without DM. The effect of the intervention on 3-month Short Physical Performance Battery (SPPB) (primary endpoint), 6-minute walk distance (6MWD), modified Fried frailty criteria, and QOL scores (Kansas City Cardiomyopathy Questionnaire [KCCQ] and EQ5D) was compared between patients with and without DM using general linear models with adjustment for baseline measure, age, sex, clinical site, and EF category (< vs. ≥45%). <h3>Results</h3> Of the 349 patients enrolled in REHAB-HF, 182 (52%) had DM. The prevalence of DM was higher in the intervention group (58% vs 47%). Patients with DM had worse baseline functional capacity as measured by the SPPB and 6MWD, but similar frailty and QOL scores. There was a consistent benefit with the intervention for 3-month SPPB, 6MWD, and EQ5D regardless of DM status (all interaction p-value >0.7) (<b>Table</b>), but patients with DM had lower benefit for frailty and KCCQ (interaction P<0.1). <h3>Conclusion</h3> Compared to those without DM, patients with DM had worse baseline functional capacity (SPPB and 6MWD), but had similar benefits from the intervention. There was evidence of attenuated intervention-related benefit for frailty and KCCQ which warrants further assessment.

The Effect of Creative Arts Therapy For Veterans: A Comparison Between In-Person and Hybrid-Based Therapy

<h3>Research Objectives</h3> To estimate the effect of creative arts therapy on mood symptomatology and quality of life and investigate whether the effect of creative arts therapy is different between in-clinic only and hybrid-based therapy (a combination of in-clinic and telehealth). <h3>Design</h3> Observational study. <h3>Setting</h3> A VA medical center. <h3>Participants</h3> A convenience sample of 110 Veterans who received creative arts therapy between 2015 to 2019 was used in this study. All participants were 18 years old or older and had at least one chronic condition, such as post-traumatic stress disorder (PTSD) or depression. <h3>Interventions</h3> Participants received weekly creative arts therapy. During the sessions, participants expressed personal feelings and emotions through art or music. Each session was delivered through a traditional face-to-face format or telehealth, depending on the patient's needs and preferences. Participants completed self-reporting mood symptomatology and quality of life measures at the first visit and at the end of the intervention. All evaluations were conducted in the clinic. <h3>Main Outcome Measures</h3> The Positive and Negative Affect Schedule–Extended Form (PANAS-X) measures mood-related symptomatology. The World Health Organization Quality of Life Survey- Brief Version (WHOQOL-BREF) measures the quality of life. <h3>Results</h3> Participants had an average of five chronic conditions. PTSD and depression were the most frequently reported conditions. Participants received, on average, eight sessions. In total, 53.6% of participants (n=59) received creative arts therapy via in-clinic only, while 46.4% (n=51) received hybrid-based creative arts therapy. There was no significant difference between in-clinic and hybrid-based creative arts therapy groups. Participants reported decreased general negative affect (p = .029) and increased general positive affect (p =.038). Creative arts therapy improved quality of life in physical health (p = .022), as well as in psychological health (p < .001). There was no significant difference in the effect of creative arts therapy between in-clinic only and hybrid-based groups. <h3>Conclusions</h3> Creative arts therapy improved perceived physical and psychological health for Veterans. The hybrid-based creative arts therapy can serve as an effective substitute for in-clinic therapy, which would improve Veterans' access to care for creative arts therapy. Future studies are recommended to examine the hybrid-based approach for other rehabilitation therapy interventions. <h3>Author(s) Disclosures</h3> Authors report no financial relationships or financial conflicts of interest.

Comparison of Effects After Applying Virtual Reality Ankle Exercise and High-frequency Current to Functional Ankle Instability

The purpose of this study is to find an optimal rehabilitation therapy intervention, especially in this study, by comparing the effects of applying both virtual reality (VR) programs and microwave diathermy (MWD) at the same time. The subjects of this study participated 19 college students in their 20s. The subjects were randomly divided into two groups. The first group received MWD (male:2 female:8) and VR ankle training, while the second group (male:2 female:7) received only the VR training. The interventions were conducted three times a week for four weeks. Biodex Balance System® is a tool to measure balance degree in this study. The MWD (PM-800S, ITO, Japan) intervention was conducted by setting the frequency of 2450㎒ and the output of 100W before the implementation of the VR exercise program. The exercise in this study was conducted using the Nintendo Wii Fit Plus program for VR exercise. Comparison of the results of the groups that implemented MWD and VR at the same time and those that implemented VR only are as follows. In the static balance, VR groups were significantly lower in all directions such as overall, anterior-posterior, and medial-lateral (p .05). If the therapist does not properly perform the examination when applying MWD for FAI, the effect might not be significant. VR exercise programs can also be used to improve the balance of FAI, although it has limitations.

Home care rehabilitation therapy services for individuals with multimorbidity: A rapid review.

Multimorbidity refers to the co-occurrence of two or more chronic conditions, where no one disease is considered the central disease. Individuals with multimorbidity experience increased patient health complexity, increased disability and functional decline, and increased health care utilization. Rehabilitation therapists are well positioned to address the complex functional needs that can contribute to disability for people living with multimorbidity; however, it is not well understood how they address these needs within the home care setting. A rapid review was conducted to identify and synthesize the existing literature on home care rehabilitation services for clients with multimorbidity and the effect of those services. Two electronic databases (Medline and CINAHL) were searched. The Journal of Comorbidity was hand-searched for thoroughness because this journal focuses on populations with multiple chronic conditions. This rapid review included observational and experimental studies that focused on rehabilitation therapy interventions embedded within existing home care systems for adults with multimorbidity. Four studies were included in the final review. The results revealed that therapists delivered interventions aimed towards improving functional outcomes related to activities of daily living and instrumental activities of daily living. Physical therapy interventions were the only therapy delivered in three of the four studies included. Furthermore, 50% of these studies explicitly included people with chronic conditions impacting the musculoskeletal system only. This review offers an important perspective on how home care rehabilitation therapy interventions and outcomes are operationalized for individuals with multimorbidity. Despite the varying definitions of multimorbidity, therapeutic intervention supported functional improvements.

Rehabilitation Therapy Intervention to Reduce Inflammation of Infected Surgical Incision

In order to explore the best treatment and rehabilitation outcome of post-infection inflammation by reducing wound infection and postoperative complications, 54 patients undergoing general surgery are divided into 2 groups to investigate rehabilitation intervention in the treatment of Infection of surgical incision. Results showed that there was no significant difference in operation time and neck drainage volume between the experimental group and the control group. C-reactive protein level of the experimental group was lower than that of the control group on days 1 and 3 after surgery. The C-reactive protein levels of the experimental group was lower than that of the control group at 12, 24, 48 and 48 h after operation. There was no significant difference in the pain score between the experimental group and the control group at 72 h after operation. The anxiety score of the experimental group was lower than that of the control group before and after operation and the satisfaction of the experimental group was higher than that of the control group. In the control group, in terms of hospitalization costs and hospitalization time, the experimental group was lower than the control group and the therapeutic effect of inflammatory infection was lower than that of the experimental group. Rehabilitation intervention needed to be carried out during the treatment of surgical incision infection and inflammation. It could reduce physical and mental discomfort of the patients and allow quick recovery as well as relieve the pain after operation, alleviate anxiety, and improve the patient satisfaction, shorten hospitalization time and reduce hospitalization expenses.

Soft directional channel operative combined applying traditional Chinese medition and early rehabilitation therapy intervention treatment in patients with cerebral hemorrhage of clinical curative effect

Soft directional channel operative combined applying traditional Chinese medition and early rehabilitation therapy intervention treatment in patients with cerebral hemorrhage of clinical curative effect

Poster 427 Atypical Presentation of Dermatomyositis in an Adolescent and Initial Rehabilitation Therapy Interventions: A Case Report

PM&RVolume 4, Issue 10S p. S337-S337 2012 AAPM&R Annual Assembly Abstract Poster 427 Atypical Presentation of Dermatomyositis in an Adolescent and Initial Rehabilitation Therapy Interventions: A Case Report Clarice Sinn DO, Clarice Sinn DO University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorKelly J. Hendricks Doctor of Osteopathy, Kelly J. Hendricks Doctor of Osteopathy University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorEvish Kamrava MD, Evish Kamrava MD University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorDesiree Roge MD, Desiree Roge MD University of Kansas, Kansas City, KS, United StatesSearch for more papers by this author Clarice Sinn DO, Clarice Sinn DO University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorKelly J. Hendricks Doctor of Osteopathy, Kelly J. Hendricks Doctor of Osteopathy University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorEvish Kamrava MD, Evish Kamrava MD University of Kansas, Kansas City, KS, United StatesSearch for more papers by this authorDesiree Roge MD, Desiree Roge MD University of Kansas, Kansas City, KS, United StatesSearch for more papers by this author First published: 23 October 2012 https://doi.org/10.1016/j.pmrj.2012.09.1037Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume4, Issue10SOctober 2012Pages S337-S337 RelatedInformation