Rehabilitation Treatment Of Patients Research Articles

Rehabilitative treatment of patients with ureterolithiasis using pulsed vacuum depression, pulsed low-frequency electric current, and radon therapy

The authors report results of the treatment of 60 patients with ureterolithiasis using a combination of pulsed vacuum depression (local vibrotherapy), low-frequency pulsed (alternating sinusoidal) current, radon water and radon baths. Clinical efficiency of combined therapy is estimated at 93.3%.

Vocational rehabilitation programs for individuals with chronic arthritis

To summarize recent literature on vocational rehabilitation interventions in patients with chronic arthritis. The current literature shows that the prevalence of work disability, including work cessation, sick leave, and any other restriction in the work status among patients with chronic arthritis, is substantial. In some studies, a trend towards a decline in work disability in chronic arthritis is seen, possibly reflecting improvements in medical treatment. The proof of effectiveness of comprehensive vocational rehabilitation interventions aimed at individuals in various stages of work disability is scanty. With prolonged sick leave being a major determinant of job loss, interventions are nowadays developed that specifically address patients with chronic arthritis at a stage in which sick leave occurs, with promising results. Economic evidence is limited, but savings on productivity are likely to outweigh the costs of an effective intervention. Despite advances in medical treatment, work disability among individuals with chronic arthritis is substantial. Although the (cost-)effectiveness of interventions in patients with established work disability is unclear, the results of studies on interventions employed in the early stages of threatened work ability point to a favorable effect.

Quantitative evaluation pre-post rehabilitative treatment in patients with traumatic brain injury with 3D gait analysis

Quantitative evaluation pre-post rehabilitative treatment in patients with traumatic brain injury with 3D gait analysis

Effect of psychological intervention for rehabilitation of patients with coronary heart disease

Objective To explore the relation between psychological and social factors and coronary heart disease among middle-aged,emotions and the effect of psychological intervention.Methods By contrast method,80 patients with coronary heart disease who aged from 40 to 60 were selected.with 40 case8 in each group at random.The experiment group adopted the method of psychological intervention and clinical treatment,the control group received the conventional treatment.The anxiety and depression emotion,the indexes of cardiac function and sometization syndrome were measured in the two groups when at admission,discharged from hospital and one month after dischaged.Results Compared to the control group,the differences of each indicator including psychological,physiological indicators,knowledge of disease and the average number of days in hospital in the experiment group had significantly statistical meaning(P<0.01 or P<0.05).Conclusions The conventional treatment and psychological intervention can effectively reduce depression,anxiety syndromes of patients,and have a certain effect on easing psychological pressure,stabilizing emotion and controlling seizures of coronary heart disease. Key words: Coronary heart disease; Psychological intervention; Rehabilitation nursing

Rehabilitation of Fecal Incontinence After Sphincter-Saving Surgery for Rectal Cancer: Encouraging Results

Some patients, having undergone sphincter-saving operations for rectal cancer, may suffer from fecal incontinence. This study was designed to evaluate the results of rehabilitative treatment in patients with fecal incontinence after sphincter-saving operations and to identify the negative factors that influence therapeutic success. Between January 2000 and June 2007, 88 incontinent patients (54 women; age range, 47-73 years; 69 had received a low anterior rectal resection; 19 a straight coloanal anastomosis) were included in the study. After a preliminary clinical evaluation, including the Wexner Incontinence Scale score, anorectal manometry was performed. All 88 patients underwent rehabilitative treatment according to the "multimodal rehabilitative program" for fecal incontinence. At the end of program, all 88 patients were reassessed by means of a clinical evaluation and anorectal manometry; their results were compared with the clinical and manometric data from ten healthy control subjects. Postrehabilitative Wexner Incontinence Scale scores were used for an arbitrary schedule of patients divided into three classes: Class I, good (score </=3); Class II, fair (score >3 to </=6); Class III, poor (score >6). After rehabilitation, there was a significant improvement in the overall mean Wexner Incontinence Scale score (P < 0.03) for both surgical operation types (low anterior rectal resection: P < 0.05; coloanal anastomosis: P < 0.02). Only 21 patients (23.8 percent) were symptom-free, and 37 (42 percent) were considered Class III. A significant postrehabilitative direct correlation was found between: 1) Wexner Incontinence Scale score and degree of genital relaxation (rrho (s) 0.78; P < 0.001); 2) Wexner Incontinence Scale score and irradiation (rrho (s) 0.72; P < 0.01); and 3) Wexner Incontinence Scale score and pelvic (rrho (s) 0.65; P < 0.01) or anal surgery (rrho (s) 0.68; P < 0.01). No significant differences were found between prerehabilitative and postrehabilitative anal pressures in low anterior rectal resection and coloanal anastomosis patients. After rehabilitation, some patients become symptom-free, many patients show an improvement in the Wexner Incontinence Scale score, and others exhibit the highest grades of fecal incontinence. Genital relaxation, radiotherapy, and previous pelvic, and/or anal surgery are impeding factors to rehabilitative success.

Comparing bar and double‐crown attachments in implant‐retained prosthetic reconstruction: a follow‐up investigation

A removable implant-retained dental prosthesis in an edentulous mandible can use telescopic crowns or a bar superstructure as anchorage elements for an overdenture. The aim of this study was to compare the clinical results for bar-anchored and telescopic crown-retained overdentures in implant prosthetic treatment of the toothless lower jaw with two or more implants placed in the intraforaminal region. A clinical and radiographical comparison was made of the telescope vs. the bar method for removable prosthetic rehabilitation treatments in patients with an edentulous mandible. For evaluation of the clinical data, the sulcus fluid flow rate, Periotest values, and the peri-implant bone loss were recorded. In the follow-up examinations, 19 implant losses were reported between insertion and review of 328 implants. The frequency distribution of the observed loss rates showed no treatment-specific trend. In the group with bar-treated implants, failure led to 'group loss' of the whole prosthetic superstructure. Failure of one of the double-crown-stabilized full dental prosthesis could usually be adapted so that the overdenture remained usable even without re-implantation. After comparing all the clinical parameters evaluated, no significant difference between the stabilization of full dentures via conus and telescopic crowns and bar-anchored dentures could be found. The choice of one particular method remains the decision of the professional treating the patient.

Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: A randomized clinical trial involving 87 patients with 3 months of follow-up

Background Approximately 12,000 hip and knee replacements were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, but there is conflicting evidence regarding the effect. We therefore performed an efficacy study of an accelerated perioperative care and rehabilitation intervention in patients receiving primary total hip replacement, and both total and unicompartmental knee replacement.Methods A randomized clinical trial was undertaken in which 87 patients were randomized to either a control group receiving the current perioperative procedure, or an intervention group receiving a new accelerated perioperative care and rehabilitation procedure. Outcome measures were length of stay (LOS) in hospital, and gain in quality of life (QOL) using EQ-5D from baseline to 3-month follow-up.Results Mean LOS was reduced (p < 0.001) from 8 days (95% CI: 7.1–8.4) in the control group to 5 days (95% CI: 4.2–5.6) in the intervention group. This was accompanied by a greater gain in QOL of 0.08 (95% CI: 0.004–0.16) in the intervention group (p = 0.03).Interpretation An accelerated perioperative care and rehabilitation intervention in patients undergoing primary total hip replacement, and total or unicompartmental knee replacement is indeed effective—and of advantage to both the hospital and the patient.

Assessing Participation in Daily Living and the Effectiveness of Rehabiliation in Age Related Macular Degeneration Patients Using the Impact of Vision Impairment Scale

Purpose: To assess if the Impact of Vision Impairment (IVI) is a valid instrument to measure participation in daily activities and rehabilitation in patients with age-related macular degeneration (AMD) and varying levels of visual impairment. Methods: Participants, recruited from a public eye hospital and low vision centers, completed the IVI questionnaire. The IVI and its three subscales were assessed for fit to the Rasch model. Unidimensionality, item fit, response category performance, and targeting of items to patients were assessed. Confirmatory factor analysis (CFA) was used to assess the three-factor model of the IVI in this sample of AMD patients. Results: 219 patients (mean ± SD age = 83.5 ± 7.4 yr) were recruited. Of these, 22%, 55% and 23% had mild (< 6/12–6/18), moderate (< 6/18–6/60) and severe (< 6/60) vision loss, respectively. The IVI total and three subscales displayed discrete thresholds indicating that the respondents understood the response categories. The IVI items fitted the scale and unidimensionality was established. Person separation reliability for the IVI score was substantial (0.94) indicating that the scale can discriminate between several groups of AMD patients. The IVI items were significantly targeted to the AMD patients with the means of the two distributions shown to be very close (0.0 and 0.1, respectively). Substantial targeting was also evident for the subscales. Poorer visual acuity was significantly associated (ANOVA; F (2, 216) = 23.4; p < 0.001) with greater restriction of participation suggesting that the IVI has substantial construct validity. CFA supported the IVI three-factor model which includes items from the “emotional well-being, “reading and accessing information” and “mobility and independence” subscales. Conclusions: Clinicians and researchers can reliably use the IVI to assess the impact on daily life and the effectiveness of clinical trials and rehabilitation interventions in patients with AMD across a range of vision loss.

ADL CAPABILITY AND COMPENSATORY MOTIONS FOR LIMITED ELBOW ANGLES

INTRODUCTION In rehabilitation treatment of patients with constrained joint motions in the upper extremity we appeal on available compensating mechanisms though we know little about the kinematic demands on the joints involved. We wish to be able to define the minimal demands for typical daily activities in terms of joint angles, to predict functional outcome based on observed joint angles and identify activity limiting joints.

Integration of monitoring and motor-training units for a tele-rehabilitation service

A tele-rehabilitation system has been designed for general use. The service can extend the rehabilitation treatment of patients affected by neurological diseases such as stroke or multiple sclerosis to their home, while under the control, supervision and responsibility of a hospital. Part of the initial work involved identifying the functional blocks of a tele-rehabilitation service. There are three parties involved in the tele-rehabilitation service: the health provider (the central unit of the system), the health operator (the medical unit of the system, generally a therapist) and the home platform (a central console with a high level of modularity). Tele-rehabilitative services that are easy to use could radically change the routine care and rehabilitation process.

695: There is no Significant difference between on-Demand PDE5-I Vs PDE5-I As Rehabilitative Treatment in Patients Treated by Bilateral Nerve-Sparing Radical Retropubic Prostatectomy

695: There is no Significant difference between on-Demand PDE5-I Vs PDE5-I As Rehabilitative Treatment in Patients Treated by Bilateral Nerve-Sparing Radical Retropubic Prostatectomy

Predictors for response to rehabilitation in patients with hip or knee osteoarthritis: a comparison of logistic regression models with three different definitions of responder

To identify pre-treatment predictors of who will benefit from a 3-4-week comprehensive rehabilitation intervention in patients with osteoarthritis (OA) of the knee or hip. A prospective cohort study with assessments at admission to the clinic and after 6 months was conducted. Two hundred and fifty patients from the rehabilitation clinic Rehaclinic Zurzach, Switzerland, were included. Three different measures of response to a 3-4-week comprehensive rehabilitation intervention were used: one indirect measure (minimal clinically important difference (MCID) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global score=18% improvement), one direct measure (transition question) and a combination of both criteria. Responders were predicted by a sequential logistic regression analysis with nine personal variables, five lifestyle risk factors, seven psychological status variables and the WOMAC global baseline score. The set of statistically significant predictors was dependent on the definition of response. The comparison of predictors that were statistically significant in any of the prediction models showed similar odds ratios (ORs) for the majority of predictors across three regression models with the different response definitions as dependent variable. Female gender, absence of depressive symptoms (dep), history of complementary medicine (cm) and low comorbidity (com) were the most stable predictors and had ORs above 2.0 (female) and above 1.5 (dep, cm, com) across the three regression models with different response definitions. A set of predictors for the outcome of rehabilitation in patients with OA was identified. If these predictors could be confirmed in future research, this knowledge might help to adopt and individualize the treatment of patients who are, at present, less likely to respond.

Prognostic factors in multidisciplinary rehabilitation treatment in multiple sclerosis: an outcome study

The aim of this outcome study was to evaluate the effectiveness and prognostic factors of inpatient multidisciplinary rehabilitation treatment in patients with multiple sclerosis (MS). We analysed 230 consecutive inpatients with MS admitted to an MS rehabilitation ward who followed an individualized, goal-oriented, multidisciplinary rehabilitation program. Every patient was submitted to a neurological examination and evaluated by means of Kurtzke's Expanded Disability Status Scale (EDSS), with its functional systems (FS), Barthel Index (BI) and the Rivermead Mobility Index (RMI). We observed an effectiveness (percentage of potential improvement achieved during rehabilitation) of nearly 16% on BI and 8% on RMI, corresponding to an improvement in 124 patients (54%) on BI and 113 patients (49%) on RMI. Basal EDSS (beta = -0.32, P <0.001), cognitive status (beta = -0.15, P <0.05) and disease duration (beta = -0.13, P <0.05) were negatively associated with effectiveness of treatment on BI (adjusted R2 = 0.176), whereas effectiveness on RMI was correlated only with the EDSS score (beta = -0.34, P <0.001, adjusted R2 = 0.113). In the logistic regression analysis, the absence of severe sphincteric disturbances was correlated with the probability of improvement on BI that was nearly twice as high (OR =2.25, 95% CI 1.24-4.08) as that of other patients. Moreover, patients without severe cognitive deficits showed a similar probability (OR =2.37, 95% CI 1.05-5.33) of improvement on RMI. The results of this study provide further evidence that intensive multidisciplinary rehabilitation in MS is effective in the majority of MS patients and that early treatment may favour functional recovery.

Early versus delayed inpatient spinal cord injury rehabilitation: An Italian study

Scivoletto G, Morganti B, Molinari M. Early versus delayed inpatient spinal cord injury rehabilitation: an Italian study. ObjectiveTo examine what effect the injury-to-rehabilitation interval has on the outcome of spinal cord injury (SCI) rehabilitation. DesignRetrospective study. SettingSpinal unit of a large rehabilitation hospital. ParticipantsConsecutive admissions were divided into groups according to age, sex, and American Spinal Injury Association impairment grade and neurologic level of injury. The patients were matched for these variables and divided into groups according to the interval from injury to admission into acute rehabilitation. This approach resulted in 150 patients with SCI grouped into 50 comparison subgroupings. InterventionsThree comparison groups—short (<30d), medium (31–60d), and long (>60d) time to admission (TTA)—were evaluated for rehabilitation outcomes. Main outcome measuresBarthel Index, Rivermead Mobility Index, Walking Index for Spinal Cord Injury, and motor scores at admission and discharge were examined. The changes and efficiencies were evaluated. ResultsThe 3 groups were comparable for all medical and demographic characteristics as well as neurologic recovery. The 3 subgroups differed significantly in activity of daily living outcomes, with the short TTA group exhibiting higher Barthel Index raw discharge scores, score increases, and score efficiencies. ConclusionsEarly rehabilitation seems to be a relevant prognostic factor of functional outcome. Rehabilitation intervention in patients with SCI should begin as soon as possible, in a specialized setting, because delay may adversely affect functional recovery.

Manipulation and arthroscopy under general anesthesia and early rehabilitative treatment for frozen shoulders

Castellarin G, Ricci M, Vedovi E, Vecchini E, Sembenini P, Marangon A, Vangelista A. Manipulation and arthroscopy under general anesthesia and early rehabilitative treatment for frozen shoulders. Arch Phys Med Rehabil 2004;85:1236–40. Objective To evaluate the efficacy of manipulation followed by arthroscopic release of the glenohumeral joint in conjunction with an immediate and intensive rehabilitation program. Design Retrospective, descriptive study. Setting A free-standing, university-affiliated orthopedics and rehabilitation hospital. Participants Forty patients with a clinical diagnosis of adhesive capsulitis resistant to pharmacologic and physical therapy (PT). Interventions Patients underwent manipulation and arthroscopic release of the capsular joint and were given an intensive PT program on the first postoperative day. Main outcome measures All patients were evaluated pre- and postoperatively at follow-up at an average of 42 months by using the Simple Shoulder Test (SST), the Constant-Murley system score, and passive (PROM) and active (AROM) range of motion. Results The SST, which showed a mean preoperative score of 2.2±0.7, was 10.8±0.7 ( P<.001) after surgery. Preoperatively, the mean Constant-Murley score was 33.2%±1.9%; postoperatively, the mean score was 91.7%±2.9% ( P<.001). PROM increased from 90° to 165° for anterior elevation, from 85° to 160° for abduction, from 20° to 60° for external rotation, and from 10° to 40° for internal rotation. AROM improved for anterior elevation from 82° to 155°; for abduction from 77° to 143°, and for external rotation, with the arm along the patient’s side, from 5° to 50°. Conclusions Results support the efficacy of manipulation follow by arthroscopic release and rehabilitative treatment for patients with resistant adhesive capsulitis of the shoulder.

A Treatment Program for Individuals With Deficient Evaluative Processing and Consequent Impaired Social and Risk Judgement

The current study evaluated the effectiveness of a rehabilitation program developed to assist individuals such as AM who have impaired social and risk judgement. AM’s difficulties developed after a severe traumatic brain injury that resulted in bilateral frontal and temporal lobe damage including damage to the amygdala. Previous work (Park et al., 2001) established that AM had impaired automatic processing of negative, but not positive evaluative information, and relatively spared processing of both types of evaluative information when using controlled or strategic processing. In the Strategic Evaluation of Alternatives (SEA) treatment program, AM was trained to compensate for his impairments by explicitly retrieving positive and negative attributes associated with potential actions prior to performing them. The SEA treatment focused specifically on improving AM’s ability to obtain financial compensation for his work-related activities. Results showed improved performance on work-related activities and evidence of generalization. Analyses suggested that the process underlying improved performance was compensatory rather than restorative in nature. We discuss the implications of these results for the development of rehabilitation treatment for patients with impaired social and risk judgement.

Bartel's index in assessing the recovery of patients with cerebral stroke in the acute period of the disease

The problem of rehabilitation treatment of patients who have suffered a cerebral stroke is extremely relevant due to its widespread prevalence, high rates of mortality and disability. One of the main reasons for persistent disability are, along with impaired speech function, psychological and social maladjustment, impaired motor functions of patients.

Robotics in the rehabilitation treatment of patients with stroke

Stroke is the leading cause of permanent disability despite continued advances in prevention and novel interventional treatments. Post-stroke neuro-rehabilitation programs teach compensatory strategies that alter the degree of permanent disability. Robotic devices are new tools for therapists to deliver enhanced sensorimotor training and concentrate on impairment reduction. Results from several groups have registered success in reducing impairment and increasing motor power with task-specific exercise delivered by the robotic devices. Enhancing the rehabilitation experience with task-specific repetitive exercise marks a different approach to the patient with stroke. The clinical challenge will be to streamline, adapt, and expand the robot protocols to accommodate healthcare economies, to determine which patients sustain the greatest benefit, and to explore the relationship between impairment reduction and disability level. With these new tools, therapists will measure aspects of outcome objectively and contribute to the emerging scientific basis of neuro-rehabilitation.

Interventions for rehabilitation of patients with early psychosis

Developing a psychotic disorder has a major impact on both the consumer and their family. This article discusses the implementation of a programme for the rehabilitation of patients with early psychosis. The programme encourages both early intervention and the involvement of families both of which are increasingly thought to produce better outcomes for young people with this disorder.

Surgical treatment of injuries and diseases of the spine using the steffee and luque systems

The experience of treatment using the Steffee transpedicular system and the Luque sublaminar system in 33 patients with spinal fractures (20), spondylolisthesis (11), spinal tuberculosis (1) and cauda equina root cavernous angioma (1) is presented. The indications for various types of operations for traumatic injuries and diseases of the spine are substantiated, depending on clinical neurological manifestations and data from special research methods (X-ray, myelography, computed and magnetic resonance imaging). Schemes of operations are given. It has been shown that the use of the Steffee and Luque systems in combination with adequate neuroorthopedic correction makes it possible to eliminate various types of spinal deformities, provides rigid fixation of it, creating an opportunity for early activation and rehabilitation treatment of patients.