Weeks Of Inpatient Rehabilitation Research Articles

Coping During Inpatient Stroke Rehabilitation: An Exploratory Study

The emotional impact of surviving a stroke has not received the same attention as physical aspects. This is particularly true regarding how stroke survivors cope during inpatient rehabilitation. This study examined the coping strategies used by stroke survivors undergoing inpatient rehabilitation and the relationships between demographic or clinical variables and coping behaviors. This case series examined 16 acute stroke survivors via standardized assessments and a medical records review completed during the first week of inpatient rehabilitation. Stroke survivors used combinations of multiple coping strategies. All stroke survivors used a higher number and frequency of adaptive rather than maladaptive strategies. Women used a higher number of adaptive strategies. Stroke survivors with depression used maladaptive coping strategies more frequently, whereas those presenting with a greater number and severity of comorbidities used adaptive coping strategies more frequently. Stroke survivors with higher levels of coping self-efficacy used the strategies of active coping and positive reframing more frequently. Based on these results, it is recommended direct-care providers place greater emphasis on objectifying the emotional consequences of stroke. Further research is recommended regarding understanding the relationship between coping and outcomes.

Limb-Loaded Cycling Program for Locomotor Intervention Following Stroke

This case report describes implementation of a limb-loaded cycling (LLC) training program as a feasible exercise for people in early phases of locomotor training following stroke. Two individuals with early-stage poststroke hemiplegia participated in the LLC program as an adjunct to physical therapy intervention. Performance of LLC involved cycling while supporting progressive amounts of applied load and weight shifting from one lower extremity to the other lower extremity. The LLC was conducted daily during 2 to 3 weeks of inpatient rehabilitation. The LLC progressed with increases in weight bearing and force generation, as evidenced by larger amounts of limb loading during pedaling. The patients tolerated all loads without cardiorespiratory distress. Limb-loaded cycling can accommodate people with little force-generating capability or weight-bearing ability as they practice locomotor skills. Gains in locomotor ability may be aided by the addition of this exercise regimen to patients' daily physical therapy.

Interdisciplinary group therapy for fibromyalgia

Fibromyalgia is present in 2% of the general population and leads to impairment by chronic pain and fatigue. It does not improve without therapy directed at the symptoms of fibromyalgia. We describe our interdisciplinary group treatment for patients with fibromyalgia. They received a physical examination, ergometry and psychometric tests both at admission and before discharge, and they were questioned to the degree and localization of their pain, to fatigue, sleeping disorders and functional symptoms. Therapy included information about fibromyalgia, learning of coping strategies, relaxation and endurance training. Our results show that our interdisciplinary group treatment is effective for fibromyalgia and improves anxiety, depression and well being after a period of 5 weeks of in-patient rehabilitation.

Relationships between disability measures and nursing effort during medical rehabilitation for patients with traumatic brain and spinal cord injury

Objective: The increasing use of disability measures requires that the validity of these instruments be adequately demonstrated. This study sought to evaluate the concurrent validity of one disability measure, the Functional Independence Measure (FIM SM) using minutes of care reported by nursing staff. Study Design: Correlational, cohort design. Setting: Eight inpatient medical rehabilitation hospitals that subscribe to the Uniform Data System for Medical Rehabilitation. Patients or Other Participants: 129 patients with traumatic brain injury (TBI) and 53 patients with traumatic spinal cord injury (SCI). Interventions: Routine rehabilitation care. Main Outcome Measures: Patient-nurse contact times were recorded with a stop watch for a 24-hour period during the first and last weeks of inpatient rehabilitation. The FIM was also completed during the first and last weeks of rehabilitation. Results: Contact times declined from the first to last weeks of rehabilitation, concurrent with improving scores on motor and cognitive measures derived from the FIM. Statistically significant correlations between contact times and FIM measures were observed for medication dispensing, treatment provision, and teaching/activities of daily living at admission and discharge. Smaller and usually nonsignificant correlations were observed in activities that did not involve direct patient contact. Contact times increased exponentially as disability increased. Conclusions: These results support the construct validity of the FIM by demonstrating strong relationships (r values in the range of .40 to .60) between burden of care and a measure of disability.