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Rehabilitation Treatment (rehabilitation + treatment)
Selected AbstractsCortical and subcortical correlates of functional electrical stimulation of wrist extensor and flexor muscles revealed by fMRIHUMAN BRAIN MAPPING, Issue 3 2009Armin Blickenstorfer Abstract The main scope of this study was to test the feasibility and reliability of FES in a MR-environment. Functional Electrical Stimulation (FES) is used in the rehabilitation therapy of patients after stroke or spinal cord injury to improve their motor abilities. Its principle lies in applying repeated electrical stimulation to the relevant nerves or muscles for eliciting either isometric or concentric contractions of the treated muscles. In this study we report cerebral activation patterns in healthy subjects undergoing fMRI during FES stimulation. We stimulated the wrist extensor and flexor muscles in an alternating pattern while BOLD-fMRI was recorded. We used both block and event-related designs to demonstrate their feasibility for recording FES activation in the same cortical and subcortical areas. Six out of fifteen subjects repeated the experiment three times within the same session to control intraindividual variance. In both block and event-related design, the analysis revealed an activation pattern comprising the contralateral primary motor cortex, primary somatosensory cortex and premotor cortex; the ipsilateral cerebellum; bilateral secondary somatosensory cortex, the supplementary motor area and anterior cingulate cortex. Within the same subjects we observed a consistent replication of the activation pattern shown in overlapping regions centered on the peak of activation. Similar time course within these regions were demonstrated in the event-related design. Thus, both techniques demonstrate reliable activation of the sensorimotor network and eventually can be used for assessing plastic changes associated with FES rehabilitation treatment. Hum Brain Mapp, 2009. © 2008 Wiley-Liss, Inc. [source] Medical Comorbidity and Rehabilitation Efficiency in Geriatric InpatientsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2001C Psych, Louise Patrick PhD OBJECTIVES: To measure and describe medical comorbidity in geriatric rehabilitation patients and investigate its relationship to rehabilitation efficiency. DESIGN: Prospective, multivariate, within-subject design. SETTING: The Geriatric Rehabilitation inpatient unit of the SCO Health Service in Ottawa, Canada. MEASUREMENTS: The rehabilitation efficiency ratio, based on gains in functional status achieved with rehabilitation treatment, and the length of stay were computed for all patients. Values were regressed on the scores of the Cumulative Illness Rating Scale (CIRS), the Mini-Mental State Examination, and the Geriatric Depression Scale to establish predictive power. RESULTS: The findings suggest that geriatric rehabilitation patients experience considerable medical comorbidity. Sixty percent of patients had impairments across six of the 13 dimensions of the CIRS, whereas 36% of patients had impairments across 11 of the 13 dimensions. In addition, medical comorbidity was negatively related to rehabilitation efficiency. This relationship was significant even after controlling for age, cognitive status, depressive symptoms, and functional independence status at admission. CONCLUSION: Medical comorbidity was a significant predictor of rehabilitation efficiency in geriatric patients. Comorbidity scores> 5 were prognostic of poorer rehabilitation outcomes and can serve as an empirical guide in estimating a patient's suitability for rehabilitation. Medical comorbidity predicted both the overall functional change achieved with rehabilitation (Functional Independence Measure gains) and the rate at with which those gains were reached (rehabilitation efficiency ratio). [source] Correlation between the Individual and the Combined Width of the Six Maxillary Anterior TeethJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 3 2009LUIZ CARLOS GONÇALVES DMD ABSTRACT Purpose:, There is a consensus in the community of dental research that the selection of undersized artificial maxillary anterior teeth offers an unnatural appearance to the denture. Several methods to select the adequate width of these teeth are of questionable validity, and many dentures have an obviously artificial appearance. This article assessed the relationship between the individual and the combined width of maxillary anterior teeth. Materials and Methods:, Impressions were made of the anterior dentition of 69 dentate undergraduate students with rubber impression silicon, and casts were formed. The individual widths of the maxillary anterior teeth were measured by using a digital caliper (SC-6 digital caliper, Mitutoyo Corporation, Tokyo, Japan), and the combined width was registered by both adding the individual width and using a flexible millimeter ruler. Results:, Student's t -test showed significant differences between the analogous teeth and different sides of the maxillary dental arch (p = 0.001), with the exception of the central incisor (p = 0.984). Pearson's product moment correlation coefficient showed significant positive correlation between all the measurements compared (p = 0.000). Linear regression analysis concluded three mathematical equations to obtain the individual tooth width after measuring the combined width of the six maxillary anterior teeth by using a flexible millimeter ruler. Conclusions:, The individual tooth width can be determined if the combined width of the maxillary anterior teeth is obtained by using a flexible millimeter ruler. CLINICAL SIGNIFICANCE The adequate selection of each maxillary anterior tooth width can offer variance and individuality to the denture, particularly for partially dentate patients. By offering an adequate tooth-to-tooth relationship, the esthetic result of the oral rehabilitation treatment can be improved. [source] Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease,MOVEMENT DISORDERS, Issue 3 2010Michelangelo Bartolo MD Abstract People with Parkinson's disease (PD) often have a posture characterized by lateral trunk flexion poorly responsive to antiparkinsonian drugs. To examine the effects of a rehabilitation programme (daily individual 90-minute-sessions, 5-days-a-week for 4-consecutive weeks) on lateral trunk flexion and mobility, 22 PD patients with mild to severe lateral trunk flexion, and 22 PD patients without trunk flexion were studied. Patients were evaluated using the Unified Parkinson's Disease Rating Scale motor subscale (UPDRS-III) score, and the kinematic behavior of the trunk was recorded by means of an optoelectronic system to determine: a) trunk flexion, inclination and rotation values in the erect standing posture; b) ranges of trunk flexion and inclination during trunk movements. After the treatment, significant decreases in trunk flexion [24°(4) vs. 14°(3), P < 0.001] and inclination in the static condition [23°(5) vs. 12°(4), P < 0.001)] were observed, both of which were maintained at the 6-month follow up. During the trunk flexion task, a significantly increased range of trunk flexion [64°(15) vs. 83°(15), P < 0.001] was observed; similarly, during the lateral bending task, the range of trunk inclination was found to be significantly increased, both toward the side of the trunk deviation [29°(8) vs. 42°(13), P < 0.01] and toward the contralateral side [14°(6) vs 29°(11), P < 0.01]. No further significant changes were observed at the 6-month follow-up. Trunk flexion and inclination values in the upright standing posture correlated slightly with the UPDRS-III score. Our findings show that significant improvements in axial posture and trunk mobility can be obtained through the 4-week rehabilitation programme described, with a parallel improvement in clinical status. © 2010 Movement Disorder Society [source] Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Kate Taylor Abstract Objective: To review the challenges facing Indigenous and mainstream services in delivering residential rehabilitation services to Indigenous Australians, and explore opportunities to enhance outcomes. Methods: A literature review was conducted using keyword searches of databases, on-line journals, articles, national papers, conference proceedings and reports from different organisations, with snowball follow-up of relevant citations. Each article was assessed for quality using recognised criteria. Results: Despite debate about the effectiveness of mainstream residential alcohol rehabilitation treatment, most Indigenous Australians with harmful alcohol consumption who seek help have a strong preference for residential treatment. While there is a significant gap in the cultural appropriateness of mainstream services for Indigenous clients, Indigenous-controlled residential organisations also face issues in service delivery. Limitations and inherent difficulties in rigorous evaluation processes further plague both areas of service provision. Conclusion: With inadequate evidence surrounding what constitutes ,best practice' for Indigenous clients in residential settings, more research is needed to investigate, evaluate and contribute to the further development of culturally appropriate models of best practice. In urban settings, a key area for innovation involves improving the capacity and quality of service delivery through effective inter-agency partnerships between Indigenous and mainstream service providers. [source] Goal Attainment Scaling in paediatric rehabilitation: a report on the clinical training of an interdisciplinary teamCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2008D. Steenbeek Abstract Background Goal Attainment Scaling (GAS) is a responsive method for individual goal setting and treatment evaluation. However, current knowledge about its reliability when used in paediatric rehabilitation treatment is insufficient and depends highly on standardization of the GAS method. A training programme was developed to introduce GAS to a team of 27 professionals from five disciplines. The purpose of the paper is to share the experiences of professionals and parents during this training. Methods The training consisted of three 2-h general discussion sessions and intensive individual feedback from the study leader (i.e. the first author). Feedback was given until the GAS scales met predetermined criteria of ordinality, described specific, measurable, acceptable, realistic abilities and activities in a single dimension, used the ,can-do' principle and could be scored within 10 min. Therapists and parents were asked to give their opinion by completing a questionnaire. Results One hundred and fifteen GAS scales were developed and scored by professionals. The development of a GAS scale remained a time-consuming procedure, despite the training: 45 (SD = 27) minutes per scale. The content criteria of GAS were found to be useful by all participants. Common issues requiring revision of the initial scales were equal scale intervals, specificity, measurability and selection of a single variable. After the training, 70% of the therapists and 60% of the parents regarded GAS as a suitable tool to improve the quality of rehabilitation treatment. Examples of GAS scales developed by the various disciplines are presented and discussed. Conclusions The experiences reported in this paper support the further development of training procedures for GAS before it can be used as an outcome measure in effect studies. The findings may be helpful in introducing GAS in the field of childhood disability. [source] Changes of elbow kinematics and kinetics during 1 year after strokeMUSCLE AND NERVE, Issue 3 2008Mehdi M. Mirbagheri PhD Abstract A precise description of the natural history of motor recovery after stroke provides a framework for understanding the mechanisms underlying this improvement and for tracking the efficacy of rehabilitation treatments. To characterize the time course of this change in motor impairment, we examined voluntary elbow movements in hemiparetic stroke survivors over a period of 1 year after stroke. Based on the possibility that both central nervous system and muscle factors could contribute to the observed clinical state, we hypothesized that we should observe at least two major recovery patterns of motor impairment. To explore these predictions, we assessed elbow movement range, movement speed, and isometric force generation. Subjects were examined five times over the 12-month period. We used the "growth mixture" model to characterize recovery of these measures, and the Fugl-Meyer scale (FMS) of upper-extremity function at 1 month to predict the recovery. We observed two distinct recovery classes. Class 1 started with low values for the physiological measures, and these increased over time, whereas class 2 tended to start with higher values and showed widely divergent recovery patterns. Using the logistic regression model, the impact of FMS on class membership was estimated for each parameter. Based on these data, we were able to accurately predict arm impairment recovery at different time-points in the first year, information of great potential value for planning targeted therapeutic interventions. Muscle Nerve, 2008 [source] Response of Native and Exotic Grasses to Increased Soil Nitrogen and Recovery in a Postfire EnvironmentRESTORATION ECOLOGY, Issue 4 2006Molly E. Hunter Abstract Native plant recovery following wildfires is of great concern to managers because of the potential for increased water run-off and soil erosion associated with severely burned areas. Although postfire seeding with exotic grasses or cultivars of native grasses (seeded grasses) may mitigate the potential for increased run-off and erosion, such treatments may also be detrimental to long-term recovery of other native plant species. The degree to which seeded grasses dominate a site and reduce native plant diversity may be a function of the availability of resources such as nitrogen and light and differing abilities of native and seeded grasses to utilize available resources. We tested the hypothesis that seeded grasses have higher growth rates than native grasses when nitrogen and light availability is high in a greenhouse experiment. To determine how differing resource utilization strategies may affect distribution of native and seeded grasses across a burned landscape, we conducted botanical surveys after a wildfire in northern New Mexico, U.S.A., one and four years after the fire. In the greenhouse study we found seeded grasses to produce significantly more biomass than native grasses when nitrogen and light availability was high. Seeded grasses increased in cover from 1,4 years after the fire only in areas where total soil nitrogen was higher. Increased cover of seeded grasses did not affect recovery of native grasses, but it did lead to reduced native species richness at small scales. The potential negative long-term consequences of seeding with exotic grasses should be considered in postfire rehabilitation treatments. [source] | |||||||||||||