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Biomedical subjects

H Hoenig

Publications and source records attributed to H Hoenig.

25 records · Page 2Linked to original sources

Educating primary care physicians in geriatric rehabilitation.

This article has reviewed the current status of primary care physician education in rehabilitation and the potential effects of current educational inadequacies on use of rehabilitation. The epidemiologic data regarding disease, development of disability, resource utilization, and its relevance to curriculum selection for rehabilitation were examined. Health care resources are limited, and given the increasingly important role the rehabilitation will play in health care, it is important that our educational efforts promote optimal use of those resources. A variety of teaching methods and their potential utility were discussed. Educating primary care physicians in the proper use of rehabilitation is of immediate importance for the large and growing older population. The use of available data on disease prevalence and impact to direct educational efforts will maximize the beneficial effects of our educational investments. The improved use of geriatric rehabilitation can make a significant impact on the health and quality of life for millions of older Americans.

Activities of Daily Living↗

A randomized controlled trial of home exercise on the rheumatoid hand.

OBJECTIVE: To study differing home hand exercise interventions to determine effects on grip strength, and secondarily any immediate or short term effects on range of motion, pain, deformities, hand disease activity, and dexterity. METHODS: Randomized controlled trial of 12 weeks of home hand exercise performed for 10-20 min twice daily. Study exercise interventions were range of motion exercises, balanced resistive exercises, and range of motion plus balanced resistive exercises. RESULTS: Aside from transient, mild to moderate discomfort, exercises were well tolerated. Range of motion exercises were associated with improved right hand joint count. Range of motion plus balanced resistive exercises were associated with increased left hand dexterity. Home hand exercise (exercise groups combined) significantly increased left grip strength. CONCLUSIONS: Temporary use of home hand exercise has acceptable side effects and is an effective means of increasing grip strength.

Ambulatory Care↗

Patient-related predictors of rehabilitation use for community-dwelling older Americans.

OBJECTIVE: To determine patient factors that predict use of physical or occupational therapy (PT/OT) services by elderly people. DESIGN: Time-series study of the relationship of PT/OT use to a variety of characteristics present at baseline. PARTICIPANTS: Eight-hundred nine community-dwelling men and women aged 65 and older. SETTING: The Medicare Screening and Health Promotion Trial at UCLA. MAIN OUTCOME MEASURES: Use of PT/OT services, as reported in a telephone survey 1 year after initial information was obtained on the same subjects by the baseline telephonic survey. RESULTS: Fifteen percent of the sample used PT/OT within 12 months of baseline. In multiple logistic regression analysis, PT/OT use was significantly less frequent among racial minorities, less well educated groups, and the oldest age group. PT/OT use was higher among those who had both functional disability and the presence of arthritis, heart or lung disease, or a prior history of stroke. However, neither functional disability alone nor the presence of arthritis, cardiovascular or lung disease, in the absence of limited functioning, was associated with PT/OT use. Patients who had obtained a pneumococcal vaccination or used transportation services were also more likely to receive PT/OT. CONCLUSIONS: Our findings suggest that there may be important sociodemographic inequalities in the use of rehabilitation services and raise the possibility of inappropriate underuse in certain subgroups. Additional studies are needed to determine whether similar inequalities of PT/OT use are found in other populations and whether rehabilitation is effective in various subgroups.

Activities of Daily Living↗

The structure and structural effects of VA rehabilitation bedservice care for stroke.

The purpose of this study was to: 1) examine the variation in organizational structure within rehabilitation bed-service units (RBU) in the Veterans Health Administration (VHA), and 2) evaluate the effects of RBU and parent hospital structure on stroke rehabilitation outcomes. Two VHA-wide surveys of acute and rehabilitation services for stroke were linked with 2 y of VHA rehabilitation outcomes for stroke patients. A random effects mixed model was used to adjust for patient level covariates, control for unique site effects, and test for facility level structural effects. After adjusting for patient covariates, four structural variables were associated with length of stay or patient functional gain. These results indicate that rehabilitation structure is important to rehabilitation outcome. The individual variables identified in this study, namely, diverse multidisciplinary staff, expert physician leadership, staff participation in team care, and richer rehabilitation equipment resources, may represent the distinct aspects of a successful, comprehensive rehabilitation unit.

Adult↗