Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “REHABILITATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,603 records · Page 89Linked to original sources
PubMed2006

[Vocational rehabilitation in transition--challenges and perspectives].

The present article outlines the challenges in occupational rehabilitation arising from the successive erosion of the financial foundations of the welfare system, from changes in industry as well as in health, education and labour-market policy. Five perspectives are discussed to design and develop strategies in occupational rehabilitation. Among these are: (1) Rehabilitation in companies is mostly based on miscarried efforts to prevent separation. The discontinuance and the re-integration in a position or in a company have therefore to be regarded as an interlocking process between vocational training centre, social insurance agencies and employers; (2) Regional vocational rehabilitation centres with the objective to promote participation in work life may advance to institutionalized junctions to connect the rehabilitation landscape and would represent the logistic context; (3) The development of participation benefits should mainly be directed towards individualized allocation of resources as well as the possibility of direct transfer to work in close cooperation with employers; (4) Structural solutions and process-innovation could be supported by application-orientated research; (5) A new consensus to assign future tasks and objectives should be defined among the responsible bodies and service organisations involved in occupational rehabilitation.

Persons with Disabilities↗
PubMedDate not supplied

[Effects of inpatient rehabilitation for patients with back pain].

BACKGROUND: This prospective, randomised longitudinal study examined the effects of inpatient medical rehabilitation. METHOD: Data was collated on the day of admission (n=261), day of discharge (n=261) and 6 months after discharge (n=243). The length of the rehabilitation measure changed every 3 months from 3 weeks (n=127) to 4 weeks (n=134) and back again. On all three specific days the VAS, the Roland-Morris-Questionnaire (RMQ) and the SF-36 were applied. The distance between fingers and floor and the Schober-sign were measured on the first and second day. The Mainz Pain Staging System (MPSS) was used to classify pain chronicity. RESULTS: On the day of discharge all parameters show an improvement. When the differing rehabilitation times are compared we can see the longer period scores better in VAS and Schober. 6 months after the rehabilitation all parameters show a slight improvement over the first day--except VAS--and a deterioration compared to the second--except RMQ. No significant predominance of the 4 week rehabilitation period is recognizable. CONCLUSION: The length of the rehabilitation measure alone seems to have no real effect on the permanence of the positive treatment of back complaints. It has advantages, though, for the result on the day of discharge.

Activities of Daily Living↗
PubMed2000

Quality of life assessment: its integration in rehabilitation care through a model of daily living.

To integrate quality of life assessment with rehabilitation care, some correspondence is required between the concepts of quality of life and of rehabilitation. A notion of quality of life is presented in which quality is conceived as degree of goodness, and life as daily living. Rehabilitation is considered both a process of adaptation and assistance to that process. These notions of quality of life and of rehabilitation can together be operationalized through a model of daily living. An individual's appraisal of his own situation in relation to adaptation can be explained, assuming a hierarchy of internal standards. Explaining appraisal by others requires external standards. Both types of appraisal are important grounds for decisions regarding assistance. In addition, general ideas on justification of rehabilitation as assistance may influence such decisions. The model integrates both objective and subjective appraisal and ideas on justification into rehabilitation, thereby offering opportunities for theoretical underpinning of the practice.

Activities of Daily Living↗
PubMed2006

The influence of neuropsychological rehabilitation on symptomatology and quality of life following brain injury: a controlled long-term follow-up.

PRIMARY OBJECTIVE: To establish whether, following acquired brain injury, intensive post-acute neuropsychological rehabilitation could have long-term beneficial effects. METHODS AND PROCEDURES: A group of 37 adults who had suffered cerebrovascular accidents or traumatic brain injuries and who had undergone a rehabilitation programme were followed up 12-22 years post-injury, together with a non-rehabilitated control group of 13 adults, matched for brain-injury and demographics characteristics. Both groups completed a set of questionnaires concerning broad aspects of psychological well-being. Significant others completed similar questionnaires. MAIN OUTCOMES AND RESULTS: The rehabilitation group showed significantly lower levels of brain injury symptoms and higher levels of competency at follow-up. They also rated internal locus of control and general self-efficacy as significantly higher than the control group. Anxiety and depression levels were significantly lower and quality of life significantly higher in the rehabilitation group for both the subjects themselves and for their significant others. CONCLUSIONS: Within methodological limitations this study suggests that post-acute neuropsychological rehabilitation can have long-term beneficial effects.

Awareness↗
PubMed2000

Patient mood and carer strain during stroke rehabilitation in the community following early hospital discharge.

PURPOSE: Patient mood and carer stress were assessed for stroke patients in the community following early hospital discharge. METHOD: Patients had low Barthel Indices (13.0 (mean) +/- 4.9 (SD)) with high anxiety and depression scores, and carers had high stress scores, on starting rehabilitation. On starting rehabilitation, patient Barthel Indices correlated inversely with patient depression (r = -0.33, p < 0.02) and carer stress scores (r = -0.48, p < 0.001). RESULTS: During rehabilitation improvements occurred in patient Barthel Indices, patient anxiety scores and carer stress scores, but not in patient depression scores. Incremental increases in patient Barthel Indices during rehabilitation correlated with reductions in carer stress scores (r = -0.55, R2 = 29.4%, p < 0.001). Following early hospital discharge stroke patients display mood abnormalities which do not resolve during rehabilitation. CONCLUSION: Carer stress and patients depression scores are related to the severity of stroke-related disability. Strategies to address patient mood and carer stress should be present in community services providing early stroke rehabilitation.

Affect↗
PubMed2005

Theory development and a science of rehabilitation.

PURPOSE: This article considers the role of theory and theory building in science and specifically in rehabilitation. It is argued that rehabilitation has tended to value theory testing over theory building and some evidence is presented for this. METHOD: Some general questions concerning the role of theory in scientific progress are discussed including: What is a theory? What is the role of theory in science? What makes a good scientific theory? How does theoretical change occur in science? Where relevant these questions are discussed in terms of examples from clinical rehabilitation research. RESULTS: Two important issues arising from the preceding discussion are then considered. First is the question of whether a general or unifying theory of rehabilitation is a desirable goal. The second concerns how we might begin to develop a coherent programme of theory building in rehabilitation. CONCLUSION: More time spent on rehabilitation theory building may enhance the fruits of empirical theory testing.

Humans↗
PubMed2006

Prognosis and prognostic factors in ADL-dependent stroke patients during their first in-patient rehabilitation--a prospective multicentre study.

PURPOSE: This prospective longitudinal study aimed at a description of ADL-functioning and at an analysis, which clinical instruments predict independency 6 months after discharge from in-patient rehabilitation following disabling first stroke. METHOD: A total of 147 patients with disabling first stroke were recruited from three neurological rehabilitation centres. They were assessed during their first in-patient rehabilitation with the NIH Stroke Scale, Hemispheric Stroke Scale (HSS), Activity Index, Barthel Index, Neurobehavioural Rating Scale, Cornell Depression Scale, and the prognostic prediction of the rehabilitation neurologist. The 6 months outcome was established with the Nottingham Extended ADL Scale (NEADL) and by the legal dependency status. RESULTS: The best prediction of 6 months outcome as measured by the NEADL was obtained by the HSS and a multivariate model that also included the physician's prognostic prediction, both early in rehabilitation and at discharge. The dependency status was best predicted by the HSS and patient's sex. CONCLUSION: Clinical scales performed during rehabilitation such as the HSS are valid for prediction of ADL-dependency 6 months after discharge.

Activities of Daily Living↗
PubMed2006

Reliability and construct validity of the client-centred rehabilitation questionnaire.

PURPOSE: A key component in assessing the performance of rehabilitation services is the client's perspective. The purpose of this paper is to report on the development of a publicly available measure of client-centred rehabilitation (CCRQ) that can be used for discriminative and evaluative purposes. METHOD: Mixed qualitatative and quantitative methods were used. Phase 1: Identification of seven domains of client-centred rehabilitation based on a literature review, focus groups with clients, and review by content experts. Phase 2: Item generation for the seven conceptually derived subscales and cognitive interviews with inpatient rehabilitation patients. Phase 3: Psychometric testing for internal reliability, test-retest reliability and discriminative construct validity using data from a mailed, self-administered survey to 1,568 patients discharged from two large inpatient rehabilitation facilities. RESULTS: The seven conceptually derived subscales all have strong internal (0.72 - 0.87) and test-retest reliability (0.74 - 0.85). Discriminative construct validity is demonstrated by the ability of subscales to identify significant differences between programs within two rehabilitation facilities. CONCLUSIONS: The results for the reliability and validity of this measure support its value for use in clinical and quality improvement work as well as research.

Adolescent↗
PubMed2004

Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemiplegic lower limb.

OBJECTIVE: To evaluate the effects of the intensive repetition of movements elicited by the facilitation technique to improve voluntary movement of a hemiplegic lower limb in patients with brain damage. DESIGN: A multiple-baseline design (A-B-A-B: A without specific therapy, B with specific therapy) across individuals. PATIENTS: The sample comprised 22 subjects with stroke and 2 brain tumour-operated subjects (age: 50.7 +/- 9.6 years, time after onset: 7.1 +/- 2.6 weeks). They were selected from among 165 patients with stroke who were admitted to our rehabilitation centre from September 1, 1995 to March 31, 1997. METHODS: Two 2-week facilitation technique sessions (more than 100 repetitions a day for each of 5 kinds of movement) were applied at 2-week intervals in patients with hemiplegia, who were being treated with continuous conventional rehabilitation exercise without the facilitation technique for hemiplegia. Motor function of the affected lower limb (Brunnstrom Recovery Stage of hemiplegia, the foot-tap test and the strength of knee extension/flexion) and walking velocity were evaluated at 2-week intervals. RESULTS: Significant improvements in Brunnstrom Stage, foot-tapping and the strength of knee extension/flexion of the affected lower limb were seen after the first conventional rehabilitation exercise session and after the first and second facilitation technique and conventional rehabilitation exercise sessions. The improvements after facilitation technique and conventional rehabilitation exercise sessions were significantly greater than those after the preceding conventional rehabilitation exercise sessions. CONCLUSION: Intensive repetition of movement elicited by the facilitation technique (chiefly proprioceptive neuromuscural facilitation pattern, stretch reflex and skin-muscle reflex) improved voluntary movement of a hemiplegic lower limb in patients with brain damage.

Activities of Daily Living↗
PubMed2005

Qualitative methodology for rehabilitation research.

Qualitative research methodology focuses on individuals' lived experiences as they are presented in thoughts, ideas, feelings, attitudes and perceptions. In addition, the research approach emphasizes human behaviour and social interaction. It explores the quality of a phenomenon, not the quantity. This article outlines the major characteristics of qualitative research methodology and gives applications and examples. The aim of qualitative methodology is to develop new knowledge based on participants' own beliefs and experiences, not on pre-defined, testable hypotheses. It is inductive rather than deductive, and it is interpretative rather than predictive. The design is flexible, iterative and emergent and therefore requires of the researcher an ability to change and adapt the research process in accordance with emerging results. Qualitative research is thus different from quantitative research as it allows for flexibility throughout the research process. Several data collection methods can be used, such as individual interviews, focus group discussions or participant observations, in order to gain a deeper understanding of health, illness and rehabilitation. It can be used in combination with quantitative studies, but also as a research method of its own. In health research, the qualitative methodology has gained increasing credibility during the last decade. However, it is not yet frequently used in rehabilitation research. As rehabilitation outcomes are dependent on people's attitudes, thoughts and motivation regarding the rehabilitation process, and as the rehabilitation process in itself builds on social interaction, studies with a qualitative design could become useful tools in the development and improvement of rehabilitation.

Attitude to Health↗
PubMed2005

Effect of financial compensation on vocational rehabilitation.

OBJECTIVE: To examine how financial compensation affects the outcome of vocational rehabilitation. DESIGN: A registry-based follow-up study. SUBJECTS: A total of 1397 rehabilitees discharged from the 5 local rehabilitation agencies in Aarhus County, Denmark from 1 July 2000 to 31 December 2001. METHODS: At submission demographic data was obtained as well as data on financial compensation, i.e. compensation for industrial injury, indemnity for off-duty injury and application for disability pension. Rehabilitation outcomes were recorded at discharge. Renouncing further attempts at rehabilitation was defined as a negative outcome; education, further rehabilitation or return-to-work on normal or less demanding terms were defined as a positive outcome. Rehabilitees with and without financial compensation were compared. RESULTS: Rehabilitees with involvement of financial compensation had an increased risk of a negative outcome compared with those without involvement of financial compensation. Adjustment for potential confounders did not change the association between financial compensation and negative outcome. The risk of a negative outcome rose with increasing age, with less than 1 year of labour market experience and with rented housing. Previous occupation as a skilled worker reduced the risk. CONCLUSION: Financial compensation was associated with an increased risk of a negative vocational rehabilitation outcome.

Accidents, Occupational↗
PubMed1999

Cognitive rehabilitation for schizophrenia: problems, prospects, and strategies.

Increasing awareness of the importance of neurocognitive impairments in schizophrenia has fostered considerable interest in the prospects for cognitive rehabilitation. Nevertheless, optimism has outpaced progress. We first review recent literature on the central assumptions that underlie cognitive rehabilitation, including the hypothesis that cognitive deficits play a central role in social disability and other problems schizophrenia patients experience in daily living, and that these impairments must be rectified if we are to achieve effective rehabilitation. We next discuss developments in knowledge about the neurobiology of schizophrenia that bear on the potential for cognitive rehabilitation and the selection of appropriate targets for intervention. Third, we propose a new research strategy for investigating cognitive functioning in schizophrenia and for examining the relationship of cognitive deficits to role functioning in the community: examining patients who have good vocational outcomes in order to identify strengths or compensatory factors that compensate for core deficits. We present new data that lend support to our proposed approach. We next discuss putative limits to cognitive rehabilitation based on data documenting cognitive deficits in healthy siblings and parents. Finally, we briefly describe an interim rehabilitation strategy that minimizes the load on cognitive processes rather than attempting to improve cognitive functioning.

Activities of Daily Living↗
PubMed1979

Foot-pounds of torque of the normal knee and the rehabilitated postmeniscectomy knee.

Foot-pounds of torque of the knee flexors and knee extensors of eight rehabilitated patients who had had meniscectomies were obtained isometrically and at 60 and 210 degrees per second by use of an isokinetic apparatus. Our purpose was to test the null hypothesis that no significant difference in torque would be manifested between the rehabilitated postmeniscectomy knee and the normal knee. Mean torque developed by the rehabilitated postoperative knee was 10 to 12 percent less than the mean torque developed by the normal knee. We found a significant difference between means of torque of the normal knee and the rehabilitated knee for isometric flexion, rapid dynamic flexion, and rapid dynamic extension. Means of torque of knee extension for the three types of contraction for both knees of the subjects demonstrated similar patterns in which torque developed isometrically was greater than torque developed by slow dynamic tension, which in turn was greater than torque developed by rapid dynamic contraction. Means of torque of knee flexion for the three types of contraction for both knees of the subjects created patterns in which torque developed isometrically was essentially equal to torque developed by slow dynamic tension, and both these measurements exceeded torque developed by rapid dynamic contractions. Overall, the results suggest that physical therapists need to use rehabilitative techniques that promote muscular power and muscular endurance in addition to muscular strength and that more attention needs to be directed to the rehabilitation of knee flexors.

Adolescent↗
PubMedDate not supplied

Functional gain and length of stay for major rehabilitation impairment categories. Patterns revealed by function related groups.

This study evaluates the relationship of functional severity to patterns of functional gain and length of stay (LOS) for patients discharged from medical rehabilitation. It further compares differences in patterns between summed and Rasch transformed subscales of the Functional Independence Measure (FIM). Two different schemes of the FIM-Function Related Groups (FIM-FRGs) are used to define groups of patients who present with similar degrees of functional severity. The first scheme was developed using summed admission motor and cognitive FIM subscores (FIM-FRGs). The second scheme was developed by transforming these same motor and cognitive FIM subscores into logits (Logit FIM-FRGs), thus making FIM scores more equal-interval. The study included 32,494 patients who were discharged from 123 facilities that submitted data to the Uniform Data System for Medical Rehabilitation (UDSMR) and involved the separate evaluation of 18 different rehabilitation impairment categories. Motor FIM gain was calculated for each FRG in both schemes as the patient's discharge motor FIM score minus the admission motor FIM score. There were four patterns of motor FIM gain and two patterns of LOS across rehabilitation impairment. The most common pattern in both schemes was linear trend, for which median gains and LOS were highest for patients in the most disabled FRGs and lowest for patients in the least disabled FRGs. Gain patterns differed across impairment and across the two schemes. The motor FIM gain distributions provide clinicians with a range of typical functional outcomes for patients admitted to medical rehabilitation. This descriptive approach provides clinicians and administrators with a simple way to compare the motor FIM gain and LOS patterns of patients teated in local facilities with broad-based norms. This sample includes about one-quarter of rehabilitation facilities nationwide, thus representing population standards for facilities participating in the UDSMR. Suggestions are made on how to use these norms most appropriately for both facility and patient comparison.

Activities of Daily Living↗
PubMedDate not supplied

A clinical rehabilitation course for college undergraduates provides an introduction to biopsychosocial interventions that minimize disablement.

A two-credits per semester clinical medicine course was established in the Department of Physical Medicine and Rehabilitation (PM&R) in cooperation with the Johns Hopkins University undergraduate Human Biology faculty to present the variety of inpatient consultation personnel, units, patient diagnostic groups, and functional problems. College students spend 4 hr weekly on the PM&R consultation service as team members under resident supervision. The curriculum emphasizes student understanding of the roles of rehabilitation team members. Objectives include demonstration of working knowledge of the Biopsychosocial Model, the World Health Organization Model of disablement and interdisciplinary rehabilitation intervention. The course includes simulations of physical impairments, demonstrations of adaptive equipment, interactive chart reviews, readings, and audio lectures. A retrospective sequential review was made of the last 100 physical medicine and rehabilitation consultations with student attendance. The results confirm student exposure to many ward settings (surgery, 30%; neurology/neurosurgery, 28%; medicine, 24%; intensive care, 15%; oncology, 2%; and psychiatry, 1%), patient complexity (averaging 10 problems), and multiple ICD-9 diagnosis categories (circulatory, 36%; neurologic, 22%; musculoskeletal, 17%; neoplasms, 10%; injury, 5%; endocrine, 4%; infections, 3%; and others, 3%). The rehabilitation consultation service is particularly effective as an introduction to hospital-based medical practice due to the diagnostic variety of the patients, the functional approach of rehabilitation, and student exposure to multiple hospital settings. The Biopsychosocial Model of medical practice is demonstrated through multiple interdisciplinary perspectives of needs and interventions for patients with obvious functional deficits. This process develops a rudimentary understanding of the effect of illness on the person and the variety of medically effective therapeutic modalities.

Adult↗
PubMed1980

The development of a psychiatric rehabilitation service: a two year pilot project.

In the history of psychiatry, one can discern conflicting trends with regard to hospitalization of people suffering from severe mental disturbances. From the beginning of the 19th century, the standard method for dealing with such people has been to take them away from their homes and work and put them in hospitals. However, since the discovery of antipsychotic drugs in the 1950's, there has developed a new movement to treat mentally disturbed people in their communities, either avoiding hospitalization altogether, or at least greatly shortening it. In many hospitals there has been a synthesis of these two trends, reflected in an upgrading of the importance of the rehabilitation function. In Shalvata Psychiatric Center, a medium-sized psychiatric hospital in Hod Hasharon, Israel, a two-year pilot project to introduce a centralized Rehabilitation Service was recently completed. The present Rehabilitation Service is based on the rehabilitation/activity therapy model in which the hospital is conceptualized as a setting in which patients may develop or recover social and vocational skills needed to function adequately in the community. It has drawn on existing, motivated staff from all mental health professions represented at the hospital, and works closely with all in-hospital wards and the day hospital. The authors discuss six areas of vocational and social rehabilitation with which the Rehabilitation Service has attempted to deal: 1. activity therapy/rehabilitation groups, 2. vocational guidance unit, 3. after-care therapeutic social club, 4. in-hospital rehabilitation consultation, 5. liaison activities with community-based facilities, 6. job placement.

Aftercare↗
PubMed1981

A European network of documentation and information in rehabilitation: its necessity and concept.

Both, the practical rehabilitation process and rehabilitation as a field of theory, research and training, can be realized and promoted only through close communication of professionals from various disciplines and levels in different countries. An interdisciplinary and international network of documentation and information is a prerequisite to such cooperation. Differentiated assessment, qualitative analysis and filtering, classified storing and aggressive and multivariate dissemination of information would be the major functions of the network. Both specialists from the various scientific disciplines of rehabilitation and documentation and information specialists would have to fulfill these functions. A corresponding European network should be brought about by close cooperation of national centers for documentation in rehabilitation, of centers specializing in various basic disciplines and different kinds of disabilities, and a European Center for Documentation and Information in Rehabilitation, which would centrally store and disseminate information both from the more specialized centers in Europe, and from corresponding centers in other continents. The necessary agreements between centers in various countries and continents should be brought about with the help and under the auspices of an international organization, like Rehabilitation International.

Documentation↗
PubMed1981

Early rehabilitation and its implementation at the work place.

During the last few decades a change has taken place in the morbidity pattern of industrialized societies. The proportion of chronic illness and disability has increased in middle-aged and elderly populations. Much of this disability appears as a result of gradual degenerative processes proceeding slowly towards severe disability. The practice of rehabilitation has not, however, been able to adapt flexibly to the new situation. The need for changing the emphasis of rehabilitation from mere restoration towards preventive aims is discussed in this paper. The branch of rehabilitation which has preventive aims is called early rehabilitation. Possibilities of implementing early rehabilitation activity at the work place are surveyed and a model, which was developed at two authorities of the City of Helsinki, is presented. In conclusion, some general problems concerning early rehabilitation are discussed.

Chronic Disease↗