Older patients hospitalized for heart failure were randomly assigned to a rehabilitation intervention (which included multiple function domains) or control; the intervention began during, or early ...after, hospitalization and continued for 3 months. At 3 months, physical function, as assessed by the Short Physical Performance Battery, was better in the intervention group than in the control group.
The aim of this review paper is to summarize recent developments in the field of wearable sensors and systems that are relevant to the field of rehabilitation. The growing body of work focused on the ...application of wearable technology to monitor older adults and subjects with chronic conditions in the home and community settings justifies the emphasis of this review paper on summarizing clinical applications of wearable technology currently undergoing assessment rather than describing the development of new wearable sensors and systems. A short description of key enabling technologies (i.e. sensor technology, communication technology, and data analysis techniques) that have allowed researchers to implement wearable systems is followed by a detailed description of major areas of application of wearable technology. Applications described in this review paper include those that focus on health and wellness, safety, home rehabilitation, assessment of treatment efficacy, and early detection of disorders. The integration of wearable and ambient sensors is discussed in the context of achieving home monitoring of older adults and subjects with chronic conditions. Future work required to advance the field toward clinical deployment of wearable sensors and systems is discussed.
The working alliance, or collaborative bond, between client and psychotherapist has been found to be related to outcome in psychotherapy.
The purpose of this study was to investigate whether the ...working alliance is related to outcome in physical rehabilitation settings.
A sensitive search of 6 databases identified a total of 1,600 titles.
Prospective studies of patients undergoing physical rehabilitation were selected for this systematic review.
For each included study, descriptive data regarding participants, interventions, and measures of alliance and outcome-as well as correlation data for alliance and outcomes-were extracted.
Thirteen studies including patients with brain injury, musculoskeletal conditions, cardiac conditions, or multiple pathologies were retrieved. Various outcomes were measured, including pain, disability, quality of life, depression, adherence, and satisfaction with treatment. The alliance was most commonly measured with the Working Alliance Inventory, which was rated by both patient and therapist during the third or fourth treatment session. The results indicate that the alliance is positively associated with: (1) treatment adherence in patients with brain injury and patients with multiple pathologies seeking physical therapy, (2) depressive symptoms in patients with cardiac conditions and those with brain injury, (3) treatment satisfaction in patients with musculoskeletal conditions, and (4) physical function in geriatric patients and those with chronic low back pain.
Among homogenous studies, there were insufficient reported data to allow pooling of results.
From this review, the alliance between therapist and patient appears to have a positive effect on treatment outcome in physical rehabilitation settings; however, more research is needed to determine the strength of this association.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
...we report on 10 steps to help ICU clinicians in optimizing early mobilization and rehabilitation. Identify barriers and facilitators A systematic review identified 28 unique barriers to early ...mobilization and rehabilitation, including patient-related barriers (e.g., physiological instability and medical devices), structural barriers (e.g., limited staff and equipment), procedural barriers (e.g., lack of coordination and delayed screening for eligibility), and cultural barriers (e.g., prior staff experience and ICU priorities for patient care) 4. Additional research is needed to further understand potential benefit or harm. ...that time, clinician judgement will play an important role and must be tailored to individual patients and to the dynamic nature of critical illness. Waldauf P, Jiroutkova K, Krajcova A, Puthucheary Z, Duska F. Effects of rehabilitation interventions on clinical outcomes in critically Ill patients: systematic review and meta-analysis of randomized controlled trials.
Abstract
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Currently, there is a lack of clinical guidelines to support clinicians working in ...driver rehabilitation. This study aimed to identify intervention practices and factors that influence driver rehabilitation recommendations by surveying driver rehabilitation specialists practicing across the United States and Canada. Results revealed both consistencies and inconsistencies in practice, which may be related to jurisdictional differences and relatively low levels of evidence in this area.
Primary Author and Speaker: W. Ben Mortenson
Contributing Authors: Brittany Langereis, Sarah Semeniuk, and Lisa Kristalovich
Abstract
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Both action observation and repetitive-task practice are efficacious interventions ...for poststroke upper limb hemiplegia individually, yet these interventions have not been combined before. A feasibility study was completed to determine preliminary evidence of the response to intervention and if a Phase III study should be completed to test efficacy of the combined intervention. The functional impact of improving post stroke upper limb performance could benefit millions of stroke survivors.
Primary Author and Speaker: Christine Griffin
Contributing Authors: Marcia Bockbrader, Erinn Hade, Anne Kloos, and John A. Buford
Abstract
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Both action observation and repetitive-task practice are efficacious interventions ...for poststroke upper limb hemiplegia individually, yet these interventions have not been combined before. A feasibility study was completed to determine preliminary evidence of the response to intervention and whether a Phase III study should be completed to test efficacy of the combined intervention. The functional impact of improving poststroke upper limb performance could benefit millions of stroke survivors.
Primary Author and Speaker: Christine Griffin
Contributing Authors: Marcia Bockbrader, Erinn Hade, Anne Kloos, John A. Buford
Abstract
Objective
Mixed methods research (MMR) integrates quantitative and qualitative methods throughout the research process to answer complex research questions. MMR designs align with the ...guiding frameworks of patient-centered care and social determinants of health by effectively examining the role of contextual factors and human experiences in influencing health and rehabilitation outcomes. Reporting standards and critical appraisal tools ensure the quality and transparency of the research process. MMR standards exist; yet, there is a need for reporting guidelines and an appraisal tool that meets field standards, is applicable across rehabilitation fields of study, and can accommodate the range of possibilities for combining research approaches and methods.
Methods
Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS) was developed using a systematic consensus-building process in accordance with published guidance and was preregistered with the Enhancing the Quality and Transparency of Health Research Network. MMR-RHS evolved through a sequence of steps, including extensive literature review, expert consultation, stakeholder feedback, pilot testing, and tool refinement.
Results
MMR-RHS consists of 20 criteria that align with field standards for rigor and transparency, with an emphasis on integration throughout the research process, a key component of MMR.
Conclusions
A systematic process was utilized to develop the reporting standards and an appraisal tool for MMR in rehabilitation and health science. The tool is comprehensive, includes a set of criteria grounded in MMR literature, and is flexible for application to a range of MMR designs commonly seen in rehabilitation research.
Impact
The MMR-RHS may improve the quality and transparency of MMR by supporting investigators, authors, reviewers, and editors during project development, manuscript preparation, and critical review. The tool may assist readers in critical appraisal, knowledge translation, and application of published MMR findings. Ultimately, the MMR-RHS may help legitimize mixed methods in rehabilitation and health research, an important step toward understanding the complexities of health care, patient outcomes, and evolving societal health needs.
Abstract
Background
Clinical research on nutritional and metabolic interventions in critically ill patients is heterogenous regarding time points, outcomes and measurement instruments used, impeding ...intervention development and data syntheses, and ultimately worsening clinical outcomes. We aimed to identify and develop a set of core outcome domains and associated measurement instruments to include in all research in critically ill patients.
Methods
An updated systematic review informed a two-stage modified Delphi consensus process (domains followed by instruments). Measurement instruments for domains considered ‘essential’ were taken through the second stage of the Delphi and a subsequent consensus meeting.
Results
In total, 213 participants (41 patients/caregivers, 50 clinical researchers and 122 healthcare professionals) from 24 countries contributed. Consensus was reached on time points (30 and 90 days post-randomisation). Three domains were considered ‘essential’ at 30 days (survival, physical function and Infection) and five at 90 days (survival, physical function, activities of daily living, nutritional status and muscle/nerve function). Core ‘essential’ measurement instruments reached consensus for survival and activities of daily living, and ‘recommended’ measurement instruments for physical function, nutritional status and muscle/nerve function. No consensus was reached for a measurement instrument for Infection. Four further domains met criteria for ‘recommended,’ but not ‘essential,’ to measure at 30 days post-randomisation (organ dysfunction, muscle/nerve function, nutritional status and wound healing) and three at 90 days (frailty, body composition and organ dysfunction).
Conclusion
The CONCISE core outcome set is an internationally agreed minimum set of outcomes for use at 30 and 90 days post-randomisation, in nutritional and metabolic clinical research in critically ill adults.
PDF
