Clinical rehabilitation
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Clinical rehabilitation · Feb 2008
Case ReportsA novel cause of intrathecal baclofen overdosage: lessons to be learnt.
A serious intrathecal baclofen overdose occurred in a 45-year-old woman with primary progressive multiple sclerosis following a catheter dye study with concomitant change in baclofen concentration. The pump and catheter were emptied of baclofen 2000 microg/mL, refilled and primed with baclofen 1000 microg/mL. No correction was made for the ;dead space' between the reservoir and catheter access port, which contained baclofen 2000 microg/mL. Failure of the priming bolus to account for the residual baclofen concentration within the dead space resulted in a serious overdose.Action: Amendments are being made to both our local and the Medtronic protocols. ⋯ We hope that by reporting this incident the risk of this potentially fatal error re-occurring is minimized.
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Clinical rehabilitation · Jan 2008
Self-rated competency in activities predicts functioning and participation one year after traumatic brain injury.
To investigate whether the Patient Competency Rating Scale at three months predicts global functioning and participation one year after traumatic brain injury. ⋯ The Patient Competency Rating Scale at three months predicted functioning and participation one year after traumatic brain injury. This indicates that rehabilitation interventions should focus on cognitive and interpersonal competency in order to enhance participation after traumatic brain injury.
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Clinical rehabilitation · Dec 2007
Randomized Controlled TrialEffects of modified constraint-induced movement therapy on reach-to-grasp movements and functional performance after chronic stroke: a randomized controlled study.
To evaluate changes in (1) motor control characteristics of the hemiparetic hand during the performance of a functional reach-to-grasp task and (2) functional performance of daily activities in patients with stroke treated with modified constraint-induced movement therapy. ⋯ In addition to improving functional use of the affected arm and daily functioning, modified constraint-induced movement therapy improved motor control strategy during goal-directed reaching, a possible mechanism for the improved movement performance of stroke patients undergoing this therapy.
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Clinical rehabilitation · Nov 2007
ReviewPrognostic factors of long-term functioning and productivity after traumatic brain injury: a systematic review of prospective cohort studies.
To systematically review prospective cohort studies that investigated prognostic factors associated with long-term activity limitations or participation restrictions and productivity after a traumatic brain injury. ⋯ Older age, pre-injury unemployment, pre-injury substance abuse and more disability at rehabilitation discharge are important predictors of long-term disability. Pre-injury unemployment, longer post-traumatic amnesia, more disability at rehabilitation admission and pre-injury substance abuse are important predictors of being non-productive.
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Clinical rehabilitation · Oct 2007
Randomized Controlled TrialA prospective, randomized, parallel group, controlled study of the effect of intensity of speech and language therapy on early recovery from poststroke aphasia.
To examine whether the amount of speech and language therapy influences the recovery from poststroke aphasia. ⋯ Intensive speech and language therapy (as delivered in this study) did not improve the language impairment significantly more than the ;standard' therapy which averaged 1.6 hours/week. The improvement in aphasia was least in patients who were in the NHS group. These patients received 0.57 (0.49) hours of therapy per week.