Disability and rehabilitation
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To evaluate changes in pain intensity and activity limitation, at group and individual levels, and their associations with the global impression of change after multimodal rehabilitation in patients with back pain. ⋯ At group level, lower VAS ratings were found in patients with back pain. However, a large individual variability in pain and activity limitation was also found resulting in low to moderate associations between GIC and the change in VAS ratings. The large individual variability might be due to the impreciseness in the ratings on the VAS. We have presented a critical discussion of statistical methods in connection with the VAS. Implications for Rehabilitation The use of VAS as a rating instrument may be questioned, especially for perceived pain intensity which is a too complex experience to be rated on a line without any visible categories. Single ratings of pain intensity should preferably be complemented with the ratings of activity limitation in patients with long-term back pain. Global impression of change is a suggested inclusive rating after rehabilitation. The improvement desired by the patient should preferably be determined before rehabilitation.
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To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury. ⋯ SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale. Implications for Rehabilitation Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. There are not many studies focused on patients with non-traumatic spinal cord lesion. Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation. We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.
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The purpose of this study was to linguistically and culturally adapt the Nordic Musculoskeletal Questionnaire (NMQ) for use in Turkey, and to examine the psychometric properties of this adapted version. ⋯ This study provided considerable evidence that the Turkish version of the NMQ has appropriate psychometric properties, including good test-retest reliability, internal consistency and construct validity. It can be used for screening and epidemiological investigations of musculoskeletal symptoms. Implications for Rehabilitation The Nordic Musculoskeletal Questionnaire (NMQ) can be used for the screening of musculoskeletal problems. The NMQ allows comparison of musculoskeletal problems in different body regions in epidemiological studies with large numbers of participants. The Turkish version of the NMQ can be used for rehabilitation due to its appropriate psychometric properties, including good test-retest reliability, internal consistency and construct validity.
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Multicenter Study
Epidemiology and clinical outcomes in a multicentre regional cohort of patients with severe acquired brain injury.
To evaluate epidemiological and clinical data on patients with severe acquired brain injury (sABI) admitted to rehabilitation units in the first 6 years since the inception of a regional register (2005-2010) in the Emilia-Romagna region (Italy). ⋯ The GRACER register is a useful tool for the assessment of epidemiological and clinical information on sABI patients. In light of the positive impact on patient outcomes, rehabilitation in specialised units is highly encouraged and should occur as soon as possible. Implications for Rehabilitation There is a need for more epidemiological and clinical data associated with severe acquired brain injury, particular regarding those of non-traumatic origin. In a retrospective multicentre study of a regional cohort using data from an online regional register in Italy (GRACER), more than three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from the rehabilitation units. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic) or absence of tracheostomy at admission. Admission to a specialised rehabilitation unit is highly encouraged for patients with severe acquired brain injury, and should occur as soon as possible. Policy-makers and service planners should continue to develop strategies and allocate adequate resources for rehabilitation services due to their positive impact on patient outcomes. In particular, patients with conditions associated with increased likelihood of poor outcomes may require special attention during rehabilitation to improve outcomes at discharge.
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Review
Group-based delivery of interventions in traumatic brain injury rehabilitation: a scoping review.
Whilst there are potential advantages of group-based interventions in rehabilitation, facilitation of groups for patients following traumatic brain injury (TBI) has challenges due to the complexity of impairments experienced. This paper aims to review the literature concerning therapy groups within TBI rehabilitation. ⋯ Studies of the effectiveness of interventions targeting 'real-world' activities and participation-based goals are under-represented in the TBI rehabilitation literature. Further research investigating the effectiveness of group processes and the perceptions of patients and clinicians is warranted to guide clinical practice. Implications for Rehabilitation Group-based interventions are common in TBI rehabilitation, usually targeting cognitive skills and impairments. The majority of studies demonstrated positive changes pre-post group interventions on some outcome measures. Few studies directly compare the outcome of an intervention delivered in a group setting to the same intervention delivered in an individual setting. Patients perceive group interventions to be beneficial for sharing experiences and reducing isolation, receiving help and feedback and, assisting with adjustment and adaptation to life after TBI, however, this research is limited. Greater emphasis on group-delivered interventions that target 'real world' activities, or participation may be beneficial with this population. Further research regarding consumer experiences and processes that facilitate effective group interventions in TBI rehabilitation is recommended.