Disability and rehabilitation
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Multicenter Study
Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project).
To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. ⋯ Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.
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Multicenter Study
Explaining daily functioning in young adults with obstetric brachial plexus lesion.
To study the influence of obstetric brachial plexus lesion (OBPL) on arm-hand function and daily functioning in adults, and to investigate the relationship of arm-hand function and pain to daily functioning. ⋯ Many young adults with OBPL experience limitations in daily functioning. Pain, rather than arm-hand function, seems to explain these limitations. Implications for Rehabilitation Obstetric brachial plexus lesion (OBPL) is caused by traction to the brachial plexus during labour, resulting in denervation of the muscles of the arm and shoulder girdle. Adults with OBPL are hardly seen in rehabilitation medicine. This study shows that many young adults with OBPL experience limitations in daily functioning. Pain, rather than arm-hand function, seems to explain these limitations. Fifty percent of the participants complained about moderate or severe pain, which was located in the affected arm, the back and the non-affected arm. There seems an age-related increase in pain prevalence. Persons who had undergone plexus surgery had a significantly worse arm-hand function, but comparable scores on daily functioning scales compared to persons without plexus surgery. When limitations in daily functioning or pain occur, referral to a rehabilitation physician is indicated.
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Comparative Study
A head-to-head comparison of the de Morton Mobility Index (DEMMI) and Elderly Mobility Scale (EMS) in an older acute medical population.
To compare the clinimetric properties of the de Morton Mobility Index (DEMMI®) and the Elderly Mobility Scale (EMS). ⋯ The DEMMI® and EMS are both valid measures of mobility for older acute medical patients. The DEMMI® has a broader scale width than the EMS with interval level measurement and therefore provides a more accurate method for measuring and monitoring changes in mobility for older acute medical patients. Implications for Rehabilitation Mobility of older acute medical patients. Hospitalised older acute medical patients are at "high risk" of mobility decline. Accurate measurement of mobility is essential for preventing and treating mobility decline. Many existing mobility measures have significant measurement limitations. The DEMMI® is a more accurate measure of mobility than the EMS in an older acute medical population.
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To create a cross-culturally adapted and clinically valid Hungarian version of the Roland-Morris Disability Questionnaire (RMQ). ⋯ Translation and cross-cultural adaptation process of the RMQ into Hungarian language was successful resulting in a reliable and valid measurement tool with good psychometric properties. Implications for Rehabilitation Low back pain (LBP) related disability is a big health, social and economical problem in industrial countries. Correct evaluation of spine related disability can be performed using valid and reliable national versions of condition specific patient reported questionnaires such as the Roland-Morris Disability Questionnaire (RMQ). After the cross-cultural adaptation and validation of the Hungarian RMQ, it can be reliably used for the evaluation of LBP patients and for their follow-up during a rehabilitation process.
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Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. ⋯ This study identified an above normal prevalence of PDs among individuals afflicted by burn and these individuals reported poor burn-specific health-related quality of life. The identification of difficulties with compliance and endurance regarding daily skin care may cause negative consequences for optimal rehabilitation and underscore the importance of offering more tailored interventions in rehabilitation. Inflexible behavioral patterns related to the PD diagnosis imply the need for communication strategies by the rehabilitation team, which include flexibility, creativity, and diplomacy. There is a need for further research focusing on identifying the factors that facilitate the individual's own ability to take action and have control.