Disability and rehabilitation
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To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. ⋯ This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with osteoarthritis. The differences in results between this Europe validation study and a previous Singaporean validation study underscore the need to validate the International Classification of Functioning, Disability and Health Core Sets in different regions of the world.
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Multicenter Study
Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury.
In a 5-year study, individual placement and support (IPS) significantly increased employment rate of United States Veterans with spinal cord injury (SCI), a historically underemployed population. In a follow-up study, data on barriers and facilitators to IPS implementation were identified. ⋯ Implementation strategies need to be adjusted as implementation progresses and matures. The strategies that succeeded in this setting, which were situated in a real-world context of providing IPS as a part of SCI medical care, may inform implementation of IPS for other populations with physical disabilities. Implications for Rehabilitation Key facilitators to IPS in SCI implementation are integrating vocational staff with expertise in IPS and SCI on clinical rehabilitation teams and providing leadership support. Ongoing barriers to IPS in SCI include patient specific and program administration factors such as caseload size and staffing patterns. Varying implementation strategies are needed to address barriers as they arise and facilitate successful implementation.
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Multicenter Study
Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands.
To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population. ⋯ High blood pressure is common in people with SCI. Screening for hypertension during annual checkups is recommended, especially in those with a SCI below C8. Implications for Rehabilitation High blood pressure is common in people with long-term SCI living in the Netherlands and its prevalence is higher in both men and women with a spinal cord lesion level below C8 compared with the age-matched Dutch general population. It is recommended to screen for hypertension during annual checkups in people with SCI, especially in those with a higher risk of developing hypertension, e.g. those with a spinal cord lesion level below C8 and an age of ≥45 years or a time since injury of ≥20 years. When a high blood pressure is measured in people with SCI, they should receive a further assessment of the blood pressure according to the available guidelines for the general population, including ambulatory 24 h-blood pressure monitoring.
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Multicenter Study
Hand pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project.
Purpose This research analysed general pain intensity, hand pain at rest and hand pain during activity in women and men in early rheumatoid arhtritis (RA). Method Out of the 454 patients that were recruited into the Swedish early RA project "TIRA" the 373 patients (67% women) that remained at 12 months follow-up are reported here. Disease activity 28 joint score (DAS-28), disability (Health Assessment Questionnaire = HAQ) and pain (VAS) were recorded at inclusion and after 3 (M3), 6 (M6) and 12 (M12) months. ⋯ The extent of hand pain evidenced in our work gives a more detailed and comprehensive account of pain status. Higher hand pain during active grip testing than that during rest indicates a potential relationship to ongoing activity limitation. Hand pain assessment can help guiding multi-professional interventions directed to reduce hand pain and thereby probably reduce activity limitations.
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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.