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Clinical Rehabilitation

Anthony G Rudd, Alex Hoffman, Lizz Paley, Benjamin Bray
Over the last 20 years, England, Wales and Northern Ireland have developed an audit programme that now encompasses nearly all patients admitted to hospital with a stroke. This article records and reviews some questions that have been answered using data from the audit: Is the rate of institutional care after rehabilitation a possible measure of outcome? Does stroke unit care in routine practice give the benefits shown in randomized controlled trials? How is the quality of stroke care affected by a patient's age and the time of their stroke? Do patient-reported measures match those obtained from the professionals recording of processes of care? How do the processes of care after stroke affect mortality? Is thrombolysis safe to use in patients over the age of 80? Do staffing levels matter? Does assessing the safety of swallowing really make a difference? Do clinicians make rational decisions about end-of-life care in patients with haemorrhage? Does socioeconomic status influence the risk of stroke, outcome after stroke and the quality of stroke care? How much does stroke really cost in England, Wales and Northern Ireland? The article concludes that this national audit has improved stroke care across the United Kingdom, has given answers to important questions that could not be answered in any other way and has shown that benefits found in research do generalize into real clinical benefits in day-to-day practice...
June 1, 2018: Clinical Rehabilitation
Marian C Brady, Jon Godwin, Helen Kelly, Pam Enderby, Andrew Elders, Pauline Campbell
OBJECTIVE: Attention control comparisons in trials of stroke rehabilitation require care to minimize the risk of comparison choice bias. We compared the similarities and differences in SLT and social support control interventions for people with aphasia. DATA SOURCES: Trial data from the 2016 Cochrane systematic review of SLT for aphasia after stroke Methods: Direct and indirect comparisons between SLT, social support and no therapy controls. We double-data extracted intervention details using the template for intervention description and replication...
June 1, 2018: Clinical Rehabilitation
Lucie Brosseau, Odette Thevenot, Olivia MacKiddie, Jade Taki, George A Wells, Paulette Guitard, Guillaume Léonard, Nicole Paquet, Sibel Z Aydin, Karine Toupin-April, Sabrina Cavallo, Rikke Helene Moe, Kamran Shaikh, Wendy Gifford, Laurianne Loew, Gino De Angelis, Shirin Mehdi Shallwani, Ala' S Aburub, Aline Mizusaki Imoto, Prinon Rahman, Inmaculada C Álvarez Gallardo, Milkana Borges Cosic, Nina Østerås, Sabrina Lue, Tokiko Hamasaki, Nathaly Gaudreault, Tanveer E Towheed, Sahil Koppikar, Ingvild Kjeken, Dharini Mahendira, Glen P Kenny, Gail Paterson, Marie Westby, Lucie Laferrière, Guy Longchamp
OBJECTIVE: To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations...
June 1, 2018: Clinical Rehabilitation
Nicola Hare, Petros Georgopoulos, Kate E Philips, Joanne E Johnson, Coralie Seary, Jalesh N Panicker, Valerie L Stevenson
OBJECTIVE: Functional electrical stimulation is used to improve walking speed and reduces falls in people with upper motor neurone foot-drop. Following anecdotal observations of changes in bladder symptoms, an observational study was performed to explore this association further. DESIGN: A total of 47 consecutive patients attending for setup with functional electrical stimulation during a six-month period were asked to complete a questionnaire assessing bladder symptoms (ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder)) at baseline and three  months during routine appointments...
June 1, 2018: Clinical Rehabilitation
Anne Mette Schmidt, Helle Terkildsen Maindal, Trine Bay Laurberg, Berit Schiøttz-Christensen, Charlotte Ibsen, Kirstine Bak Gulstad, Thomas Maribo
OBJECTIVE: To justify and describe an integrated rehabilitation programme for patients with chronic low back pain prior to evaluation in a randomized controlled trial. METHOD: The Template for Intervention Description and Replication (TIDieR) checklist was used as a structural framework for the description of the integrated rehabilitation programme. As a part of the description, the Medical Research Council guidance, 'Developing and evaluating complex interventions', was used as a framework to justify the integrated rehabilitation programme...
June 1, 2018: Clinical Rehabilitation
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June 1, 2018: Clinical Rehabilitation
Romi Haas, Lisa O'Brien, Kelly-Ann Bowles, Terry Haines
OBJECTIVE: To investigate the effect of an acute weekend physiotherapy service compared to no physiotherapy service on short-term outcomes following lower limb joint replacement. DESIGN: Pre-post intervention (quasi-experimental) study nested within two stepped-wedge cluster randomized controlled trials. SETTING: Public tertiary hospital in Melbourne, Australia. SUBJECTS: Consecutive patients undergoing hip and knee replacement...
June 1, 2018: Clinical Rehabilitation
Isabel Fialho Fontenele Garcia, Carina Tiemi Tiuganji, Maria do Socorro Morais Pereira Simões, Adriana Claudia Lunardi
OBJECTIVE: To test the measurement properties (reliability, interpretability, and validity) of the Life-Space Assessment questionnaire for older adults with chronic obstructive pulmonary disease. DESIGN: Clinimetric study. SETTING: Pneumology service, ambulatory care, São Paulo, SP, Brazil. PARTICIPANTS: Consecutive sample of older adults ( n = 62; 38 (61%) men, 24 (39%) women) with chronic obstructive pulmonary disease...
June 1, 2018: Clinical Rehabilitation
Derick T Wade
OBJECTIVE: To estimate the number of people in a prolonged disorder of consciousness (PDOC) who may need a formal best interests decision-making process to consider starting and/or continuing life-sustaining treatment each year in the population of a developed country. METHOD: Identification of studies on people with a PDOC giving information about incidence, and/or prevalence, and/or cause, and/or location of long-term care. Sources included systematic reviews, a new search of MEDLINE (April 2018), and a personal collection of papers...
May 21, 2018: Clinical Rehabilitation
Sarah F Tyson, Kate Woodward-Nutt, Sarah Plant
OBJECTIVE: To describe the dose, intensity and context of physiotherapy for balance and mobility problems after stroke. DESIGN: Process mapping to describe the context and non-participant observation of therapy sessions to describe the dose and content of therapy. SETTING: Four inpatient stroke units in North-West England. PARTICIPANTS: Therapy staff and previously mobile stroke survivors who were treating, or receiving treatment for balance and mobility problems in the participating units...
May 1, 2018: Clinical Rehabilitation
Fatemeh Mosalanejad, Ardashir Afrasiabifar, Mohammad Zoladl
OBJECTIVE: To evaluate the combined effect of pelvic floor muscle exercise and mindfulness on sexual function in women with multiple sclerosis. DESIGN: It was a three-arm parallel randomized clinical trial study. SETTING: Outpatient clinic. SUBJECTS: Patients with multiple sclerosis. INTERVENTIONS: Participants in the intervention groups completed an eight-week program consisting of pelvic floor muscle exercise, mindfulness, and pelvic floor muscle exercise along with mindfulness...
May 1, 2018: Clinical Rehabilitation
Esra Pehlivan, Fatma Mutluay, Arif Balcı, Lütfiye Kılıç
OBJECTIVE: To investigate whether inspiratory muscle training would contribute to the improvement of exercise capacity, dyspnea perception and respiratory functions in lung transplantation candidates. DESIGN: Prospective randomized controlled trial. SETTING: Pulmonary Rehabilitation center. SUBJECTS: A total of 34 patients with severe lung disease requiring lung transplantation were randomly allocated to either pulmonary rehabilitation plus inspiratory muscle training group (PR + IMT group, n = 17) or pulmonary rehabilitation group (PR group, n = 17) before any lung transplantation operation...
May 1, 2018: Clinical Rehabilitation
Li Cheng, Botao Tan, Ying Yin, Sanrong Wang, Lang Jia, Gerry Warner, Gongwei Jia, Wei Jiang
OBJECTIVE: To investigate the short- and long-term effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF). DATA SOURCES: An electronic search of MEDLINE, Embase and Cochrane Central databases along with hand search of relevant papers were performed on 15 March 2018. REVIEW METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
May 1, 2018: Clinical Rehabilitation
Angela Vratsistas-Curto, Catherine Sherrington, Annie McCluskey
OBJECTIVE: To determine the responsiveness of five arm function measures in people receiving acute inpatient stroke rehabilitation. DESIGN: Inception cohort study. SETTING: Comprehensive stroke unit providing early rehabilitation. SUBJECTS: A total of 64 consecutively admitted stroke survivors with moderately severe disability (Modified Rankin Scale score median (interquartile range (IQR)): 4.0 (1.0)). MAIN MEASURES: Responsiveness was analyzed by calculating effect size, standardized response mean and median-based effect size...
May 1, 2018: Clinical Rehabilitation
Mohammad Reza Pourahmadi, Holakoo Mohsenifar, Mozhdeh Dariush, Amirreza Aftabi, Ali Amiri
OBJECTIVE: To evaluate evidence on the effectiveness of Mulligan techniques on low back pain. DATA SOURCES: PubMed/Medline, Scopus, Ovid, CINAHL, Embase, PEDro, Google Scholar, and Cochrane Library were searched from inception to 31 March 2018 for randomized clinical trials reporting outcomes of pain or disability in adult patients (⩾18 years) with low back pain. REVIEW METHODS: Two authors screened the results and extracted data for use in this review...
May 1, 2018: Clinical Rehabilitation
Kelly M Jones, Rohit Bhattacharjee, Rita Krishnamurthi, Sarah Blanton, Suzanne Barker-Collo, Alice Theadom, Amanda G Thrift, Steven L Wolf, Narayanaswamy Venketasubramanian, Priya Parmar, Annick Maujean, Annemarei Ranta, Dominique Cadilhac, Emmanuel O Sanya, Marilyn MacKay-Lyons, Jeyaraj D Pandian, Deepti Arora, Reginald O Obiako, Gustavo Saposnik, Shivanthi Balalla, Natan M Bornstein, Peter Langhorne, Bo Norrving, Nita Brown, Michael Brainin, Denise Taylor, Valery L Feigin
OBJECTIVE: To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. DESIGN: Non-funded, pilot randomized controlled trial of intervention versus usual care. SETTING: International, multicentre, community-based. PARTICIPANTS: Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers...
May 1, 2018: Clinical Rehabilitation
Bilal Akhter Mateen, Matthias Bussas, Catherine Doogan, Denise Waller, Alessia Saverino, Franz J Király, E Diane Playford
OBJECTIVE: To determine whether tests of cognitive function and patient-reported outcome measures of motor function can be used to create a machine learning-based predictive tool for falls. DESIGN: Prospective cohort study. SETTING: Tertiary neurological and neurosurgical center. SUBJECTS: In all, 337 in-patients receiving neurosurgical, neurological, or neurorehabilitation-based care. MAIN MEASURES: Binary (Y/N) for falling during the in-patient episode, the Trail Making Test (a measure of attention and executive function) and the Walk-12 (a patient-reported measure of physical function)...
May 1, 2018: Clinical Rehabilitation
Marjan Asadollahi, Mahtab Ramezani, Ziba Khanmoradi, Ehsan Karimialavijeh
OBJECTIVE: The present study aimed to assess the effectiveness of oral citalopram, compared with fluoxetine and a placebo, in patients with post-stroke motor disabilities. DESIGN: A randomized double-blind placebo-controlled clinical trial was conducted between January 2015 and January 2016. SETTING: The neurology department of a university-affiliated urban hospital in Tehran, Iran. SUBJECTS: Ninety adult patients with acute ischemic stroke, hemiplegia, or hemiparesis and a Fugl-Meyer Motor Scale score of below 55 were included...
May 1, 2018: Clinical Rehabilitation
Wing Nga Chan, William Wai-Nam Tsang
OBJECTIVE: To compare the effect of Tai Chi training with conventional exercise on dual-tasking performance among stroke survivors. DESIGN: An assessor-blinded, randomized controlled trial. SUBJECTS: Community-dwelling stroke survivors. SETTING: Community centers and university. INTERVENTIONS: Subjects in the Tai Chi group and the conventional exercise group were trained with the corresponding exercises for 12 weeks (1 hour/session, 2/week)...
May 1, 2018: Clinical Rehabilitation
Sofia Straudi, Sergio Buja, Andrea Baroni, Claudia Pavarelli, Giulia Pranovi, Felipe Fregni, Nino Basaglia
OBJECTIVE: To test the efficacy of transcranial direct current stimulation (tDCS) in addition to group exercise on non-specific chronic low back pain. DESIGN: Double-blinded randomized control trial. SUBJECTS: Patients with non-specific chronic low back pain. METHODS: A total of 35 subjects were recruited and allocated to real- or sham-tDCS followed by a group exercise protocol. Each patient underwent five sessions of brain stimulation followed by 10 sessions of group exercise...
May 1, 2018: Clinical Rehabilitation
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