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Rehabilitation and intensive care

Andreas Bender, Christine Adrion, Luzia Fischer, Martin Huber, Kerstin Jawny, Andreas Straube, Ulrich Mansmann
BACKGROUND: Patients with acquired brain injury who have been discharged from inpatient neurological rehabilitation often continue to suffer from limited independence, participation, and quality of life. Participation-focused outpatient treatment (in German: teilhabeorientierte ambulan. METHODS: In a randomized, controlled trial, 53 patients who had sustained an acquired brain injury approximately four years earlier were allotted to two different sequences of treatment (26 TEAM/control, 27 control/TEAM)...
September 23, 2016: Deutsches Ärzteblatt International
Charlotte Gilart de Keranflec'h, François Décaillet
Vaudois university hospital in Lausanne, Switzerland, has an acute neurological rehabilitation unit. An interdisciplinary team cares for patients with brain injuries after their transfer from intensive care. In this context, nurses base their practice on different concepts and techniques for introducing early neurological rehabilitation into each care procedure.
October 2016: Revue de L'infirmière
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Catharina A Nordin, Peter Michaelson, Gunvor Gard, Margareta K Eriksson
BACKGROUND: Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR). OBJECTIVE: The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data...
October 5, 2016: Journal of Medical Internet Research
Wanli Li, Xinjiang An, Mingyu Fu, Chunli Li
Pneumonia refers to lung inflammation caused by different pathogens or other factors, and is a common pediatric disease occurring in infants and young children. It is closely related to the anatomical and physiological characteristics of infants and young children and is more frequent during winter and spring, or sudden changes in temperature. Pneumonia is a serious disease that poses a threat to children's health and its morbidity and mortality rank first, accounting for 24.5-65.2% of pediatric inpatients...
October 2016: Experimental and Therapeutic Medicine
Rita Formisano, Eva Azicnuda, Maryam Khan Sefid, Mauro Zampolini, Federico Scarponi, Renato Avesani
Establish the best time to start rehabilitation by means of scientific evidence. Observational study in patients with a diagnosis of Severe Brain Injury who received intensive inpatient rehabilitation after acute care. 1470 subjects enrolled: 651 with Traumatic Brain Injury (TBI) and 819 with Non-TBI. Male gender was prevalent in the population study, but sex distribution was not different among groups, with a prevalence of male gender in both populations. This project involved 29 rehabilitation facilities for Severe ABI...
October 1, 2016: Neurological Sciences
Janet F Jensen, Ingrid Egerod, Morten H Bestle, Doris F Christensen, Ask Elklit, Randi L Hansen, Heidi Knudsen, Louise B Grode, Dorthe Overgaard
PURPOSE: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. METHODS: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC)...
September 30, 2016: Intensive Care Medicine
E Billis, C Koutsojannis, C Matzaroglou, J Gliatis, K Fousekis, G Gioftsos, M Papandreou, C McCarthy, J A Oldham, E Tsepis
BACKGROUND: Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in Mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. OBJECTIVE: To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
Dorien De Meyer, Nele Van Damme, Karen Van den Bussche, Ann Van Hecke, Sofie Verhaeghe, Dimitri Beeckman
AIM: The aims of this trial were as follows: (1) to compare the (cost-) effectiveness of a turning and repositioning system and an algorithm for a tailored repositioning vs. usual care to improve reposition frequency in patients at risk; and (2) to compare the (cost-) effectiveness of standardized incontinence care vs. usual care. BACKGROUND: Pressure ulcers are a serious and common problem for hospitalized patients. In many countries, pressure ulcers are recognized as a national health issue and governments designate pressure ulcers as one of the most important sentinel events for health care...
September 28, 2016: Journal of Advanced Nursing
Christophe Duret, Anne Gaelle Grosmaire, Ophélie Courtial
OBJECTIVE: In stroke patients, motor impairments evaluated during the first few weeks usually predict upper limb motor outcomes after rehabilitation. However, a recent growing literature suggests that severe patients might not follow this principle [1]. This study aimed at exploring predictors of motor recovery after intensive training in that sub population of stroke patients. MATERIAL/PATIENTS AND METHODS: Thirty-eight patients with sub-acute hemiparesis (19 females, age 56±17 [19-87] years; time from stroke, 55±22 days) carried out 16 sessions (33±12 days) of robot-assisted adaptive training using a shoulder/elbow device integrated into conventional care...
September 2016: Annals of Physical and Rehabilitation Medicine
Laure Mathevon, Nicolas Leroux, Céline Piscicelli, Emmanuelle Clarac, Shenhao Dai, Patrice Davoine, Paul Krack, Dominic Perennou
OBJECTIVE: To take care of postural disorders is a major issue in Parkinson's disease (PD). We present a documented observation suggesting the existence of a biased representation of verticality in PD, resulting in a severe retropulsion and recurrent falls. A rehabilitation program aimed to modulate verticality perception dramatically improved the postural perception of the vertical, trunk posture and balance abilities, and reduced retropulsion as well as lastingly fall frequency. OBSERVATIONS: A 68 year-old patient with Parkinson's disease fall backward 3 times a day...
September 2016: Annals of Physical and Rehabilitation Medicine
Anne-Lyse Jaquot, Emmanuel Vega, Xavier Molders, Walter Daveluy, François Kopciuch, Anne Benoit, Etienne Allart
OBJECTIVE: Management of tracheotomy is a key point of the coma arousal phase. Tracheal lesions can interfere with the decannulation of the patient. The objectives of our study were to determine the incidence of post-tracheotomy tracheal lesions in patients with brain injury, identify their associated factors and to specify their impact on rehabilitation. MATERIAL/PATIENTS AND METHODS: We retrospectively included brain-injured patients hospitalized in the neurosurgical intensive care unit then in the coma arousal unit of the Lille university hospital between January 2012 and December 2014...
September 2016: Annals of Physical and Rehabilitation Medicine
Tiphaine Bourseau, Flavie Fremondière, Valérie Dubus, Bénédicte Gohier, Dewi Le Gal, Fabien Cave, Isabelle Richard, Nicolas Lerolle
OBJECTIVE: After critical illness, some survivors experience long-term physical, functional, neurocognitive and/or mental health impairments, which has been termed "Post-Intensive Care syndrome" (PICS) [1]. A specific follow-up is required and many specialized follow-up clinics have been created both abroad and in France. The aim of this study is to evaluate long-term outcomes after critical illness, through the International Classification of Functioning, Disability and Health, and to analyse rehabilitation needs after intensive care unit (ICU) discharge...
September 2016: Annals of Physical and Rehabilitation Medicine
Catherine Montaut, Xavier de Boissezon, Philippe Marque, Evelyne Castel-Lacanal
OBJECTIVE: Post intensive care rehabilitation is a relatively new concept that aims to admit in rehabilitation unit patients just after intensive care to deliver appropriate rehabilitation treatment while ensuring monitoring of heavy medical conditions. AIMS: Assess activity of post intensive care rehabilitation service in Toulouse University Hospital from 2008+ (year of creation) to 2015 and compare it to the work of other French post intensive care rehabilitation...
September 2016: Annals of Physical and Rehabilitation Medicine
Soumaya Boudokhane, Amine Kalai, Aymen Haj Salah, Houda Migaou, Sana Salah, Anis Jellad, Mourad Gahbiche, Zohra Ben Salah Frih
OBJECTIVE: The aim of our study was to determine the demographic characteristics and the pathway of severe traumatic brain injury (STBI) victims in the Tunisian population. MATERIAL/PATIENTS AND METHODS: Our study included 26 patients victims of STBI hospitalized in intensive care unit, among 450 traumatic head injuries admitted to the Teaching Hospital of Fattouma Bourguiba in Monastir during the year 2014. The studied parameters were: demographic characteristics of the population, circumstances of the accident, transport modalities to the hospital, assessments of the injury types, duration of coma, length of hospitalization in the Intensive Care Unit (ICU) and finally the discharge mode after the ICU stay (transfer to neurosurgery ward, to rehabilitation unit, or home discharged)...
September 2016: Annals of Physical and Rehabilitation Medicine
Sameh Ghroubi, Samar Alila, Islem Feki, Mohamed Habib Elleuch
OBJECTIVE: The aim of this study was to assess the quality of life (QoL) of traumatic brain injury (TBI) patients and to explore its predictive factors. MATERIAL/PATIENTS AND METHODS: This is a descriptive and analytical cross-sectional study, including 27 TBI patients followed in the physical medicine and rehabilitation department (PMR). The collected data were: age, educational level, marital status, initial Glosgow score and intensive care unit length of stay...
September 2016: Annals of Physical and Rehabilitation Medicine
Soumaya Boudokhane, Hichem Ben Brahim, Aymen Haj Salah, Houda Migaou, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: To determine factors influencing long-term functional and professional outcomes in patients post severe traumatic brain injury (STBI). MATERIAL/PATIENTS AND METHODS: A descriptive analytical transversal and cross-sectional study involving patients with STBI dated more than 1 year and managed in rehabilitation department on an outpatient basis. Described parameters were: coma duration, post-traumatic amnesia duration (PTA), duration of hospitalization in intensive care unit, rehabilitation delay management, brain imaging findings, motor impairment, neuropsychological impairment assessed with Neurobehavioral Rating Scale-Revised (NRS-R), functional outcomes assessed with Functional Independence Measure (FIM) and disability assessed with Glasgow Outcome Scale (GOS)...
September 2016: Annals of Physical and Rehabilitation Medicine
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
Astrid Balança
OBJECTIVE: We report an emphysematous cystitis in a diabetic patient complicated by peritonitis. OBSERVATIONS: A 66-year-old male presented to the emergency with septic shock. Patient's history: poorly controlled diabetes and prostate adenoma. Clinical examination revealed a surgical abdomen and signs of shock. Blood sugar was 6g/L. CRP 274mg/L. The abdomino-pelvic CT scan showed a perforated bladder with emphysema of the bladder wall and endoluminal air bubbles...
September 2016: Annals of Physical and Rehabilitation Medicine
Carole Vuillerot, Mickael Dinomais, Stephane Marret, Stephane Chabrier, Thierry Debillon
Neonatal arterial ischemic stroke (NAIS) affects one child in 6-17 100,000-birth term neonates, most of these children will keep long-term motor and cognitive impairment. In 2014, initiated by the French Center for Pediatric Stroke in association with the French Society of Neonatology, a steering committee was created to propose clinical guidelines after NAIS. From all the relevant questions, the importance is given to long-term outcomes after a NAIS with a need for a better description of motor and cognitive outcomes after a NAIS in order to propose a more consensual monitoring for these children to improve their management...
September 2016: Annals of Physical and Rehabilitation Medicine
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