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Community Based Rehabilitation

Nora E Mueller, Trishan Panch, Cathaleene Macias, Bruce M Cohen, Dost Ongur, Justin T Baker
BACKGROUND: Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, treaters, and the health care system at large. Community-based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness but has only been implemented in specialty centers. It remains unclear how the peer-based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain...
August 15, 2018: JMIR Mental Health
Jaap Swanenburg, Karin Wild, Dominik Straumann, Eling D de Bruin
Background: The use of Exergames designed to improve physical and cognitive functioning is relatively new in rehabilitation. Exergaming allows the training of skills, the handling of tools, and procedures; however, often, the potential of these aspects are not assessed before they are adopted in clinical settings. This study aimed at exploring the effects of exergaming on vestibular functions and gait in healthy community dwelling older adults using a proof-of-concept study design registered under ClinicalTrials...
2018: Frontiers in Physiology
Kevin D Bui, Michelle J Johnson
There is increasing evidence that HIV is an independent risk factor for stroke, resulting in an emerging population of people living with both HIV and stroke all over the world. However, neurorehabilitation strategies for the HIV-stroke population are distinctly lacking, which poses an enormous global health challenge. In order to address this gap, a better understanding of the HIV-stroke population is needed, as well as potential approaches to design effective neurorehabilitation strategies for this population...
August 14, 2018: Journal of Neuroengineering and Rehabilitation
Zephanie Tyack, Suzanne Kuys, Petrea Cornwell, Kerrie-Anne Frakes, Steven M McPhail
Objective To evaluate the reproducibility, longitudinal validity, and interpretability of the disease burden morbidity assessment in people with chronic conditions including multimorbidity. Methods The study was conducted using a longitudinal cohort design. A large consecutive sample of adult patients at an Australian community-based rehabilitation service was included with testing at baseline and three-month follow-up (testing longitudinal validity and interpretability). A smaller subsample of patients completed a one-week test-retest (testing reproducibility)...
August 13, 2018: Chronic Illness
Jérôme Gauvin-Lepage, Debbie Friedman, Lisa Grilli, Maria Sufrategui, Carol De Matteo, Grant L Iverson, Isabelle Gagnon
OBJECTIVE: (1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI. DESIGN: A multicenter prospective quasi-experimental control group design. SETTING: Tertiary care pediatric trauma center and community health care providers...
August 8, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Jessica Louise Roberts, Aaron W Pritchard, Michelle Williams, Nikki Totton, Val Morrison, Nafees Ud Din, Nefyn H Williams
OBJECTIVES: To describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared with usual rehabilitation. To compare processes between the two and to collect the views of patients, carers and therapy staff about trial participation. DESIGN: Mixed methods process evaluation in a randomised feasibility study. SETTING: Patient participants were recruited on orthopaedic and rehabilitation wards; the intervention was delivered in the community following hospital discharge...
August 8, 2018: BMJ Open
Cecilie Lindström Egholm, Henriette Knold Rossau, Per Nilsen, Gitte Bunkenborg, Morten Hulvej Rod, Patrick Doherty, Paul Bartels, Lotte Helmark, Ann-Dorthe Zwisler
A politically initiated national clinical guideline was launched in Denmark in 2013 to improve quality and equality of cardiac rehabilitation (CR) services. The guideline is to be implemented in both hospital and community (municipality) settings due to shared responsibility for provision of CR services. Little is known about implementation outcomes of a guideline in these two settings. We aimed to study this by determining the extent to which Danish CR services in hospitals and municipalities adhered to national recommendations following the launch of the guideline...
July 30, 2018: Health Policy
Eric W Tsang, Henry Kwok, Aidan K Y Chan, Kah Lin Choo, Kin Sang Chan, Kam Shing Lau, Chetwyn C H Chan
BACKGROUND: Pneumoconiosis patients receive community-based or home-based pulmonary rehabilitation (PR) for symptom management and enhancement of physical and mental well-being. This study aimed to review the clinical benefits of community-based rehabilitation programmes (CBRP) and home-based rehabilitation programmes (HBRP) for PR of pneumoconiosis patients. METHODS: Archival data of pneumoconiosis patients who participated in CBRP and HBRP between 2008 and 2011 was analysed...
August 9, 2018: BMC Pulmonary Medicine
Jonathan C Rawstorn, Nicholas Gant, Anna Rolleston, Robyn Whittaker, Ralph Stewart, Jocelyn Benatar, Ian Warren, Andrew Meads, Yannan Jiang, Ralph Maddison
OBJECTIVE: Evaluate user experiences of an exercise-based cardiac telerehabilitation intervention (REMOTE-CR) that provided near universal access to real-time remote coaching and behavioural support from exercise specialists. DESIGN: Secondary analysis (12 week follow-up) of a parallel group, single blind, randomised controlled non-inferiority trial (ACTRN12614000843651). SETTING: Community-based cardiac rehabilitation. PARTICIPANTS: Adults with coronary heart disease who were eligible for outpatient cardiac rehabilitation...
August 1, 2018: Archives of Physical Medicine and Rehabilitation
Laura Asher, Charlotte Hanlon, Rahel Birhane, Alehegn Habtamu, Julian Eaton, Helen A Weiss, Vikram Patel, Abebaw Fekadu, Mary De Silva
BACKGROUND: Community-based rehabilitation (CBR), or community-based inclusive development, is an approach to address the complex health, social and economic needs of people with schizophrenia in low and middle-income countries. Formative work was undertaken previously to design a culturally appropriate CBR intervention for people with schizophrenia in Ethiopia. The current study explored the acceptability and feasibility of CBR in practice, as well as how CBR may improve functioning among people with schizophrenia...
August 3, 2018: BMC Psychiatry
Noelle E Carlozzi, Phillip A Ianni, Rael T Lange, Tracey A Brickell, Michael A Kallen, Elizabeth A Hahn, Louis M French, David Cella, Jennifer A Miner, David S Tulsky
OBJECTIVE: To examine the reliability and validity of the short form (SF) and computer adaptive test (CAT) versions of the Patient Reported Outcomes Measurement Information System (PROMIS) measures of social health of caregivers of civilians and service members/veterans (SMVs) with traumatic brain injury (TBI). DESIGN: Self-report questionnaires administered through an on-line data collection platform. SETTING: Hospital and community-based outreach at three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility PARTICIPANTS: 560 (344 civilians and 216 military) caregivers of individuals with a documented TBI INTERVENTION: N/A MAIN OUTCOME MEASURES: 5 PROMIS Social Health Measures RESULTS: All five PROMIS social health measures exceeded the a priori criterion for internal consistency reliability (≥ 0...
July 31, 2018: Archives of Physical Medicine and Rehabilitation
Xiangli Xiao, Jian Wang, Yanmei Gu, Yanfang Cai, Lixin Ma
BACKGROUND: Low self-efficacy in chronic disease patients is one of the main disturbances which require physical and mental rehabilitation, calling for the development of a home accessible way to improve self-management. OBJECTIVES: The purpose of this study was to explore the effectiveness of a community based Baduanjin exercise on self-efficacy in adults with cardiovascular disease. DESIGN: A randomized controlled trial, longitudinal research design was employed...
2018: PloS One
Meriel Norris, Leon Poltawski, Raff Calitri, Anthony I Shepherd, Sarah Gerard Dean
Rehabilitation Training (ReTrain) is a group-based approach to functional training post stroke. ReTrain has recently been evaluated through a pilot randomised controlled trial. OBJECTIVE: This article reports on the acceptability of the intervention as described by trial participants. DESIGN: A qualitative approach was undertaken. Of the 45 participants recruited into the trial, 23 were randomised to receive ReTrain. Following a sampling strategy, 10 participants undertook 1:1 semistructured audio-recorded interviews...
July 25, 2018: BMJ Open
Faith N Mambulu-Chikankheni, John Eyles, Prudence Ditlopo
As primary providers of preventive and curative community case management services in low- and middle-income countries (LMICs), community health workers (CHWs) have emerged as a formalised part of the health system (HS). However, discourses on their practices as formalised cadres of the HS are limited. Therefore, we examined their role in care, referral (to clinics) and rehabilitation of severe acute malnutrition (SAM) cases. Focusing on SAM was essential since it is a global public health problem associated with 30% of all South Africa's (SA's) child deaths in 2015...
July 26, 2018: Health & Social Care in the Community
Hueiming Liu, Richard Lindley, Mohammed Alim, Cynthia Felix, Dorcas Bc Gandhi, Shweta J Verma, Deepak K Tugnawat, Anuradha Syrigapu, Ramaprabhu K Ramamurthy, Jeyaraj D Pandian, Marion Walker, Anne Forster, Maree L Hackett, Craig S Anderson, Peter Langhorne, Gudlavalleti Vs Murthy, Pallab K Maulik, Lisa A Harvey, Stephen Jan
Background Training family carers to provide evidence-based rehabilitation to stroke patients could address the recognized deficiency of access to stroke rehabilitation in low-resource settings. However, our randomized controlled trial in India (ATTEND) found that this model of care was not superior to usual care alone. Aims This process evaluation aimed to better understand trial outcomes through assessing trial implementation and exploring patients', carers', and providers' perspectives. Methods Our mixed methods study included process, healthcare use data and patient demographics from all sites; observations and semi-structured interviews with participants (22 patients, 22 carers, and 28 health providers) from six sampled sites...
July 25, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Kirsten Aikman, John L Oliffe, Mary T Kelly, Fairleth McCuaig
Sexual health has been well established as a salient priority for men following traumatic spinal cord injury; yet, it continues to be under-addressed by health-care providers in both inpatient and community settings. Given that most men with traumatic spinal cord injuries will be followed by community-based primary health-care providers, including family physicians and nurse practitioners, for their long-term health-care needs, these clinicians are well positioned to address ongoing sexual health issues with this population...
July 25, 2018: American Journal of Men's Health
Jasmine C Menant, Americo A Migliaccio, Daina L Sturnieks, Cameron Hicks, Joanne Lo, Mayna Ratanapongleka, Jessica Turner, Kim Delbaere, Nickolai Titov, Daniela Meinrath, Catherine McVeigh, Jacqueline C T Close, Stephen R Lord
BACKGROUND: Dizziness is common among older people and is associated with a cascade of debilitating symptoms, such as reduced quality of life, depression, and falls. The multifactorial aetiology of dizziness is a major barrier to establishing a clear diagnosis and offering effective therapeutic interventions. Only a few multidisciplinary interventions of dizziness have been conducted to date, all of a pilot nature and none tailoring the intervention to the specific causes of dizziness...
July 2018: PLoS Medicine
David M Werner, Joaquin Barrios
CONTEXT: Core stability is considered critical for the successful execution of rehabilitative and athletic tasks. While no consensus definition exists, different components related to core stability have been identified. An important component is the domain of motor control. There are few clinical tests assessing the motor control component of core stability (MCCS). OBJECTIVE: To evaluate the interrater reliability and known-groups validity of a novel test of MCCS, the in-line half-kneeling test...
July 24, 2018: Journal of Sport Rehabilitation
Yvonne C Learmonth, Dominique Kinnett-Hopkins, Robert W Motl
BACKGROUND: Patient and public involvement and engagement and consumer feedback are encouraged by community leaders, policymakers, and funders to address health problems. Patient and consumer feedback is a critical step in scaling research applications among persons with multiple sclerosis (MS). This is important as there are physical activity guidelines for exercise in MS that have important translational utility for research, yet participation in exercise research is low among persons with MS...
July 24, 2018: Disability and Rehabilitation
Charlotte Handberg, Ole Mygind, Jan Sau Johansen
PURPOSE: To describe and analyse social interactions among the users, partners and stakeholders involved in developing a rehabilitation park to determine a future approach to community-based rehabilitation. MATERIALS AND METHODS: The design was qualitative using the methodology interpretive description and symbolic interactionism as the theoretical framework. Data was generated through a two-year ethnographic fieldwork throughout the development of the SPARK (Sound Park Activities Rehabilitation and Climate) rehabilitation park...
July 24, 2018: Disability and Rehabilitation
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