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Driving rehabilitation

Isabelle Magro, Susan D Emmett, James Saunders
PURPOSE OF REVIEW: Cost-effectiveness of cochlear implants is a major concern for expanding these services to low-income and middle-income developing countries. RECENT FINDINGS: Recent studies have applied appropriate methodology to make determination of cost-effectiveness for cochlear implants in developing countries. In addition, important parameters that effect cost-effectiveness have been reviewed in a systematic way. The combination of these new studies along with existing reports of cochlear implant programmes in developing countries allows for a discussion of cost and outcomes determinants that drive cost-effectiveness in these environments...
March 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Suzanne Perea Burns, Jaclyn Schwartz, Shannon Scott, Hannes Devos, Mark Kovic, Ickpyo Hong, Abiodun Akinwuntan
Adults with mild stroke face substantial challenges resuming valued roles in the community. The term "mild" provides false representation of the lived experience for many adults with mild stroke who may continue to experience persistent challenges and unmet needs. Rehabilitation practitioners can identify and consequently intervene to facilitate improved independence, participation, and quality of life by facilitating function and reducing the burden of lost abilities among adults with mild stroke...
March 5, 2018: Archives of Physical Medicine and Rehabilitation
Jacob M Drew, Jonathan Neilio, Lisa Kunze
Perioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the comparative effectiveness of myriad options...
March 7, 2018: Journal of Knee Surgery
Chiara Arienti, Francesca Gimigliano, Joel Pollet, Carlotte Kiekens, Stefano Negrini
INTRODUCTION: After approval by Cochrane Steering Group, Cochrane Rehabilitation has been launched on 16th December 2016. The aim of Cochrane Rehabilitation is to bridge between Cochrane and Rehabilitation stakeholders, systematically identifying and spreading evidence, but also improving its quality and quantity production per clinical needs. METHODS: Cochrane Rehabilitation is a network of individuals, coming from all continents. Therefore, a clear and well-structured organisation is required to make Cochrane Rehabilitation functioning effectively...
February 2018: Recenti Progressi in Medicina
Carolyn A Unsworth, Anne Baker, Natasha Lannin, Priscilla Harries, Janene Strahan, Matthew Browne
INTRODUCTION: It is difficult to determine if, or when, individuals with stroke are ready to undergo on-road fitness-to-drive assessment. The Occupational Therapy - Driver Off Road Assessment Battery was developed to determine client suitability to resume driving. The predictive validity of the Battery needs to be verified for people with stroke. AIM: Examine the predictive validity of the Occupational Therapy - Driver Off Road Assessment Battery for on-road performance among people with stroke...
February 28, 2018: Disability and Rehabilitation
Nicola Lamberti, Sofia Straudi, Efisio Lissia, Lorenza Cavazzini, Sergio Buja, Roberto Manfredini, Nino Basaglia, Fabio Manfredini
BACKGROUND: Peripheral arterial disease (PAD) is a common cardiovascular pathology affecting mobility in elderly. Osteoarticular diseases (ODs), responsible for functional limitations and confounding leg symptoms, may interfere with exercise therapy. This study evaluates the feasibility and effectiveness of a structured home-based exercise programme on rehabilitative outcomes in a cohort of elderly PAD patients with and without coexisting ODs. PATIENTS AND METHODS: Patients were enrolled from 2002 to 2016 in an exercise programme prescribed and controlled at the hospital and based on two daily 10-minute home walking sessions below the self-selected speed...
February 21, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Annabel McNamara, Christopher John Barr, Malcolm J Bond, Stacey George
BACKGROUND/AIMS: Useful Field of View scores are predictive of on-road performance post-stroke. No objective data exist to determine if the Useful Field of View (UFOV) assessment can be used as a repeated measure in the post-stroke population to determine timing of occupational therapy on-road assessment as recovery occurs. The aims of this study were to determine whether there is a practice effect if the UFOV is administered at one, two and three months' post-stroke and to assess optimal time post-stroke to refer to an on-road assessment...
February 20, 2018: Australian Occupational Therapy Journal
Kimberly S Erler, Shannon B Juengst, Diane L Smith, Therese M O'Neil-Pirozzi, Thomas A Novack, Jennifer A Bogner, Jamie Kaminski, Joseph T Giacino, Gale G Whiteneck
Participation is often considered a primary goal of traumatic brain injury (TBI) rehabilitation, but little is known about the influence of driving on participation after TBI. The objective of this study was to examine the independent contribution of driving status to participation at 5 years post TBI, after controlling for demographic, psychosocial, and functional factors. Participants ( N = 2,456) were community-dwelling individuals with moderate to severe TBI, age 18 to 65 at time of injury, and enrolled in the TBI Model Systems (TBIMS) National Database (NDB)...
February 1, 2018: OTJR: Occupation, Participation and Health
Cynthia Owsley, Gerald McGwin, Jonathan F Antin, Joanne M Wood, Jennifer Elgin
BACKGROUND: Older drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver's own vehicle...
February 7, 2018: BMC Ophthalmology
Peter Jensen, Nicole Jacqueline Jensen, Cecilie Ulbaek Terkildsen, Julia T Choi, Jens Bo Nielsen, Svend Sparre Geertsen
When we walk in a challenging environment, we use visual information to modify our gait and place our feet carefully on the ground. Here, we explored how central common drive to ankle muscles changes in relation to visually guided foot placement. Sixteen healthy adults aged 23 ± 5 years participated in the study. Electromyography (EMG) from the Soleus (Sol), medial Gastrocnemius (MG), and the distal and proximal ends of the Tibialis anterior (TA) muscles and electroencephalography (EEG) from Cz were recorded while subjects walked on a motorized treadmill...
February 2018: Physiological Reports
Evelien Nackaerts, Jochen Michely, Elke Heremans, Stephan P Swinnen, Bouwien C M Smits-Engelsman, Wim Vandenberghe, Christian Grefkes, Alice Nieuwboer
Despite recent advances in clarifying the neural networks underlying rehabilitation in Parkinson's disease (PD), the impact of prolonged motor learning interventions on brain connectivity in people with PD is currently unknown. Therefore, the objective of this study was to compare cortical network changes after 6 weeks of visually cued handwriting training (= experimental) with a placebo intervention to address micrographia, a common problem in PD. Twenty seven early Parkinson's patients on dopaminergic medication performed a pre-writing task in both the presence and absence of visual cues during behavioral tests and during fMRI...
2018: Frontiers in Neuroscience
Laura E Diamond, Kim L Bennell, Tim V Wrigley, Rana S Hinman, Michelle Hall, John O'Donnell, Paul W Hodges
BACKGROUND: Femoroacetabular impingment (FAI) syndrome is common among young active adults and a proposed risk factor for the future development of hip osteoarthritis. Pain is dominant and drives clinical decision-making. Evidence for altered hip joint function in this patient population is inconsistent, making the identification of treatment targets challenging. A broader assessment, considering adjacent body segments (i.e. pelvis, trunk) and individual movement strategies, may better inform treatment programs...
January 11, 2018: Gait & Posture
Michelle M Shannon, Marie Elf, Leonid Churilov, John Olver, Alan Pert, Julie Bernhardt
PURPOSE: To evaluate if a changed physical environment following redesign of a hospital ward influenced neurological patient physical and social activity. METHODS: A "before and after" observational design was used that included 17 acute neurological patients pre-move (median age 77 (IQR 69-85) years Ward A and 20 post-move (median age 70 (IQR 57-81) years Ward B. Observations occurred for 1 day from 08.00-17.00 using Behavioral Mapping of patient physical and social activity, and location of that activity...
January 17, 2018: Disability and Rehabilitation
Renerus J Stolwyk, Judith L Charlton, Pamela E Ross, Michel Bédard, Shawn Marshall, Sylvain Gagnon, James R Gooden, Jennie L Ponsford
OBJECTIVE: To characterise on-road driving performance in individuals with traumatic brain injury who fail on-road driving assessment, compared with both those who pass assessment and healthy controls, and the injury and cognitive factors associated with driving performance. STUDY DESIGN: Cross-sectional. METHODS: Forty eight participants with traumatic brain injury (Age M = 40.50 SD = 14.62, 77% male, post-traumatic amnesia days M = 28...
January 15, 2018: Disability and Rehabilitation
Steven Wesselhoff, Timothy A Hanke, Christian C Evans
Background Stroke is the leading cause of severe disability and many survivors report long-term physical or cognitive impairments that may impact their ability to achieve community mobility (CM). PURPOSE: To determine the extent to which people with chronic stroke achieve CM compared to age-matched norms or non-neurologically impaired controls. Methods The StrokEDGE outcome measures were searched to identify validated tools that included >25% of items addressing CM. MEDLINE, CINAHL, Google Scholar, PubMed, PEDro and the Cochrane databases were searched from 2001 to 2015 with the identified outcome measures cross-referenced against search terms related to stroke and CM...
January 11, 2018: Topics in Stroke Rehabilitation
Stefan Tino Kulnik, Lucinda Hollinshead, Fiona Jones
PURPOSE: There is increasing interest in tailoring self-management support, but little detail is available on the relevance and impact of such approaches for people with progressive neurological conditions. The aim of this study was to draw on individuals' experiences to inform the practice of self-management support for these groups. METHOD: Community rehabilitation service users were purposively recruited and took part in in-depth qualitative interviews. Interviews were audio-recorded and transcribed...
January 11, 2018: Disability and Rehabilitation
Matthias Volz, Manuel C Voelkle, Katja Werheid
Post-stroke depression (PSD) is the most common psychiatric condition after stroke, affecting one third of survivors. Despite identification of meaningful predictors, knowledge about the interplay between these factors remains fragmentary. General self-efficacy (GSE) is closely linked to PSD, yet direction and magnitude of this relationship remains unclear. The authors assessed the relationship between GSE and depression during the first two years post-stroke while controlling for stable inter-individual differences using continuous time (CT) structural equation modelling (SEM)...
January 4, 2018: Neuropsychological Rehabilitation
Joseph K Sagers, Blair L Waldron, Joseph Earl Creech, Ivan W Mott, Bruce Bugbee
Halogeton (Halogeton glomeratus) is an invasive species that displaces Gardner's saltbush (Atriplex gardneri) on saline rangelands, whereas, forage kochia (Bassia prostrata) potentially can rehabilitate these ecosystems. Salinity tolerance has been hypothesized as the predominant factor affecting frequency of these species. This study compared relative salinity tolerance of these species, and tall wheatgrass (Thinopyrum ponticum) and alfalfa (Medicago sativa). Plants were evaluated in hydroponics, eliminating the confounding effects of drought, for 28 days at 0, 150, 200, 300, 400, 600, and 800 mmol/L NaCl...
December 2017: Ecology and Evolution
Richard Chee Houw Lee, Nazirah Hasnan, Julia Patrick Engkasan
STUDY DESIGN: Cross sectional study. OBJECTIVES: To determine the prevalence, characteristics of and barriers to driving among persons with a spinal cord injury (SCI). SETTING: SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC). METHODS: This is a questionnaire-based study on persons with SCI who attended the UMMC SCI Rehabilitation Clinic between June 2015 and November 2016. The questionnaire comprised demographic data, clinical characteristics, driving variables, Spinal Cord Independence Measure III, WHOQOL-BREF, and Craig Handicap Assessment and Reporting Technique Short Form...
December 29, 2017: Spinal Cord
Christine Kroll, Thomas Fisher
The Centers for Medicare and Medicaid Services (CMS) has scrutinized the provision of rehabilitation services in skilled nursing facilities (SNFs) for some time. Little research guidance exists on appropriate dosage or rehabilitation intensity (RI) among SNF patients or patients in other postacute care (PAC) settings. CMS developed a PAC assessment, the Continuity Assessment Record and Evaluation (CARE) Tool, in response to questions about what issues drive placement in various PAC settings under Medicare. The ability to adequately assess functional outcomes and correlate them to the RI provided by using the CARE Tool is promising...
January 2018: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
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