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Orthopaedic rehabilitation

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https://www.readbyqxmd.com/read/28913405/post-acute-care-disparities-in-total-joint-arthroplasty
#1
Roy H Lan, Atul F Kamath
BACKGROUND: Understanding the socioeconomic factors that influence hospitalization and post-discharge metrics after joint replacement is important for identifying key areas of improvement in the delivery of orthopaedic care. METHODS: An institutional administrative data set of 2869 patients from an academic arthroplasty referral center was analyzed to quantify the relationship between socioeconomic factors and post-acute rehabilitation care received, length of stay, and cost of care...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28898867/cerebral-fat-embolism-clinical-presentation-diagnostic-steps-and-long-term-follow-up
#2
Juliane Dunkel, Christian Roth, Frank Erbguth, Wenke Dietrich, Monika Hügens-Penzel, Andreas Ferbert
OBJECTIVE: Symptomatic cerebral fat embolism (CFE) is a rare complication that occurs after a traumatic injury or orthopaedic surgery and is diagnostically challenging. No data is currently available concerning long-term follow-up. METHODS: We identified from medical records 9 patients with CFE and revised the clinical signs and the diagnostic process. We then analysed long-term follow-up data, targeting clinical course after discharge, neurological impairment, and current quality of life, using the Barthel index and the modified Rankin Scale...
2017: European Neurology
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#3
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28867040/-brain-plasticity-and-early-rehabilitative-care-for-children-after-neonatal-arterial-cerebral-infarction
#4
M Dinomais, S Marret, C Vuillerot
Currently, in the literature of the evidence based medicine, little data are available to confirm the benefit and the specific procedures of an early intervention for a neonatal arterial ischemic stroke. However, data about the effect of an early physical rehabilitation program on the cerebral plasticity, and preliminary results of clinical studies in children with cerebral palsy strongly suggest the benefit of an early rehabilitation with a multidisciplinary approach. The type of the rehabilitation and its frequency must be determined because a wide variability in the practices exists...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28845464/molecular-signatures-of-differential-responses-to-exercise-trainings-during-rehabilitation
#5
Yi-Wen Chen, Chris Gregory, Fan Ye, Naoe Harafuji, Donovan Lott, San-Huei Lai, Sunita Mathur, Mark Scarborough, Parker Gibbs, Celine Baligand, Krista Vandenborne
The loss and recovery of muscle mass and function following injury and during rehabilitation varies among individuals. While recent expression profiling studies have illustrated transcriptomic responses to muscle disuse and remodeling, how these changes contribute to the physiological responses are not clear. In this study, we quantified the effects of immobilization and subsequent rehabilitation training on muscle size and identified molecular pathways associated with muscle responsiveness in an orthopaedic patient cohort study...
2017: Biomedical genetics and genomics
https://www.readbyqxmd.com/read/28837458/early-lessons-on-bundled-payment-at-an-academic-medical-center
#6
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28836493/developing-a-multidisciplinary-rehabilitation-package-following-hip-fracture-and-testing-in-a-randomised-feasibility-study-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur
#7
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Joanna M Charles, Nicola Totton, Michelle Williams, Kevin Mawdesley, Claire A Hawkes, Val Morrison, Andrew Lemmey, Rhiannon T Edwards, Zoe Hoare, Aaron W Pritchard, Robert T Woods, Swapna Alexander, Catherine Sackley, Pip Logan, Clare Wilkinson, Jo Rycroft-Malone
BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES: To develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28834916/factors-predicting-dysphagia-after-anterior-cervical-surgery-a-multicenter-retrospective-study-for-2-years-of-follow-up
#8
MULTICENTER STUDY
Tao Wang, Lei Ma, Da-Long Yang, Hui Wang, Zhi-Long Bai, Li-Jun Zhang, Wen-Yuan Ding
A multicenter retrospective study.The purpose of this study was to explore risk factors of dysphagia after anterior cervical surgery and factors affecting rehabilitation of dysphagia 2 years after surgery.Patients who underwent anterior cervical surgery at 3 centers from January 2010 to January 2013 were included. The possible factors included 3 aspects: demographic variables-age, sex, body mass index (BMI): hypertension, diabetes, heart disease, smoking, alcohol use, diagnose (cervical spondylotic myelopathy or ossification of posterior longitudinal ligament), preoperative visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA), surgical-related variables-surgical option (ACDF, ACCF, ACCDF, or Zero profile), operation time, blood loss, operative level, superior fusion segment, incision length, angle of C2 to C7, height of C2 to C7, cervical circumference, cervical circumference/height of C2 to C7...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833976/what-contributes-to-action-plan-enactment-examining-characteristics-of-physical-activity-plans
#9
Lena Fleig, Benjamin Gardner, Jan Keller, Sonia Lippke, Sarah Pomp, Amelie U Wiedemann
OBJECTIVES: Individuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so-called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user-specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental. DESIGN AND METHODS: The study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation...
August 18, 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/28833302/patient-experience-with-early-discharge-after-total-knee-arthroplasty-a-focus-group-study
#10
Lise Husby Høvik, Bjørg Aglen, Vigdis Schnell Husby
BACKGROUND: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast-track pathway aims at improving patient outcome, and patients are now discharged 2-3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. AIM: To explore the experience of patients undergoing total knee arthroplasty in a fast-track pathway during the first 2 weeks after surgery...
August 23, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28805066/active-controlled-motion-in-early-rehabilitation-improves-outcome-after-ankle-fractures-a-randomized-controlled-trial
#11
Hendrik Jansen, Martin Jordan, Sönke Frey, Stefanie Hölscher-Doht, Rainer Meffert, Timo Heintel
OBJECTIVE: To evaluate the use of active controlled motion (ACM) after unstable ankle fractures needing initial partial weight-bearing. DESIGN: Prospective randomized controlled trial. SETTING: Inpatient and outpatient clinic. SUBJECTS: A total of 50 patients with unstable ankle fractures and the need for partial weight-bearing for six weeks. INTERVENTIONS: Randomization in two groups: physiotherapy alone or physiotherapy with an additional ACM device...
August 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28800719/total-ankle-arthroplasty-comparing-perioperative-outcomes-when-performed-at-an-orthopaedic-specialty-hospital-versus-an-academic-teaching-hospital
#12
David M Beck, Eric M Padegimas, David I Pedowitz, Steven M Raikin
BACKGROUND: The number of total ankle arthroplasties (TAAs) performed in the United States has risen significantly in recent years, as has utilization of orthopaedic specialty hospital (OSH) to treat healthy patients undergoing elective surgery. The purpose of this study was to compare postoperative outcomes following TAA at an OSH when compared with a matching population of patients undergoing TAA at an academic teaching hospital (ATH). METHODS: We identified all TAA from January 2014 to December 2014 at the OSH and January 2010 to January 2016 at the ATH...
August 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28761696/ankle-syndesmosis-repair-and-rehabilitation-in-professional-rugby-league-players-a-case-series-report
#13
Alex James Latham, Peter Charles Goodwin, Ben Stirling, Adam Budgen
BACKGROUND/AIM: The distal tibiofibular joint is described as a syndesmosis. Traditionally, severe syndesmotic injuries with diastasis have been treated surgically with screw fixation. This case series details an ankle syndesmosis tightrope repair and an accelerated rehabilitation protocol that reduces the amount of time to return to professional rugby league in the UK. The aim of this study was to describe players' journey from injury, through diagnosis to surgery, rehabilitation and return to participation, detailing time scales and methods used at each stage to highlight the change in current practice...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/28738891/pivotal-trials-of-orthopedic-surgical-devices-in-the-united-states-predominance-of-two-arm-non-inferiority-designs
#14
S Raymond Golish
BACKGROUND: The United States Food and Drug Administration (FDA) reviews class III orthopedic devices submitted for premarket approval with pivotal clinical trials. The purpose of this study was to determine the types of orthopedic devices reviewed, the design of their pivotal clinical trials, and the subjective factors affecting the interpretation of clinical trial data. METHODS: Meetings of the FDA Orthopaedic and Rehabilitation Devices Panel were identified from 2000-2016...
July 24, 2017: Trials
https://www.readbyqxmd.com/read/28737616/the-role-of-therapeutic-modalities-in-surgical-and-nonsurgical-management-of-orthopaedic-injuries
#15
Catherine A Logan, Peter D Asnis, Matthew T Provencher
Rehabilitation professionals often use therapeutic modalities as a component of the surgical and nonsurgical management of orthopaedic injuries. Myriad therapeutic modalities, including cryotherapy, thermotherapy, ultrasonography, electrical stimulation, iontophoresis, and laser therapy, are available. Knowledge of the scientific basis of each modality and the principles of implementation for specific injuries enables musculoskeletal treatment providers to prescribe these modalities effectively. The selection of specific therapeutic modalities is based on their efficacy during a particular phase of rehabilitation...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28735718/prevalence-and-characteristics-of-work-anxiety-in-medical-rehabilitation-patients-a-cross-sectional-observation-study
#16
Beate Muschalla, Michael Jöbges
OBJECTIVE: To investigate frequency, type and characteristics of work-anxieties in somatic rehabilitation inpatients. Work-anxieties are serious disorders which affect occupational functioning and often go along with long-term sick leave. Somatic patients may suffer from work-related participation problems due to their chronic health condition. Work-anxieties need specific diagnostic and treatment. DESIGN: This is a cross-sectional observation study. SETTING: We investigated inpatients from a neurological, orthopedic and cardiologic rehabilitation clinic...
July 20, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28730863/non-operative-management-of-ulnar-collateral-ligament-injuries-in-the-throwing-athlete
#17
Mia Smucny, Robert W Westermann, Matthew Winters, Mark S Schickendantz
Medial ulnar collateral ligament (UCL) injuries have become increasingly prevalent in overhead athletes. The orthopaedic literature contains a wealth of information on operative management of these injuries. However, there are few high-quality longitudinal studies on non-operative care of UCL injuries. The purpose of this review is to describe the non-operative approach to managing UCL injuries, including recommended rehabilitation strategies and predictors of successful non-operative treatment.
July 25, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28730332/-a%C3%A2-phase-model-of-trauma-rehabilitation-how-can-we-avoid-the-rehab-hole
#18
Stefan Simmel, Wolf-Dieter Müller, Christoph Reimertz, Christian Kühne, Jean-Jacques Glaesener
Advances in the rescue chain and first aid of polytrauma patients, which have consequently increased their chance of survival, have led to an increase in demands for rehabilitation. However, there is still a large hole in the continuity of rehabilitation between acute patient care and in-patient rehabilitation, the so-called "rehab-hole". The consequences are untapped rehabilitation potential, loss of strength, endurance and motivation as well as impairment of function of the patient.Based on the phase model of neurological/neurosurgical rehabilitation, we propose a step model for the rehabilitation of polytrauma patients that ensures an uninterrupted chain of rehabilitation...
July 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28729323/gait-outcomes-of-older-adults-receiving-subacute-hospital-rehabilitation-following-orthopaedic-trauma-a-longitudinal-cohort-study
#19
Saira A Mathew, Paul Varghese, Suzanne S Kuys, Kristiann C Heesch, Steven M McPhail
OBJECTIVES: This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination. DESIGN: A longitudinal cohort study was conducted. SETTING: Australian tertiary hospital subacute rehabilitation wards. PARTICIPANTS: Patients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706095/elucidating-the-information-exchange-during-interfacility-care-transitions-insights-from-a-qualitative-study
#20
Lianne Jeffs, Marianne Saragosa, Madelyn Law, Kerry Kuluski, Sherry Espin, Jane Merkley, Chaim M Bell
OBJECTIVE: To explore the perceptions of patients, their caregivers and healthcare professionals associated with the exchange of information during transitioning from two acute care hospitals to one rehabilitation hospital. DESIGN: An exploratory qualitative study using semi-structured interviews and observation. PARTICIPANTS AND SETTING: Patients over the age of 65 years admitted to an orthopaedic unit for a non-elective admission, their caregivers and healthcare professionals involved in their care...
July 12, 2017: BMJ Open
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