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acute inpatient rehabilitation

Annette Haywood, Sarah Barnes, Hazel Marsh, Stuart G Parker
BACKGROUND: Older people with an acute illness, many of whom are also frail, form a significant proportion of the acute hospital inpatient population. Attention is focusing on ways of improving the physical environment to optimize health outcomes and staff efficiency. PURPOSE: This article explores the effects of the physical environment in three acute care settings: acute hospital site, in-patient rehabilitation hospital, and intermediate care provision (a nursing home with some beds dedicated to intermediate care) chosen to represent different steps on the acute care pathway for older people and gain the perspectives of patients, family carers, and staff...
January 1, 2018: HERD
Conran Joseph, Björn Stömbäck, Maria Hagströmer, David Conradsson
OBJECTIVE: To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. DESIGN: Longitudinal observational study. PARTICIPANTS: Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and December 2016. METHODS: Volume and intensity of physical activity were assessed with accelerometers throughout the rehabilitation period...
March 15, 2018: Journal of Rehabilitation Medicine
Ronald E Delanois, Chukwuweike U Gwam, Jeffrey J Cherian, Jennifer I Etcheson, Nicole E George, Kathleen A Schneider, Michael A Mont
BACKGROUND: The state of Maryland was granted a waiver by the Center for Medicare and Medicaid Services to implement a Global Budget Revenue (GBR) reimbursement model. This study aims to compare (1) costs of inpatient hospital stays; (2) postacute care costs; (3) lengths of stay (LOS); and (4) discharge disposition who underwent primary total hip arthroplasty at a single Maryland-based orthopedic institution before and after the implementation of GBR. METHODS: The Maryland Center for Medicare and Medicaid Services database was queried to obtain all Medicare patients who underwent total hip arthroplasty at a single institution before and after the implementation of GBR...
February 15, 2018: Journal of Arthroplasty
Tania Gutiérrez Panchana, Viviane Hidalgo Cabalín
BACKGROUND: The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is rare. The aim of this paper is to describe adherence to standardized assessments by physical therapists using a complexity-based model for categorizing rehabilitation (CMCR) at the Clínica Alemana of Santiago, an acute hospital in Chile. METHODS: This retrospective cohort study used 145,968 participant records that were stored in the inpatient database between July 2011 and December 2015...
March 12, 2018: BMC Medical Informatics and Decision Making
Ajimsha M S, Smithesh Kooven, Noora Al-Mudahka
BACKGROUND: Clinical guidelines are systematically developed statements designed to help practitioners and patients to make decisions about appropriate health care. Clinical practice guideline adherence analysis is the best way to fine tune the best practices in a health care industry with international benchmarks. OBJECTIVE: To assess the physical therapist's adherence to structured stroke clinical practice guidelines in an active inpatient rehabilitation center in Qatar...
March 9, 2018: Disability and Rehabilitation
Amol S Navathe, Alexander M Bain, Rachel M Werner
BACKGROUND: While early evidence suggests that Medicare accountable care organizations (ACOs) may reduce post-acute care (PAC) utilization for attributed beneficiaries, whether these effects spill over to all beneficiaries admitted to hospitals participating in ACOs stray is unknown. OBJECTIVE: The objective of this study was to evaluate whether changes in PAC use and Medicare spending spill over to all beneficiaries admitted to hospitals participating in the Medicare Shared Savings Program (MSSP)...
March 8, 2018: Journal of General Internal Medicine
Stephanie Rigot, Lynn Worobey, Michael L Boninger
OBJECTIVES: To investigate relation of gait training (GT) during inpatient rehabilitation (IPR) to outcomes of people with traumatic spinal cord injury (SCI). DESIGN: Prospective observational study using the SCIRehab database. SETTING: Six IPR facilities. PARTICIPANTS: Patients with new SCI receiving initial rehabilitation (n=1376). INTERVENTIONS: Patients were divided into groups of who did and did not receive GT...
March 3, 2018: Archives of Physical Medicine and Rehabilitation
Jo Murray, Ingrid Scholten, Sebastian Doeltgen
Dysphagia has been strongly associated with poor hydration in acute stroke settings. However, in sub-acute settings, the contribution to dehydration of dysphagia in combination with other common stroke comorbidities has not been explored. The aim of this study was to investigate which demographic and stroke comorbidities, including dysphagia, contribute most significantly to oral fluid intake, hydration status and specific adverse health outcomes for patients in sub-acute rehabilitation following stroke. Data from 100 inpatients from three Australian rehabilitation facilities (14 with confirmed dysphagia and 86 without dysphagia) were analysed...
March 1, 2018: Dysphagia
Yusuke Sawada, Yusuke Sasabuchi, Yasuo Nakahara, Hiroki Matsui, Kiyohide Fushimi, Nobuhiko Haga, Hideo Yasunaga
BACKGROUND: Community-acquired pneumonia is one of the most common infectious diseases and can be fatal. The benefits of early rehabilitation in intensive care units are known, but the association between early rehabilitation and in-hospital mortality of patients with community-acquired pneumonia admitted to intensive care units has not been studied. OBJECTIVES: To study the association between early rehabilitation and the in-hospital mortality of patients with community- acquired pneumonia admitted to intensive care units, effects of early rehabilitation on unit and hospital lengths of stay, and total costs of hospitalization...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Tijn van Diemen, Eline Wm Scholten, Ilse Jw van Nes, Jan Hb Geertzen, Marcel Wm Post
BACKGROUND: People with recently acquired spinal cord injury (SCI) experience changes in physical, social and psychological aspects of their lives. In the last decades, attention has grown for aspects of self-management and self-efficacy in SCI research. However, we still do not know what the self-management and self-efficacy outcomes of first rehabilitation are and whether utilizing these skills may prevent secondary health conditions (SHCs) and increase participation and psychological adjustment early after SCI...
February 26, 2018: JMIR Research Protocols
Christopher M Wilson, Christina L Mitchell, Katherine M Hebert
Cerebellar stroke increases the risk of extensive physical disability and long-term institutionalization. The purpose of this case report is to describe the 14-month longitudinal rehabilitation management and outcomes from the intensive care unit, inpatient rehabilitation unit and outpatient care of a patient after cerebellar stroke. A goal of this case report is to provide rehabilitation clinicians with a long-term perspective and understanding of the course of recovery for a patient after cerebellar cerebrovascular accident or related injury...
December 14, 2017: Curēus
Vanessa Gallegos-Kearin, Sasha E Knowlton, Richard Goldstein, Jacqueline Mix, Ross Zafonte, Michael Kwan, Julie Silver, Jeffrey C Schneider
OBJECTIVE: This study describes characteristics and trends of inpatient rehabilitation among cancer patients within the United States over a 13-year period. DESIGN: This was a retrospective study of data from the Uniform Data System for Medical Rehabilitation (UDSMR®) from 2002 to 2014. Patients over the age of 17 admitted to inpatient rehabilitation facilities with a diagnosis of malignant cancer were included. Trends of rehabilitation outcomes including length of stay, Functional Independence Measure (FIM®) Instrument scores, and discharge location were examined...
February 21, 2018: American Journal of Physical Medicine & Rehabilitation
Meenakshi Singh, Boriana Parvez, Agnes Banquet, Jordan S Kase
OBJECTIVE: To investigate whether Post-Acute Care Inpatient Rehabilitation (PACIR) admission after NICU stay affects the total length of stay (LOS) of very preterm (VPT: ≤30 weeks of gestation) infants. METHODS: A retrospective case control study of VPT infants d/c'd from the NICU at Maria Fareri Children's Hospital (MFCH) to either a PACIR (Blythedale Children's Hospital: BH) for convalescent care (cases) or directly home (controls). RESULTS: 35 cases and 70 controls...
February 20, 2018: Developmental Neurorehabilitation
Hitoshi Mutai, Tomomi Furukawa, Ayumi Wakabayashi, Akihito Suzuki, Tokiji Hanihara
Background As the population continues to age rapidly, clarifying the factors affecting the prognosis in very elderly stroke patients is essential to enhance the quality of their rehabilitation. Objectives To compare the functional recovery of elderly stroke patients classified into three age groups and to identify the predictors of functional recovery in the very elderly following acute inpatient rehabilitation. Methods Observational study: We collected data on 461 stroke patients in the neurology and neurosurgery ward and classified them into three age groups (65-74, 75-84, and ≥ 85 years)...
February 19, 2018: Topics in Stroke Rehabilitation
I Churilov, L Churilov, R J MacIsaac, E I Ekinci
Sarcopenia is associated with poor function and increased risk of falls and disability. This work reports a systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation. Sarcopenia is found to be present in approximately 50% of rehabilitation patients and its prevalence may vary with admission diagnosis. PURPOSE:  To conduct a systematic review and meta-analysis of reported prevalence of sarcopenia in post acute inpatient rehabilitation. METHODS:  Systematic review conducted according to PRISMA guidelines (PROSPERO registration number CRD42016054135)...
February 18, 2018: Osteoporosis International
Pawel Kiper, Andrzej Szczudlik, Michela Agostini, Jozef Opara, Roman Nowobilski, Laura Ventura, Paolo Tonin, Andrea Turolla
OBJECTIVE: To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke aetiology (i.e. ischemic or hemorrhagic). DESIGN: Randomized controlled trial. SETTING: Inpatients in a hospital facility for intensive rehabilitation. PARTICIPANTS: 136 patients within one year from onset of a single stroke...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
Arinori Kamono, Naomichi Ogihara
The ability to shift weight toward the paretic leg has been considered an essential ability to restore independent walking for post-acute stroke patients. However, few data are available regarding the relationship between the weight-shift ability and gait performance. No clear mechanism has been provided as to why and how the weight-shift ability improves walking performance in stroke patients. We therefore investigated changes in the weight-shift ability and kinematic and kinetic parameters of walking gait in post-stroke patients during rehabilitation...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
Ku-Chou Chang, Jen-Wen Hung, Hsuei-Chen Lee, Chu-Ling Yen, Ching-Yi Wu, Chung-Lin Yang, Yu-Ching Huang, Pei-Li Lin, Hui-Hsuan Wang
BACKGROUND: It remains unclear whether rehabilitation has an impact on reducing the long-term risk of mortality or readmission following stroke or transient ischemic attack (TIA). OBJECTIVES: To investigate the association between the dosage and continuation of rehabilitation and the risk of outcome events (OEs) after stroke or TIA. RESEARCH DESIGN: A retrospective cohort study using Taiwan's National Health Insurance database. SUBJECTS: In total, 4594 patients admitted with first-ever acute stroke or TIA were followed-up for 32 months...
February 6, 2018: Medical Care
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