The latest medical research on Rehabilitation Medicine

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about rehabilitation medicine gathered by our medical AI research bot.

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Functional outcomes of rehabilitation in patients with subacute stroke on haemodialysis.

Journal of Rehabilitation Medicine

To examine functional outcomes in patients with subacute stroke who are on haemodialysis.

Data on the Functional Independence Measure (FIM) and discharge destination were collected from medical records as outcomes. Outcomes were compared for patients who received haemodialysis and those who did not. Multiple regression analyses were carried out to explore the impact of haemodialysis on functional outcomes.

Among 859 patients, 34 (mean age (standard deviation; SD) 63.6 (11.7) years) required haemodialysis while staying in rehabilitation wards. One hundred patients not receiving haemodialysis (mean age 70.7 (SD 13.8) years) were randomly selected as controls. The total FIM score at discharge, FIM gain, FIM efficiency, FIM effectiveness, and discharge destination were not significantly different between the 2 groups (p > 0.05). Multiple regression analysis, adjusted for other confounding factors, found no significant difference in total FIM score between groups at discharge (p = 0.427).

Dialysis was not an inhibitory factor affecting outcomes during subacute rehabilitation in patients with stroke. Rehabilitation should be considered for patients with subacute stroke requiring haemodialysis, in order to provide every opportunity to achieve adequate functional outcomes.

Does inspiration efficiency influence the stability limits of the trunk in patients with chronic low back pain?

Journal of Rehabilitation Medicine

To determine the effects of diaphragm-strengthening training on the stability limits of the trunk and inspiratory function in patients with low back pain.

The inspiratory functions (chest excursion, maximal inspiratory pressure, peak inspiratory flow, and volume of inspired air) and stability limits of the trunk with the subject in the sitting position (modified functional and lateral reach test) were assessed.

Maximal inspiratory pressure and stability limit tests showed a statistically discernible improvement only in the diaphragm training group. Statistically discernible improvements in chest excursion and peak expiratory flow tests were found in both groups; however, the improvement was more meaningful in the diaphragm training group.

Conventional exercises together with diaphragm training result in a greater improvement than conventional exercises alone.

Efficacy of Myoelectric Bracing in Moderately Impaired Stroke: A Randomized, Controlled Trial.

Journal of Rehabilitation Medicine

Repetitive, task-specific practice (RTP) increases functioning of the paretic upper extremity and decreases upper extremity motor impairment. One method to increase participation in RTP is an upper extremity myoelectric device, called the "Myomo", which uses surface electromyography signals to assist with active movement of the moderately impaired hemiplegic upper extremity.

To determine the efficacy of regimens comprised of: (i) Myomo + RTP; (ii) RTP only; and (iii) Myomo only on outcomes for hemiplegic arm.

Using a randomized, controlled, single-blinded design, 34 subjects (20 males; mean age = 55.8 years), exhibiting chronic, moderate, stable, post-stroke, UE hemiparesis, were included. Participants were randomized to 1 of the above conditions, and administered treatment for 1 h/day on 3 days/week over an 8-week period. The primary outcome measure was the upper extremity section of the Fugl-Meyer Impairment Scale (FM); the secondary measurement was the Arm Motor Activity Test (AMAT).

The groups exhibited similar score increases of approximately +2 points, resulting in no differences in the amount of change on the FM (H = 0.376, p = 0.83) and AMAT (H = 0.978 p = 0.61).

The results suggest that a therapeutic approach integrating myoelectric bracing yields highly comparable outcomes to those derived from RTP-only. Myoelectric bracing could be used as alternative for labour-intensive upper extremity training due to its equivalent efficacy to hands-on manual therapy [AQ1] with moderately impaired stroke survivors.

Case manager-assisted rehabilitation for lumbar spinal fusion patients: an economic evaluation alongside a randomized controlled trial with two-year follow-up.

Clinical Rehabilitation

To examine the cost-effectiveness of case manager-assisted rehabilitation as an add-on to usual physical rehabilitation after lumbar spinal fusion, given the lack of any clinical benefits found on analysing the clinical data.

Economic evaluation alongside a randomized controlled trial with two-year follow-up.

Patients from the outpatient clinics of a university hospital and a general hospital.

A total of 82 lumbar spinal fusion patients.

Patients were randomized one-to-one to case manager-assisted rehabilitation programme as an add-on to usual physical rehabilitation or to usual physical rehabilitation.

Oswestry Disability Index and EuroQol 5-dimension. Danish preference weights were used to estimate quality-adjusted life years. Costs were estimated from micro costing and national registries. Multiple imputation was used to handle missing data. Costs and effects were presented with means (95% confidence interval (CI)). The incremental net benefit was estimated for a range of hypothetical values of willingness to pay per gain in effects.

No impact of case manager-assisted rehabilitation on the Oswestry Disability Index or estimate quality-adjusted life years was observed. Intervention cost was Euros 3984 (3468; 4499), which was outweighed by average reductions in inpatient resource use and sickness leave. A cost reduction of Euros 1716 (-16,651; 20,084) was found in the case manager group. Overall, the probability for the case manager-assisted rehabilitation programme being cost-effective did not exceed a probability of 56%, regardless of willingness to pay. Sensitivity analysis did not change the conclusion.

This case manager-assisted rehabilitation programme was unlikely to be cost-effective.

Does adding case management to standard rehabilitation affect functional ability, pain, or the rate of return to work after lumbar spinal fusion? A randomized controlled trial with two-year follow-up.

Clinical Rehabilitation

To examine the effect of a case manager-assisted rehabilitation programme as an add-on to usual physical rehabilitation in patients undergoing lumbar spinal fusion.

A randomized controlled trial with a two-year follow-up.

Outpatient clinics of a university hospital and a general hospital.

In total, 82 patients undergoing lumbar spinal fusion.

The patients were randomized one-to-one to case manager-assisted rehabilitation (case manager group) or no case manager-assisted rehabilitation (control group). Both groups received usual physical rehabilitation. The case manager-assisted rehabilitation programme included a preoperative meeting with a case manager to determine a rehabilitation plan, postsurgical meetings, phone meetings, and voluntary workplace visits or roundtable meetings.

Primary outcome was the Oswestry Disability Index. Secondary outcomes were back pain, leg pain, and return to work.

Of the 41 patients in the case manager group, 49% were men, with the mean age of 46.1 (±8.7 years). In the control group, 51% were male, with the mean age of 47.4 (±8.9 years). No statistically significant between-group differences were found regarding any outcomes. An overall group effect of 4.1 points (95% confidence interval (CI): -1.8; 9.9) was found on the Oswestry Disability Index, favouring the control group. After two years, the relative risk of return to work was 1.18 (95% CI: 0.8; 1.7), favouring the case manager group.

The case manager-assisted rehabilitation programme had no effect on the patients' functional disability or back and leg pain compared to usual physical rehabilitation. The study lacked power to evaluate the impact on return to work.

Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial.

Clinical Rehabilitation

The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital.

Randomized controlled trial.

Home and community.

Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention (n = 59) or a control (standard care, n = 58) group.

The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counseling, and standard care.

Physical activity and sedentary time were assessed using an accelerometer and a single question. Mobility was evaluated with the Short Physical Performance Battery, self-reported use of a walking aid, and ability to negotiate stairs and walk outdoors. Intervention effects were analyzed with generalized estimating equations.

Daily physical activity was 127 ± 78 minutes/day and 121 ± 70 at baseline and 167 ± 81 and 164 ± 72 at six months in the intervention and control group, respectively; mean difference of 3.4 minutes (95% confidence interval (CI) = -20.3 to 27.1). In addition, no significant between-group differences were shown in physical performance.

The rehabilitation program was not superior to standard care for increasing physical activity or improving physical performance. Mobility-limited older people who had recently returned home from hospital would have needed a longer and more frequently monitored comprehensive geriatric intervention.

Multiple psychological factors predict pain and disability among community-dwelling knee osteoarthritis patients: a five-year prospective study.

Clinical Rehabilitation

To identify predictors of long-term pain and disability in knee osteoarthritis.

A longitudinal cohort study of five years.

Primary care providers.

In all, 108 patients (mean age = 63.6 years, standard deviation (SD) = 7.2 years) with knee pain (⩾40 mm on a 100 mm visual analogue scale in the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index pain scale) and radiographic grading (Kellgren-Lawrence: 2-4) of knee osteoarthritis who participated in a randomized controlled trial.

Disease-specific pain and functioning were assessed using the corresponding WOMAC subscales. Generic functioning was assessed by the RAND-36 subscales for function and physical and mental component summary scores. Possible baseline predictors for these outcomes were (1) demographic and disease-related variables and (2) psychological variables of mood (anxiety, depression), pain-related cognitions (pain self-efficacy, pain catastrophizing, kinesiophobia), and positive resource factors (life satisfaction, sense of coherence).

Multivariate linear mixed model analyses revealed that minimal anxiety at baseline predicted significantly better results for pain (WOMAC, P = 0.019) and function (WOMAC, P = 0.001, RAND-36 function P = 0.001). High pain self-efficacy predicted significantly better scores in RAND-36 function (P = 0.006), physical (P = 0.004) and mental (P = 0.001) component summaries. Pain catastrophizing predicted higher pain (P = 0.015), whereas fear of movement predicted poorer functioning in RAND-36 physical (P = 0.016) and mental (P = 0.009) component summaries. Those satisfied with life reported higher scores in RAND-36 function (P = 0.002) and mental component summary (P = 0.041). A low number of comorbidities predicted significantly better results in pain (WOMAC P = 0.019) and function (WOMAC P = 0.033, RAND-36 P = 0.009).

Anxiety, pain-related cognitions, and psychological resources predict symptoms in knee osteoarthritis in the long term.

The Challenge of Basic Itch Research.

Journal of Rehabilitation Medicine

Basic mechanisms and pathways of itch signaling are reviewed, with an emphasis on the progress to date as well as remaining challenges in translati...

Mechanisms and Management of Itch in Dry Skin.

Journal of Rehabilitation Medicine

Chronic itch is a burdensome clinical problem that often accompanies pathological dry skin-based conditions, such as atopic dermatitis, and systemi...

Non-dermatological Challenges of Chronic Itch.

Journal of Rehabilitation Medicine

Chronic itch occurs in many skin diseases, but also in a variety of systemic, neurological, and psychogenic/psychosomatic disorders, or is caused b...

Itch and Psyche: Bilateral Associations.

Journal of Rehabilitation Medicine

Beginning from embryological development, skin and psyche are closely related to physiological state regardless of age. Altering the homeostasis of...

A New Generation of Treatments for Itch.

Journal of Rehabilitation Medicine

For decades, antihistamines have been the mainstay of treatment for chronic pruritus, yet they often only work by making patients drowsy and forget...