Crafting the Future of Community-Based Medical Rehabilitation: Exploring Optimal Models for Non-Inpatient Rehabilitation Services through a Narrative Review.

Community-based medical rehabilitation encompasses diverse programs that cater to patients outside of inpatient settings, such as home rehabilitation, day rehabilitation centers, and ambulatory clinics. While inpatient rehabilitation principles are widely standardized, outpatient programs display significant variability influenced by healthcare models, local environments, economic constraints, and available resources. This narrative review aims to explore and synthesize the various models of non-inpatient rehabilitation services, evaluating their effectiveness, cost-efficiency, and patient satisfaction.

[WHAT IS "PHYSICAL MEDICINE" - THE FIELD OF PHYSICAL MEDICINE AND REHABILITATION IN ISRAEL?].

Background: The field of Physical Medicine and Rehabilitation is as diverse and broad as any field in medicine. The two, seemingly different, fields developed separately and over time (as later presented) merged into one specialty. This resulted in an initial asymmetry of focus amongst training programs - and indeed countries.

[COMMUNITY-BASED REHABILITATION: IMPORTANCE, PRINCIPLES AND ADVANCEMENT IN ISRAEL].

Medical rehabilitation is developing rapidly in Israel and around the world due to the aging of the population, improvement of results of medical care, and growing awareness of the importance of rehabilitation medicine. An option of comprehensive community rehabilitation treatment is also developing quickly, both in the model of replacing hospitalization and as a professional treatment after early discharge from an inpatient program. Rehabilitation in the community has many benefits, including financial, high patient satisfaction, and in some cases even more successful results of rehabilitation.

[REHABILITATION MEDICINE IN DEPTH AND WIDTH].

Modern rehabilitation medicine focuses on evaluating and treating patients whose quality of life has been compromised by medical conditions. This field endeavors to enhance well-being and independence levels by adopting a comprehensive approach that addresses physical, mental, psychological, and social aspects, while incorporating advancements in medical research. Grounded in the International Classification of Functioning, Disability, and Health (ICF) model by the World Health Organization, rehabilitation targets diverse levels of functional impairment.

Physical Rehabilitation of Motor Functional Neurological Disorders: A Narrative Review.

Functional Neurological Disorders (FNDs) are one of the most common and disabling neurological disorders, affecting approximately 10-30% of patients in neurology clinics. FNDs manifest as a range of motor, sensory, and cognitive symptoms that are not explained by organic disease. This narrative review aims to assess the current state of knowledge in physical-based rehabilitation for motor/movement FNDs in the adult population, with the goal of improving research and medical care for this patient population.

Unilaterally Applied Resistance to Swing Leg Shows a Different Adaptation Pattern Compared to Split-Belt Treadmill in Patients with Stroke.

Persons with chronic stroke (PwCS) have a decreased ability to ambulate and walk independently. We aimed to investigate the differences between the motor adaptation process for two different perturbation methods: split-belt treadmill walking and unilaterally applied resistance to the swing leg during walking. Twenty-two PwCS undergo split-belt treadmill walking and unilaterally applied resistance to the swing leg during walking, each one week apart.

Hospital-Based Rehabilitation of Patients Who Had Undergone an Open Reduction and Internal Fixation of the Ribs Due to a Flail Chest: Case Series.

Flail chest, a severe chest injury, is caused by multiple rib fractures. The open reduction and internal fixation (ORIF) of rib fractures is an effective treatment; however, the patients' subsequent condition remains unsatisfactory in terms of the activities of daily living (ADL) and pain. No research study has, as yet, reported on hospital-based rehabilitation of patients who had undergone an ORIF.

The Individual Rehabilitation Project as the core of person-centered rehabilitation: the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists Framework for Rehabilitation in Europe.

To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.

Ethical Issues in Medical Rehabilitation: The Dilemma of Who to Admit.

Ethical allocation of scare medical resources is a ubiquitous challenge in many, if not all, medical specialties. The field of physical medicine and rehabilitation is no exception and presents its own unique dilemmas. We report on a small inpatient rehabilitation unit at a large university medical center with a large catchment area representing a vast range of socioeconomic classes.

Effects of mechanical perturbation gait training on gait and balance function in patients with stroke: A pre-post research study.

Patients with stroke (PwS) demonstrate impaired gait and balance, and asymmetric gait, placing them at high risk of falls. We aimed to investigate the effects of a single training session that included mechanical external perturbation which resists forward movement of the paretic leg during its swing phase of walking on gait and balance in PwS. In a pre-post pilot study, gait asymmetry and balance function were assessed in 22 first-event chronic PwS (i.

Open-loop and closed-loop control of posture: Stabilogram-diffusion analysis of center-of-pressure trajectories among people with stroke.

Many people with stroke (PwS) demonstrate reduced balance and increased postural sway afterwards, which may ultimately lead to falls and injury. In this study, we aimed to better understand postural sway behavior and the mechanisms of balance control by examining balance in upright standing among PwS using methods from statistical mechanics i.e.

A Preliminary Study of Dual-Task Training Using Virtual Reality: Influence on Walking and Balance in Chronic Poststroke Survivors.

Background: Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility.

Objective: To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors.

Methods: Twenty-two individuals chronic poststroke participated in the study, and were divided into 2 groups (each group performing an 8-session exercise program): 11 participated in dual-task walking (DTW), and the other 11 participated in single-task treadmill walking (TMW).

Myofascial component of cancer pain review.

Background: Pain is a common complaint of cancer patients, experienced by 38%-85% of patients. Some studies have shown a high incidence of myofascial pain syndrome (MPS) in cancer patients.

Aims: 1) To estimate the prevalence of MPS in cancer patients; 2) to examine the efficacy of current treatment options for MPS in cancer patients.

The impact of patient's weight on post-stroke rehabilitation.

Purpose To evaluate the influence of patient's weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study.

Effect of kinesio tape application on hemiplegic shoulder pain and motor ability: a pilot study.

The aim of our single-group pre-post design pilot study was to evaluate the short-term effect of kinesio taping (KT) application on pain and motor ability of hemiplegic shoulder pain (HSP) patients. Eleven poststroke patients with HSP hospitalized in the Department of Neurology C, Loewenstein Rehabilitation Hospital, Raanana, Israel, received a KT application in addition to their usual rehabilitation protocol. KT, consisting of one to three strips according to a predefined algorithm, was applied to the painful shoulder region.

The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial.

Background/objective: Stroke is a major cause of disability and death in the Western world. Studies have shown a direct relationship between specific mental and motor activity and changes in cerebral blood flow. Acupuncture is often used in post-stroke patients, but there is a lack of sham-controlled studies evaluating the effects of acupuncture on cerebral blood flow following a stroke.

Muscle Strength, Function and Heart Autonomic Regulation System Recovery at the Sub-Acute Stage Post Stroke.

Background: To compare the rate of recovery of motor and functional ability and heart rate variability (HRV) parameters during the inpatient rehabilitation period.

Summary: Twenty-three patients post first stroke at the sub-acute phase underwent motor and functional ability and HRV assessments 20 and 50 days after the event. A significant improvement was noted in motor and functional ability performance during the follow-up period, while no such change was noted in the HRV parameters.

Rehabilitation versus Nursing Home Nurses' Low Back and Neck-Shoulder Complaints.

Purpose: To compare the prevalence of those complaints in nurses working in rehabilitation departments and nursing homes, and to evaluate factors associated with them.

Design: A cross-sectional study in rehabilitation and in nursing home departments.

Methods: Data were obtained from questionnaires relating to basic demographics, prevalence of musculoskeletal complaints, potentially harmful positions and actions and job satisfaction.

Physical therapists versus nurses in a rehabilitation hospital: comparing prevalence of work-related musculoskeletal complaints and working conditions.

The objective of this study was to investigate the prevalence and work avoidance of work-related musculoskeletal complaints and to compare patient handling tasks and psychosocial factors of physical therapists (PTs) and nurses in a rehabilitation hospital. Cross-sectional observational study was carried out using questionnaires relating to basic demographics, prevalence of musculoskeletal morbidity, workload, and job satisfaction. Comparing 26 PTs and 54 nurses, all females, lower back pain was significantly more prevalent in PTs, even after adjusting for the confounding demographic factors; PTs performed full and partial manual patient transfer, as well as trunk bending and walking assistance more frequently than the nurses and were significantly more satisfied.

Modified constraint-induced movement therapy improved upper limb function in subacute poststroke patients: a small-scale clinical trial.

Background: Constraint-induced movement therapy (CIMT) has been advocated as a means of facilitating motor function in poststroke patients; however, the evidence for its efficacy is controversial.

Objective: To evaluate the effect of modified CIMT on improving paretic arm function in poststroke patients during a subacute rehabilitation period.

Methods: A single-blinded randomized controlled trial was conducted at the Loewenstein Rehabilitation Hospital, Israel.

Constraint-induced movement therapy alters cerebral blood flow in subacute post-stroke patients.

We attempted to evaluate patterns of hemispheric activation, according to cerebral blood flow changes, in post-stroke patients during motor tasks with and without arm restriction. Bilateral continuous middle cerebral artery monitoring of 6 healthy subjects (control group) and 28 post-stroke patients by transcranial Doppler sonography was executed while performing three simple motor tasks using the paretic or nondominant (in controls) hand: ball grasping, pegs insertion, and "eating" with a spoon. The nonaffected or dominant (in controls) arm was free and thereafter restricted.