Lessons Learned: The Difficulties of Incorporating Intensity Principles Into Inpatient Stroke Rehabilitation.

Objective: The objective of this study was to determine the feasibility of a rehabilitation approach focusing on cardiovascular, strength, and gait training intensity in the inpatient rehabilitation setting after a new onset of stroke. We additionally aimed to determine the efficacy of this intensity-based program on rehabilitation outcomes compared with usual care.

Design: Participants were pseudo-randomized to an intensity-based program focusing on gait, cardiovascular, and strength training or to usual care.

Implementation of an Evidence-Based, Nurse-Driven Sepsis Protocol to Reduce Acute Care Transfer Readmissions in the Inpatient Rehabilitation Facility Setting.

Purpose: The aim of this study was to determine if implementing an evidence-based, nurse-driven sepsis protocol would reduce acute care transfer (ACT) readmissions from an inpatient rehabilitation facility compared to nonprotocolized or usual standard of care for adult sepsis patients undergoing physical rehabilitation.

Design: This study used a preintervention and postintervention model for quality improvement, which involved comparing the nonprotocolized care of adult sepsis patients in the inpatient rehabilitation population to the application of an evidence-based, nurse-driven sepsis protocol to determine its effect on reducing ACT readmissions.

Methods: Patients who screened positive for suspected sepsis and received protocolized interventions were analyzed to determine the occurrence of ACT readmission.

Gender and posture are significant risk factors to musculoskeletal symptoms during touchscreen tablet computer use.

[Purpose] To investigate the prevalence of neck and shoulder symptoms during the use of tablet computer, and to identify the risk factors associated with these symptoms. [Subjects and Methods] A cross-sectional survey was conducted to study tablet computer usage, posture during use, and neck and shoulder symptoms in 412 participants in a school setting. Significant risk factors for musculoskeletal symptoms during tablet computer use were identified.

Treatment of Postanoxic Action Myoclonus With Intrathecal Baclofen: A Case Report.

Unlabelled: A case of severe action myoclonus after pulmonary arrest is described. Although there was benefit from oral pharmacotherapy, action myoclonus remained disabling. A favorable response to baclofen during an intrathecal trial led to eventual placement of an intrathecal baclofen pump.

The Influence of a Mexican Cultural Immersion Experience on Personal and Professional Healthcare Practices.

The purpose of this study was to understand the influence of a cultural immersion experience on personal and professional healthcare practices of occupational therapists. The experience, a 10-day course in Oaxaca, Mexico, exposed participants to alternative and complementary medicine through interactive sessions with Mexican indigenous traditional healers. The literature indicates that cultural immersion experiences can increase the perceived cultural effectiveness of healthcare professionals.

Cognitive effects of modafinil in patients with multiple sclerosis: A clinical trial.

Purpose/objective: To assess the efficacy of modafinil for the treatment of new learning and memory deficits and fatigue in multiple sclerosis. Only 1 previous study in the literature, to our knowledge, examined the effect of modafinil on cognition specifically in persons with multiple sclerosis.

Research Method/design: Sixteen patients with a diagnosis of multiple sclerosis (MS) and documented new learning impairment completed the study.

Evaluating the Siebens Model in Geriatric-Stroke Inpatient Rehabilitation to Reduce Institutionalization and Acute-Care Readmissions.

Background: The objective of the study is to evaluate the use of Siebens Domain Management Model (SDMM) in geriatric-stroke patients during inpatient rehabilitation (IR) to increase functional independence, and to reduce institutionalization and acute-care readmissions, which are quality indicators under the U.S. Affordable Care Act.

Responsiveness of the Neuromuscular Recovery Scale During Outpatient Activity-Dependent Rehabilitation for Spinal Cord Injury.

Background: The Neuromuscular Recovery Scale (NRS) was developed by researchers and clinicians to functionally classify people with spinal cord injury (SCI) by measuring functionally relevant motor tasks without compensation. Previous studies established strong interrater and test-retest reliability and validity of the scale.

Objective: To determine responsiveness of the NRS, a version including newly added upper-extremity items, in an outpatient rehabilitation setting.

Randomized, placebo-controlled trial of incobotulinumtoxina for upper-limb post-stroke spasticity.

Introduction: Efficacy and safety of incobotulinumtoxinA in post-stroke upper-limb spasticity were studied.

Methods: Subjects randomized 2:1 to incobotulinumtoxinA (fixed dose 400 U) or placebo, with fixed doses for the primary target clinical pattern (PTCP; flexed elbow, 200 U; flexed wrist, 150 U; clenched fist, 100 U). Doses for non-primary patterns were flexible within predefined ranges.

Behavioral intention to use a virtual instrumental activities of daily living system among people with stroke.

Objective: The purpose of this study was to investigate the behavioral intention to use (BIU) regarding a virtual system for practicing instrumental activities of daily living (IADLs) among people with stroke.

Method: Fourteen people who had sustained a stroke used a virtual world-based system over four sessions to participate in virtual occupations of preparing meals and putting away groceries. To investigate intention to use the technology, participants responded to a questionnaire based on the Technology Acceptance Model and were interviewed about the experience.

Evaluating Siebens Domain Management Model for inpatient rehabilitation to increase functional independence and discharge rate to home in geriatric patients.

Objective: To evaluate the Siebens Domain Management Model (SDMM) for geriatric inpatient rehabilitation (IR) to increase functional independence and dispositions to home.

Design: Before and after study.

Setting: IR facility.

Evaluating use of the Siebens Domain Management Model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients.

Objective: To evaluate use of the Siebens Domain Management Model (SDMM) during stroke inpatient rehabilitation (IR) to increase functional independence and rate of discharge to home.

Design: Before and after study.

Setting: IR facility.

Usefulness of the Berg Balance Scale to predict falls in the elderly.

Objective: The purpose of this systematic review was to complete a comprehensive search and review of the literature to determine the ability of the Berg Balance Scale (BBS) to predict falls in the elderly with and without pathology. Specifically, the cutoff score that is most predictive of falls in the older adults and the sensitivity and specificity of the BBS in predicting falls.

Methods: A search of English-language-based literature with relevant search terms using the OVID, CINAHL, PubMed, and MEDLINE search engines from 1985 to March 2009.

Backpack use in children.

Purpose: This article describes backpack use and incidence of back pain in children.

Methods: A convenience sample of 345 children, grades five through eight, served as subjects. A written questionnaire was developed to gather information on demographics, leisure activity level, bag type, locker use, students' perceptions of bag weight and comfort, and students' reports of history of back pain.

Interrater reliability of the active-knee-extension test for hamstring length in school-aged children.

Purpose: The purpose of this study was to determine the interrater reliability of the active knee-extension test (AKET) using a stabilizing apparatus to measure hamstring length.

Methods: One hundred one subjects (53 girls, 48 boys) ranging in age from 10 to 13 years with no known neuromuscular problems participated. The AKET was performed with subjects lying supine with the hip flexed to 90 degrees with a stabilization device attached to a plinth.

Conversational skills of children with cleft lip and palate: a replication and extension.

Objective: To replicate and to extend a previous study examining the conversational skills of children with cleft lip and palate.

Participants: Thirty-four children (33 to 44 months) participated: 17 children with cleft lip and palate and 17 noncleft children.

Methods: The children were observed during an interaction with caregivers in their homes.

The effects of collaborative goal-focused occupational therapy on self-care skills: a pilot study.

Objective: This pilot study examined collaborative, goal-focused therapy to determine its effects on performance of self-care activities, including eating, grooming, bathing, upper body dressing, lower-body dressing, and toileting.

Method: Thirty-one patients at a rehabilitation hospital, divided between control and experimental groups, comprised the sample. Participants' performances on self-care activities were measured using the Functional Independence Measure (FIM) at admission to therapy and again at a 2-week follow-up.

Presence of post-concussion syndrome symptoms in patients with chronic pain vs mild traumatic brain injury.

Primary Objective: Post-concussion syndrome (PCS) is a controversial diagnosis, in part because many symptoms may be present in other conditions, such as chronic pain (CP). However, direct comparisons between people with CP and mild traumatic brain injury (MTBI) are limited. The purpose of this study was to compare people with CP and MTBI on a measure of PCS symptoms.

Collaborative practice: a successful model.

Recognizing the need for better collaboration, nursing personnel from two nonrelated health care facilities, acute care and rehabilitation hospitals, came together to establish a methodology to improve outcomes for patients with spinal cord injury (SCI). Focus areas were to facilitate communication and transition between hospitals. A collaborative practice model evolved for the patient with tetraplegia who is ventilator-dependent.

Positive outcomes in traumatic brain injury-vegetative state: patients treated with bromocriptine.

Objective: To assess the effects of multidisciplinary rehabilitation interventions and use of bromocriptine on outcome in patients with traumatic brain injury-vegetative state (TBI-VS).

Design: Retrospective review of clinical cases.

Setting: Free-standing rehabilitation hospital; Acute and extended rehabilitation hospital.

Cardiopulmonary rehabilitation and cancer rehabilitation. 1. Cardiac rehabilitation.

Unlabelled: This self-directed learning module highlights cardiac rehabilitation issues facing able-bodied populations. It is part of the chapter on cardiovascular, pulmonary, and cancer rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article focuses on various aspects of the management of cardiac disease and rehabilitation, including medication, exercise, risk-factor modification, secondary prevention, and surgery.