373 results match your criteria: "Shepherd Center.[Affiliation]"

Study Design: Randomized-controlled trial (RCT) with immediate intervention (IMM) and wait-list control (WLC) groups; WLC participants received the intervention during delivery to subsequent cohorts.

Objectives: Investigate the effectiveness and feasibility of a virtually-delivered exercise intervention.

Setting: Home and community.

View Article and Find Full Text PDF

Objective: Whole-body vibration (WBV) appears to modulate reflex hyperexcitability and spasticity. Due to common underlying neural mechanisms between spasticity and neuropathic pain, WBV may also reduce chronic pain after spinal cord injury (SCI). Our objective was to determine whether there are dose-related changes in pain following WBV and to examine the relationships between neuropathic pain and reflex excitability.

View Article and Find Full Text PDF

Development of RehaBot-A Conversational Agent for Promoting Rewarding Activities in Users With Traumatic Brain Injury.

J Head Trauma Rehabil

June 2022

Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Rabinowitz, Ms Vaccaro, and Mr Wingfield); and Shepherd Center, Atlanta, Georgia (Dr Collier).

Objective: In this article, we describe the development and preliminary testing of RehaBot-a chatbot that users communicate with via text messaging designed to augment behavioral activation (BA) treatment of reducing depression and increasing participation in individuals with moderate to severe traumatic brain injury (TBI).

Setting: Outpatient brain injury rehabilitation facility.

Participants: Outpatient brain injury clinicians and individuals with moderate to severe TBI.

View Article and Find Full Text PDF

Background: Vestibular Rehabilitation Therapists (VRT) utilize outcome measures to quantify gait and balance abilities in individuals with vestibular disorders (IVD). The minimal clinically important difference (MCID) in gait and balance outcome measures for IVD is unknown.

Objective: The purpose of this study is to estimate the MCID of the Activities-specific Balance Confidence Scale (ABC), Functional Gait Assessment (FGA), and Gait Speed (GS) using distribution and anchor-based methods relative to the Dizziness Handicap Inventory (DHI) in IVD.

View Article and Find Full Text PDF

Study Design: Pre-post design; before and after vibration intervention.

Objectives: To explore effect of a focal, self-applied upper extremity (UE) vibration intervention on UE spasticity for individuals with tetraplegia. The secondary objectives were to explore the acceptability and ease of use of this intervention.

View Article and Find Full Text PDF

The management of patients with chronic pain is one of the most important issues In medicine and public health. Chronic pain conditions cause substantial suffering for patients, their significant others and society over years and even decades and increases healthcare utilization resources including the cost of medical care, loss of productivity and provision of disability services. Primary care providers are at the frontline in the identification and management of patients with chronic pain, as the majority of patients enter the healthcare system through primary care and are managed by primary care providers.

View Article and Find Full Text PDF

Purpose: Speech-language pathologists are increasingly being recognized as key members of concussion management teams. This study investigates whether self-report of communication problems postconcussion may be useful in identifying clients who could benefit from speech-language pathology services.

Method: Participants included 41 adolescents and adults from an outpatient specialty concussion clinic.

View Article and Find Full Text PDF

Purpose/objective: To date, there are no published formal surveys of the "state of the field" of Rehabilitation Psychology in terms of education, training, practice patterns, professional identity, and relative salary and income structures for those who identify as Rehabilitation Psychologists.

Research Method/design: In an effort to gather this information, the Practice Committee of APA Division 22 (Rehabilitation Psychology) conducted a convenience-sample survey of its listserv subscribers to obtain a representation of Rehabilitation Psychologists across the United States, and a depiction of the fields in which they work.

Results: There were 282 respondents to the survey.

View Article and Find Full Text PDF

Convergent clinical and neuroimaging evidence suggests that higher vestibular function is subserved by a distributed network including visuospatial, cognitive-affective, proprioceptive, and integrative brain regions. Clinical vestibular syndromes may perturb this network, resulting in deficits across a variety of functional domains. Here, we leverage structural and functional neuroimaging to characterize this extended network in healthy control participants and patients with post-concussive vestibular dysfunction (PCVD).

View Article and Find Full Text PDF

Purpose Of Review: This review will focus on the use of clinically accessible neuromodulatory approaches for functional restoration in persons with spinal cord injury (SCI).

Recent Findings: Functional restoration is a primary rehabilitation priority for individuals with SCI. High-tech neuromodulatory modalities have been used in laboratory settings to improve hand and walking function as well as to reduce spasticity and pain in persons with SCI.

View Article and Find Full Text PDF

Predicting Duration of Outpatient Physical Therapy Episodes for Individuals with Spinal Cord Injury Based on Locomotor Training Strategy.

Arch Phys Med Rehabil

April 2022

Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois; Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Objective: To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy.

Design: Observational study of participants at 4 SCI Model Systems centers with survival.

View Article and Find Full Text PDF

Adherence to home exercise programs (HEPs) during physical rehabilitation is usually unmonitored and is thought to be low from self-reports. This article describes exploratory implementation of a Sensor Enhanced Activity Management (SEAM) system that combines HEP management software with a movement sensor for monitoring and motivating HEP adherence. The article also presents results from attempting to gain reimbursement for home use of the system with therapist oversight using Remote Physiologic Monitoring (RPM) codes.

View Article and Find Full Text PDF

Objective: To evaluate effectiveness of a peer mentor intervention for caregivers of patients with acquired brain injury (ABI) in encouraging caregiver participation in support services to prepare them for the role of caregiving and in reducing caregiver stress and depression.

Design: Controlled trial with participants randomized to either usual care or 1-to-1 visits with a family caregiver peer mentor during the ABI inpatient rehabilitation stay.

Setting: Nonprofit rehabilitation hospital specializing in care of persons with brain and spinal cord injury.

View Article and Find Full Text PDF

Stroke commonly results in gait deficits which impacts functional ambulation and quality of life. Robotic exoskeletons (RE) for overground walking are devices that are programmable to provide high dose and movement-impairment specific assistance thus offering new rehabilitation possibilities for recovery progression in individuals post stroke. The purpose of this investigation is to present preliminary utilization data in individuals with acute and chronic stroke after walking overground with an RE.

View Article and Find Full Text PDF

Aims: Patient satisfaction is paramount to health-related quality of life (HR-QoL) outcomes. High quality, quantitative data from the US describing patients' actual experiences, difficulties, and HR-QoL while on an intermittent self-catheterization (ISC) regimen is very scarce. Our objective was to better understand patient practices with and attitudes towards ISC.

View Article and Find Full Text PDF

Transcutaneous spinal stimulation (TSS) and whole-body vibration (WBV) each have a robust ability to activate spinal afferents. Both forms of stimulation have been shown to influence spasticity in persons with spinal cord injury (SCI), and may be viable non-pharmacological approaches to spasticity management. In thirty-two individuals with motor-incomplete SCI, we used a randomized crossover design to compare single-session effects of TSS versus WBV on quadriceps spasticity, as measured by the pendulum test.

View Article and Find Full Text PDF
Article Synopsis
  • Many first-line health care providers (FHPs) lack knowledge about the role of speech-language pathologists (SLPs) in managing mild traumatic brain injury (mTBI), with over half rating their understanding as low.
  • A significant number of FHPs rarely or never refer patients with mTBI to SLPs, indicating a gap in collaborative care practices.
  • The study highlights the need for educational initiatives aimed at improving FHPs' understanding of SLPs' contributions to mTBI management to enhance patient care.
View Article and Find Full Text PDF

A continued weakness in the cognitive neurosciences is the lack of a model to explain the phenomenological experience of the "self." This article proposes a model that suggests that the right hemisphere association area integrates physical sensations and mental experiences into a unified experience (i.e.

View Article and Find Full Text PDF

Mild traumatic brain injury (mTBI) remains a diagnostic challenge and therefore strategies for objective assessment of neurological function are key to limiting long-term sequelae. Current assessment methods are not optimal in austere environments such as athletic fields; therefore, we developed an immersive tool, the Display Enhanced Testing for Cognitive Impairment and mTBI (DETECT) platform, for rapid objective neuropsychological (NP) testing. The objectives of this study were to assess the ability of DETECT to accurately identify neurocognitive deficits associated with concussion and evaluate the relationship between neurocognitive measures and subconcussive head impacts.

View Article and Find Full Text PDF

Increased use of epidural Spinal Cord Stimulation (eSCS) for the rehabilitation of spinal cord injury (SCI) has highlighted the need for a greater understanding of the properties of reflex circuits in the isolated spinal cord, particularly in response to repetitive stimulation. Here, we investigate the frequency-dependence of modulation of short- and long-latency EMG responses of lower limb muscles in patients with SCI at rest. Single stimuli could evoke short-latency responses as well as long-latency (likely polysynaptic) responses.

View Article and Find Full Text PDF

Background And Purpose: Damage to the insula results in cardiovascular complications. In rats, activation of N-methyl-d-aspartate receptors (NMDARs) in the intermediate region of the posterior insular cortex (iIC) results in sympathoexcitation, tachycardia and arterial pressure increases. Similarly, focal experimental hemorrhage at the iIC results in a marked sympathetic-mediated increase in baseline heart rate.

View Article and Find Full Text PDF

Implementing Patient-Reported Outcome Measures in Inpatient Rehabilitation: Challenges and Solutions.

Arch Phys Med Rehabil

May 2022

School of Epidemiology and Public Health, University of Ottawa, Ottowa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottowa, Ontario, Canada.

A project with the goal of implementing electronic health record (EHR)-based patient-reported outcome measures (PROMs) into a large inpatient spinal cord injury (SCI) rehabilitation program took twice as long as expected. This report details the lessons learned from the barriers, successes, and unexpected issues that arose during this prolonged, but now successful, project. The goals of this implementation project were to (1) identify barriers and supports to the use of PROMs; (2) develop an implementation strategy to incorporate the use of PROMs into inpatient rehabilitation; and (3) implement the strategy and evaluate its effects on team communication.

View Article and Find Full Text PDF

Objective: To identify the self-reported frequency of emergency department (ED) visits, ED-related hospitalizations, and reasons for ED visits among people with traumatic spinal cord injury (SCI) and compare them with general population data from the same geographic area.

Design: Cross-sectional.

Setting: A specialty hospital in the Southeastern United States.

View Article and Find Full Text PDF

Objective: To characterize the qualities that individuals with spinal cord injury (SCI) associate with their experience of spasticity and to describe the relationship between spasticity and perceived quality of life and the perceived value of spasticity management approaches.

Design: Online cross-sectional survey.

Setting: Multicenter collaboration among 6 Spinal Cord Injury Model Systems hospitals in the United States.

View Article and Find Full Text PDF

Growing evidence demonstrates that people with disabilities face more challenges in accessing healthcare and wellness resources, compared to non-disabled populations. As mobile applications focused on health and wellness (mHealth apps) become prevalent, it is important that people with disabilities can access and use mHealth apps. At present, there is no source of unified information about the accessibility and usability of mHealth apps for people with disabilities.

View Article and Find Full Text PDF