How to support professionals to better understand the effective components of inpatient and outpatient physical rehabilitation programmes after acquired brain injury. In addition how out-patient group rehabilitation programmes and physical and occupational therapy gives brain injury patients the tools they need to change their everyday lives and integrate new routines and habits that contribute to improvements in their everyday lives. These points are discussed by Lexell EM et al. from Department of Rehabilitation Medicine, Skåne University Hospital , Lund , Sweden in Brain Injury, 05/07/2013.
Posts Tagged ‘Brain Injury’
1 May
Resting-State fMRI pinpoints changes in brain organization after TBI
Evidence from functional MRI findings show the traumatic effect on brain network function of traumatic brain injury (tbi). Writing in Neurology, 04/26/2013 Zhou Y et al. from New York University Langone Medical Center, New York.USA report that RS-fMRI shows a variety of changes in subjects after mild TBI that may be responsible for both physical deficits and behavioral symptoms following traumatic brain injury.
1 May
Patient functioning after traumatic brain injury
Laxe S et al. disucuss International Classification on Functioning in Brain Injury, 05/01/2013.
The group from Brain Injury Unit, Institut Guttmann-Universitat Autónoma de Barcelona Spain report on the use of 23 Brief Core Sets within the International Classification on Functioning, Disability and Health (ICF) as a basic international standard for the multidisciplinary assessment of a TBI patient’s functioning.
4 Apr
Predicting outcome after traumatic brain injury (TBI)
Working at the Keck Medical Center of University of Southern California and the Keck Hospital, Dr. Singh et al write up in Brain Injury, 04/04/2013 their findings on the predictive power of the Simplified Motor Score (SMS) and Glasgow Coma Scale (GCS) in predicting outcomes in patients with traumatic brain injury (TBI).
20 Mar
Average length of inpatient stay following tbi
According to Dr. Kim of Department of Occupational Therapy, College of Rehabilitation Sciences, Daegu University , Republic of Korea, the average length of inpatient stay for traumatic brain injury (tbi) in Korea is 51 days.
This data was quoted in research in Brain Injury, 03/20/2013 where her group discussed reasons for patient discharge against medical advice from brain injury inpatient rehabilitation.
14 Mar
Warrior Transition Unit – WTU and tbi
The Warrior Transition Unit – WTU have physicans and physical and occupational therapists that specialize in individualized rehabilitation that ensure that soldiers with – traumatic brain injury – tbi regain the best possible functional ability post injury. Examples are that some patients may need vestibule rehab for balance, others speech, or occupational therapy, however all treatment is planned to daily living activities and quality of life. The military began implementing the Automated Nueropsychological Assessment Metric or ANAM, in 2008. This is a computer-based cognitive assessment tool that aids early brain injury identification.
13 Mar
Improving participation in adult TBI
Writing in Archives of Physical Medicine and Rehabilitation Dr. Brasure M et al from Minnesota Evidence-based Practice Center, University of Minnesota USA and the Center for Chronic Disease Outcomes Research as well as the Minneapolis VA Health Care System discuss participation after Multidisciplinary Rehabilitation for Moderate to Severe Traumatic Brain Injury in Adults. A systemic review of the literature that used participation–related outcomes in adults with movement impairments due to moderate to severe traumatic brain injury – TBI did not show differences in the comparative effectiveness in multidisciplinary rehabilitation programs for impairments.
11 Feb
Plasticity targets for physical and occupational therapy after brain injury
Dr. Kirton from the Calgary Pediatric Stroke Program at Alberta Children’s Hospita, Department of Pediatrics and neurology looks at a model of plastic motor development after perinatal stroke that causes motor disability and hemiparetic cerebral palsy. The research aims at finding therapeutic targets that can be used to direct evidence based physical and occupational therapy rehabilitation techniques and improve rehabilitation outcomes after brain injury.
17 Jan
How to synchronize electrical stimulation with active movement to improve upper extremity function
electrical stimulation and stroke
Writing in the January edition of Brain Injury Dr. Inobe and his group from Rehabilitation Centre, Inobe Hospital , Nakao, Oita , Japan look at the effectiveness of finger-equipped electrode (FEE)-triggered electrical stimulation to improve upper extremity function in chronic stroke patients with severe hemiplegia.
It is well accepted that electric stimulation (ES) is an effective tool used by physical and occupational therapists to improve motor function in patients with severe UE function after stroke. It is also recognised that it is important for ES to be synchronized with voluntary movement or active movement ability.
One possibility is to allow the patients to trigger the ES. In this study, the trigger is on the patients finger so the technology is referred to as finger-equipped electrode or FEE triggered electrical stimulation.
This pilot study showed 4 patients and 3 controls. Each group underwent physical and occupational therapy treatment five times a week for 4 weeks. Both groups were assessed with the Fugl–Meyer Assessment (FMA) and Brunnstrom recovery staging.
The group that received the FEE triggered stimulation in addition to the traditional therapy showed a significant improvement in UE function.
20 Dec
Five Ways to Relieve Arthritis Pain
Doctors say that physical activity is the best medicine there is for arthritis pain relief, .
Patience White, M.D., chief public health officer of the Arthritis Foundation and professor of medicine and pediatrics at the George Washington University School of Medicine states that exercise can decrease pain, especially for people with osteoarthritis which is the most common type of arthritis.
In the Cochrane Database of Systematic Reviews it was reported that exercise, such as walking, was as effective as drugs like Aleve or Advil in reducing knee pain.
By working out regularly it may prevent sore joints and stop arthritis from getting worse.
Kevin Fontaine, Ph.D., assistant professor of medicine at the Center for Mind-Body Research at Johns Hopkins University School of Medicine in Baltimore states that physically active people have a higher quality of life and are less likely to become disabled or have days with lots of pain.
Workouts also keep off the pounds. Obesity can increase the risk of arthritis and/or make its symptoms worse.
Just 20 minutes three times a week or two 10 minute intervals is enough to make a difference according to Arthritis Today, the journal of the Atlanta-based Arthritis Foundation.
There are also new medications that can help relieve arthritis pain and swelling allowing patients to work out according to Halsted Holman, M.D., professor emeritus of medicine and former director of the Stanford Multi-Purpose Arthritis Center at Stanford University’s School of Medicine.
Generally it is necessary to begin exercising only with a physician’s agreement.
A workout should be a challenging experience, but not painful enough to cause injury, Dr. Holman says.
If you have sore joints or muscle pain that continues for even two hours after exercising or if the pain is worse the next day then the exercises were overdone. In that case the workout should be shortened or done more gently.
Here are 5 arthritis exercises that are sure to ease arthritis symptoms:
1. Walking
Walking is known to strengthen muscles, which in turn helps shift pressure away from the joints, and reduces pain.
It also brings nourishing oxygen to the joints by compressing and releasing cartilage in the knees.
The Arthritis Foundation recommends walking 10 minutes at least 3-5 days a week to start.
As you progress, take longer walks and include short bursts of speed getting to a moderate pace until you are able to walk 3-4 miles an hour.
People with serious hip or knee problems should first check with their doctor before beginning a walking program.
2. Water Exercise
How it helps: The University of Washington Department of Orthopedics and Sports Medicine recommends warm water – between 83˚ F and 90˚ F – to help relax muscles and decrease pain.
Swimming and aerobics exercises in water are good for stiff, sore joints.
Water also supports the body as one moves. This reduces stress on the knees, hips and spine, and offers resistance without any weights.
Water exercises are ideal for people who need to relieve severe arthritis pain in knees and hips.
Arthritis Today quotes “Water provides 12 times the resistance of air, so one is really strengthening and building muscle”.
When immersed in the water don’t pedal faster than 50-60 revolutions a minute. Add resistance after a warm up period of five minutes and don’t add more pedaling than you can handle.
Matthew Goodemote, head physical therapist at Community Physical Therapy & Wellness in Gloversville, N.Y. says that indoor cycling is one of the best ways to get a cardiovascular workout without stressing weight-bearing joints.
Since there’s no need to lean the bike to turn a stationary bike is a good option for people with balance issues – a common problem among some arthritis patients.
When starting this arthritis exercise be sure that the seat height is at a position which allows the knee to be completely straight when the pedal is at the lowest point, according to the University of Washington Department of Orthopedics and Sports Medicine.
One should not pedal faster than 50-60 revolutions per minute. A warm up period of five minutes should be allowed at first. Then patients should start 5 minute sessions 3 times a day. Then increase gradually to 7 and up to 20 minutes a day providing there is no pain.
People with very painful knees should avoid indoor cycling, because it can aggravate the condition.
4. Yoga
Steffany Haaz, MFA, a certified movement analyst, registered yoga teacher and research coordinator at Johns Hopkins Arthritis Center says that beginner yoga classes that have simple, gentle movements gradually build balance, strength and flexibility which are elements that can be beneficial for people with arthritis.
Yoga reduces inflammation, increases energy and, in general, allows for a more positive mental outlook, according to Psychosomatic Medicine, an Ohio State University study published in their journal.
To start, take a class at a gym, community center or yoga studio. You can find a certified teacher through the Yoga Alliance, the accrediting body for yoga instructors worldwide. It is important to tell the instructor before class about your arthritis so that they can modify poses to accommodate your limited mobility.
For those that prefer doing Yoga at home, there is a company called Gaiam that produces yoga videos and recently collaborated with the Mayo Clinic to produce a DVD entitled “The Arthritis Wellness Solution” . It contains tips from specialists and a segment showing specific yoga for arthritis sufferers and includes meditation exercises which are designed to enhance circulation and relieve tension which helps relieve arthritis pain.
Yoga should never hurt. If it does that means it’s overdone.
Straps, blankets and chairs can be used to accommodate people with limited range of motion, strength or balance.
5. Tai Chi
This traditional style of Chinese martial arts goes back centuries and features slow, rhythmic movements to induce mental relaxation and enhance balance, flexibility and strength.
Tai chi is very valuable to arthritis patients because its movements are very slow and controlled. They put little force on the joints.
Some studies have shown that Tai Chi can improve life satisfaction, mental well-being and perceptions of health, which oppose negative effects of pain associated with arthritis.
The November 2009 issue of Arthritis Care & Research, a journal of the American College of Rheumatology has an article that describes Tai Chi as being beneficial for knee pain. Another research study by a Tufts University group found that Tai Chi was especially helpful for patients that were over 65 and had knee osteoarthritis.
According to another university’s Orthopedics and Sports Medicine department, Tai chi should preferably be done in the morning, when there is least pain and stiffness, when you’re not tired and when the arthritis medication is most effective.
Taking a warm shower is always a good idea before exercise if joints are stiff.
One of the most effective exercise programs for arthritis sufferers is by using the TUTOR system of physical therapy products. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR were originally designed to help patients that suffered a stroke, brain injury, Parkinson’s or other upper and lower limb disabilities. However much relief has been gained for arthritis patients as well who would like a challenging and entertaining system of exercising arthritic joints. The TUTORs are ergonomically designed gloves and braces that contain sensors connected to sophisticated exercise games. The physical and occupational therapists monitor and record the progress made and design a customized exercise program for that patient.
Currently in use in leading U.S. and European hospitals and clinics the TUTORs are fully certified by the FDA and CE. They are also available in the home through the use of telerehabilitation and can be used by adults and children from the age of 5 and up.
See WWW.MEDITOUCH.CO.IL for further information.
