Balance and mobility problems in patients with Mild Traumatic Brain Injury MTBI

Reliability, validity, and responsiveness of the High–Level Mobility Assessment Tool (HiMAT) in Mild Traumatic Brain Injury MTBI was looked at in Physical Therapy, 05/08/2013. The research was conducted by

Kleffelgaard I et al from the Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Norway together with the Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Norway. The group concluded that the above measure is a reliable outcome measure for balance and mobility in Mild Traumatic Brain Injury MTBI.

 

Post-stroke spasticity Management

An estimated 16 million people worldwide experience first-time strokes each yea. Of these two-thirds of stroke patients are younger than 70 years of age. Stroke is therefore a leading cause of disability in adults with functional movement disability being caused by spasticity, cognitive impairment, paresis, and depression. Disabling spasticity is defined as spasticity that is severe enough to require intervention. This post-stroke spasticity  occurs in 4% of stroke survivors within 1 year of first-time stroke. Post-stroke spasticity – PSS management and rehabilitation  is discussed in Acta Neurologica Scandinavica, 05/07/2013  by Sunnerhagen KS et al. from the Institute of Neuroscience and Physiology – Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden.

Rehabilitation of traumatic and non-traumatic spinal cord injuries (SCI)

Kennedy P et al. working at the National Spinal Injuries Centre, Stoke Mandeville Hospital, UK discuss whether patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries benefitted from the same rehabilitation programme. The research published in Spinal Cord, 05/07/2013 found that the two groups has the same rehabilitation outcome. The Needs Assessment Checklist (NAC) was used as the outcome measure. The group concluded that it is effective to admit and rehabilitate patients with injuries resulting from both traumatic and non-traumatic aetiologies in the same specialised in patient and out patient rehabilitation setting.

 

Unraveling the `black box of physical rehabilitation’

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.

The impact of rehabilitative services in the lives of adults and children with disabilities

What is the impact of rehabilitative services in the lives of adults and children with disabilities and is their a relationship between amount of treatment and functional gains. This question was asked by Dr. Patel from St. Bartholomew’s Hospital , London , UK in Disability & Rehabilitation, 05/06/2013. Occupational therapy and physical therapy were the primary rehabilitation services received by patients across impairment groups. The authors failed to find enough evidence in the literature to answer these questions and concluded that better systematic reporting of type and quantity of rehabilitation therapies along with functional assessments is needed.

Home therapy to improve arm and hand function after brain injury in New Zealand

Over 30,000 New Zealanders have a traumatic brain injury (TBI) each year. Added to this only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital.

Because of this the Health Research council of New Zealand have awarded two grants to physical therapists from  The University of Auckland who will use technologies to treat and support brain injury patietns including stroke after discharge from in patient therapy. Firstly, Dr Kersten and her team will train people in the community who have had a TBI in the past to act as mentors or peer mentors for people with a recent moderate to severe TBI. Participation is considered a fundamental outcome of rehabilitation for people with TBI,” Dr Kersten says.

A second project lead by Dr Stinear will evaluate a new home-coach model of therapy for stroke survivors. In New Zealand, only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital. This is despite research that shows rehabilitation therapy is capable of improving hand and arm function months or years after stroke. Dr James Stinear from The University of Auckland says “There are tens of thousands of people living with stroke in our community who have an untapped capacity to recover,” explains Dr Stinear and the objective of this study is to test and design a ‘home-therapy’ protocol.”

After a physiotherapist has assessed the therapy needs of a person with stroke a family member, carer, friend or other volunteer will act as a ‘home-coach’ to deliver daily therapy in the home.

New Evidence for Therapies in Stroke Rehabilitation

A report in Current Atherosclerosis Reports, 05/03/2013 looks at the evidence based in medicine for physical therapy interventions to promote Neurologic rehabilitation post stroke.

The report by Dobkin BH et al. from Department of Neurology, Geffen School of Medicine, University of California Los Angeles, CA, USA shows that persons with serious stroke do return to participation in usual self-care and daily activities as independently as is feasible. The physical and occupational therapy detailed includes progressive task-related practice of skills, exercise for strengthening and fitness, neurostimulation, and drug and biological manipulations. The group also discuss how intensive practice can induce adaptations at multiple levels of the nervous system which lead to neuroplasticity and functional improvement.  The group discuss recent clinical trials to manage walking, reach and grasp, aphasia, visual field loss, and hemi-inattention.

Upper limb arm and hand home-based exercise training for people after stroke in the UK

New research in the UK will be conducted on administering Physiotherapy at home after stroke. Neuro physical therapists from Bristol, Birmingham and Newcastle will recruit patients with upper-limb motor impairment including shoulder  and hand movement deficits after discharge from hospital post-stroke. The stroke patients will be up to 12 months post stroke. The primary outcome measures for assessment of arm function will be the Action Research Arm Test (ARAT) and Wolf Motor Function Test (WMFT). The secondary measures will be the Motor Activity Log, Stroke Impact Scale, Carer Strain Index, and health and social care resource use.

Cost of Total Hip and total Knee Replacement

Costs of Hip and Knee replacement – THA/ TKA

According to the IFHP – International Federation of Health Plans, the U.S. average for all hospital and physician costs including in patient and out patient Physical therapy was $40,364 for hip replacement and $25,637 for knee replacement. The next most expensive country was Australia with a cost of $27,810 for hip replacement and $22,421 for knee replacement.

 

Choreoathetosis and dyskinetic pediatric Cerebral Palsy (CP)

What scales exist to distinguishing between choreoathetosis and dyskinetic movement impairments in pediatric Cerebral Palsy (CP)? Choreoathetos is characterized by irregular involuntary movements that may involve the fa e, neck, trunk, extremities, or respiratory muscles, giving an appearance of restlessness. Onbaliu E et al from Department of Rehabilitation Sciences, Belgium discuss the use of the Dyskinesia Impairment Scale (DIS) by Physical therapists (PT) in the European Paediatric Neurology Society Journal 04/25/2013.