Intensity of usual care physical therapy during inpatient rehabilitation for people with neurologic diagnoses

PM&R ◽  
2021 ◽  
Author(s):  
Jake DiPasquale ◽  
Molly Trammell ◽  
Kelly Clark ◽  
Hayden Fowler ◽  
Librada Callender ◽  
...  
2018 ◽  
Vol 38 (3) ◽  
pp. 151-156
Author(s):  
Stephanie Rouch ◽  
Elizabeth R. Skidmore

Therapist approach and feedback during rehabilitation may influence patient outcomes. It is unclear how much guided cueing, the approach used in strategy training, is present in usual rehabilitation care. We compared the frequency of guided and directed cueing in strategy training sessions with cueing in usual care occupational and physical therapy. We videotaped strategy training, occupational therapy, and physical therapy sessions among 20 patients admitted to inpatient rehabilitation after stroke. Using a standardized coding scheme, we coded and analyzed frequencies of therapists’ cues (guided or directed). The proportion of guided cues was significantly higher in strategy training intervention (42%) compared with occupational therapy (4%) and physical therapy (3%). Preliminary research suggests that guided cueing may be more prevalent in strategy training than in usual care. Given that guided cueing provides more opportunity for patients to take an active role in their rehabilitation, guided cueing may lead to superior outcomes.


Author(s):  
María Jesús Muñoz-Fernández ◽  
Esther M. Medrano-Sánchez ◽  
Beatriz Ostos-Díaz ◽  
Rocío Martín-Valero ◽  
Carmen Suárez-Serrano ◽  
...  

Selective sentinel lymph node biopsy (SLNB) represents a minimally invasive surgery in patients with breast cancer. The purpose of this study was to explore the possible effect of an early physiotherapy intervention for the recovery of the upper limb and the surgical scars after SLNB in comparison with usual care. A total of 40 patients were enrolled in either the control group (n = 20) or the experimental group (n = 20). The intervention group performed an early physiotherapy program based on functional exercises, scar manual therapy, and educational tips. The control group received usual care. Shoulder range of motion (ROM), grip strength, upper limb pain and disability (SPADI), scar recovery (POSAS), myofascial adhesions (MAP-BC), quality of life (EORTCQLA-BR-23) and the presence of axillary web syndrome (AWS) and lymphoedema were assessed at baseline and immediately after intervention. A follow-up period of 6 months was performed for lymphoedema surveillance. Between groups significant differences in favor of the intervention were found for ROM (r = 0.43), grip strength (r = 0.32), SPADI (d = 0.45), POSAS (d = 1.28), MAP-BC (d = 1.82) and EORTCQLQ-BR 23 general function subscale (d = 0.37) (p < 0.05 for all variables). Our results suggest that an early physical therapy program seems to be more effective than usual care in women after SLNB. However, results should be interpreted with caution and future randomized trial with a larger sample size is needed.


Author(s):  
Howard S. Kim ◽  
Sabrina H. Kaplan ◽  
Danielle M. McCarthy ◽  
Daniel Pinto ◽  
Kyle J. Strickland ◽  
...  

2020 ◽  
Vol 16 (S1) ◽  
pp. 64-70
Author(s):  
Kelsey Rosen ◽  
Monika Patel ◽  
Cecelia Lawrence ◽  
Brianne Mooney

Abstract Background Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists’ contact with patients when possible. Telehealth has been viewed as “electronic personal protective equipment” during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients. Purpose Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program. Methods We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques. Results Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home. Conclusions Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.


2005 ◽  
Vol 85 (2) ◽  
pp. 159-168 ◽  
Author(s):  
David A Brown ◽  
Sabina Nagpal ◽  
Sam Chi

Abstract Background and Purpose. This case report describes implementation of a limb-loaded cycling (LLC) training program as a feasible exercise for people in early phases of locomotor training following stroke. Case Description. Two individuals with early-stage poststroke hemiplegia participated in the LLC program as an adjunct to physical therapy intervention. Performance of LLC involved cycling while supporting progressive amounts of applied load and weight shifting from one lower extremity to the other lower extremity. The LLC was conducted daily during 2 to 3 weeks of inpatient rehabilitation. Outcomes. The LLC progressed with increases in weight bearing and force generation, as evidenced by larger amounts of limb loading during pedaling. The patients tolerated all loads without cardiorespiratory distress. Discussion. Limb-loaded cycling can accommodate people with little force-generating capability or weight-bearing ability as they practice locomotor skills. Gains in locomotor ability may be aided by the addition of this exercise regimen to patients' daily physical therapy.


2012 ◽  
Vol 2012 ◽  
pp. 1-61 ◽  
Author(s):  
Andrea D. Furlan ◽  
Fatemeh Yazdi ◽  
Alexander Tsertsvadze ◽  
Anita Gross ◽  
Maurits Van Tulder ◽  
...  

Background. Back pain is a common problem and a major cause of disability and health care utilization.Purpose. To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain.Data Sources. Records without language restriction from various databases up to February 2010.Data Extraction. The efficacy outcomes of interest were pain intensity and disability.Data Synthesis. Reports of 147 randomized trials and 5 nonrandomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically nonsignificant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature.Conclusions. CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.


2017 ◽  
Vol 69 (7) ◽  
pp. 1050-1059 ◽  
Author(s):  
François Rannou ◽  
Isabelle Boutron ◽  
Luc Mouthon ◽  
Katherine Sanchez ◽  
Vincent Tiffreau ◽  
...  

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