Principles of neurological rehabilitation

2011 ◽  
Author(s):  
Michael Donaghy
Keyword(s):  
Controlled Trial ◽  
Well Being ◽  
Primary Diagnosis ◽  
World Health ◽  
International Classification Of Functioning ◽  
Neurological Rehabilitation ◽  
Rehabilitation Team ◽  
Wide Range ◽  
Neurological Patients ◽  
Reasonable Evidence

Neurology has an undeserved reputation for being a speciality where diagnosis requires great intellectual effort, although from which little therapeutic intervention flows. The reader will form their own opinion about the difficulty of making diagnoses, but now neurological rehabilitation can offer all patients great help subsequently. Other chapters discuss the roles of specific medical and surgical treatments in transforming neurological patients’ lives; this chapter discusses the role of neurological rehabilitation in focusing primarily on reducing limitations on patient activities rather than by detailing the specific nature of these individual interventions.Neurological rehabilitation can be defined as a process that aims to optimize a person’s participation in society and sense of well-being. This definition highlights several important features: rehabilitation is not a particular type of intervention; the focus is on the patient as a person; the goals relate to social functioning, as well as health or well-being; it is not a process restricted to patients who may recover, partially or completely, but applies to all patients left with long-term problems. The contrast to traditional neurology is in the broader scope, extending well away from the underlying pathology but always being fully informed by the paramount importance of the primary diagnosis.This chapter will start by giving a fuller description of rehabilitation in terms of structure, represented by the resources needed, process, consisting of what happens, and outcome, defined by the goals. Subsequently the general evidence supporting neurological rehabilitation as a process is reviewed. It is not practicable to review the wide range of high class randomized controlled trial evidence investigating different and detailed aspects of the process. Some specific diseases and specific clinical problems are considered in Section 6.4.Neurological rehabilitation has a sound theoretical and conceptual basis derived from the World Health Organisation’s International Classification of Functioning, the WHO ICF (Wade and Halligan 2004) and from a general problem-solving approach (Wade 2005). There is strong evidence supporting its effectiveness as a process, and reasonable evidence in support of some specific treatments. The approach of neurological rehabilitation extends the intellectual challenge of neurology; in most clinical situations the physician and the wider rehabilitation team have to make pragmatic decisions based on incomplete information concerning many important factors.

The Relationship Between Client-Centered Goal-Setting and Treatment Outcomes

2012 ◽  
Vol 22 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Jennifer L. Womack
Keyword(s):  
Treatment Outcomes ◽  
Goal Setting ◽  
Well Being ◽  
World Health ◽  
International Classification Of Functioning ◽  
Client Relationships ◽  
Centered Care ◽  
Communication Challenges ◽  
Treatment Priorities

Shifting definitions of health and well-being, prompted by the World Health Organization's International Classification of Functioning (2001), have stimulated changes in traditional clinician-client relationships in rehabilitation. Among these changes, in keeping with the concept of client-centered care, is a trend toward more collaborative goal-setting and joint determination of intervention plans. Evidence suggests that supporting clients' autonomy in prioritizing personally meaningful goals leads to increased engagement in intervention, less emotional anxiety about the rehabilitation process, and improved treatment outcomes. Supporting people with aphasia in a process of collaborative goal formulation may also serve to alter treatment priorities so that they address more relevant communication challenges embedded in post-rehabilitation life.

scholarly journals Effect of a Low-fodmap Diet for the Management of Functional Abdominal Pain Disorders in Children: A Study Protocol for a Randomized Controlled Trial

2020 ◽  
Author(s):  
Agata Stróżyk ◽  
Andrea Horvath ◽  
Jane Muir ◽  
Hania Szajewska
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Controlled Trial ◽  
Well Being ◽  
World Health ◽  
Reliable Change Index ◽  
Functional Abdominal Pain ◽  
Regular Diet ◽  
Randomized Controlled ◽  
Fodmap Diet

Abstract Background Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared with a regular diet for the management of children with FAPDs. Methods We will perform a randomized, quadruple-blinded, controlled trial. Seventy-four children aged 8 to 18 years with a FAPD (Irritable Bowel Syndrome or Functional Abdominal Pain-Not Otherwise Specified), diagnosed according to the Rome IV criteria, will be randomly allocated to receive either a low-FODMAP diet or a regular diet for 4 weeks. The primary outcome will be the percentage of the responders, defined as the participants who have at least 30% improvement in abdominal pain intensity on a Visual Analogue Scale (VAS) during the last week of the trial compared with baseline, that is at least equal to the Reliable Change Index (≥ 25 mm change on VAS). Other outcomes will include changes in stool consistency, abdominal pain frequency, total scores on the Gastrointestinal Symptom Rating Scale, KIDSCREEN-10 Index and World Health Organization Five Well-Being Index, child’s school attendance and parents’ work absenteeism, and BMI-for-age z-score. Compliance, tolerability of the low-FODMAP diet, and adverse events also will be evaluated. Each FAPD subtype will be assessed separately.DiscussionThere is a need for high-quality evidence regarding the dietary management of children with FAPDs. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness, if any, of a low-FODMAP diet for the management of FAPDs in the pediatric population. The findings of this RCT will assist with the development of guidelines and influence the direction of further research. Trial registration: NCT04528914

scholarly journals THE COVID-19 PANDEMIC AND THE MENTAL HEALTH OF STUDENTS

2021 ◽  
Author(s):  
Madona Kekelia ◽  
Eliso Kereselidze ◽  
Ina Shanava
Keyword(s):  
Well Being ◽  
World Health ◽  
Psychological Well Being ◽  
Difficult Situation ◽  
Policies And Measures ◽  
The Social ◽  
Wide Range ◽  
The World ◽  
Mental Wellness ◽  
Health Organization

The disease COVID-19, caused by the new coronavirus (SARS-CoV-2), was first detected in Wuhan, China in late December 2019, and, due to its high degree of virulence, it has spread rapidly around the world ever since. On March 11, 2020, the World Health Organization descried the situation as a pandemic, and in March 2020, a state of emergency was declared in Georgia. To limit the spread of the virus “lockdown” was ordered and, except in emergencies, the population was restricted from leaving home, the learning process in educational institutions was suspended, and all sorts of gatherings and public transport were put off. In these circumstances, as well as the risks associated with deteriorating health and economic problems, students also found themselves in a difficult situation in terms of getting access to education, caused by the transition to distance learning. The social category of students is characterized by an active lifestyle, a wide range of relationships and contacts. In consequence of the social distancing policies and measures implemented across the country to slow the spread of the virus, the reduction in contacts has given rise to feelings of loneliness and depression. The entire situation is likely to negatively affect the psychological well-being of students. It has been proven that high levels of stress among students are associated with low mental wellness, which in turn, may lead to poor academic performance and the emergence of social and psychological problems. Based on the abovestated, the aim of the present paper was to establish a link between the indicators of loneliness, depression and psychological well-being with students in the context of constraints caused by the COVID pandemic. Patient Health Questionnaire (PHQ-4), Loneliness Scale (UCLA) and Psychological Well-Being Scale (PWBS) were used for the purpose. Analysis of the results revealed that depression, anxiety and loneliness have a negative bearing on psychological well-being. The differences were analyzed in obedience to demographic characteristics.

Body Image and Functional Loss

2018 ◽  
Author(s):  
Melissa Henry ◽  
Ali Alias
Keyword(s):  
Body Image ◽  
Well Being ◽  
World Health ◽  
International Classification Of Functioning ◽  
Functional Loss ◽  
Psychological Mechanisms ◽  
Body Image Disturbances ◽  
The Individual ◽  
Biopsychosocial Assessment

Abstract: The implications of functional loss following cancer is an area of psychosocial oncology that is rarely ventured. This is especially true in the context of limb and sensory losses, which have important repercussions on the patient’s well-being, namely as the individual is required to reassess and redefine his or her identity in face of these adversities. This chapter explores the implications of these losses via the intersection of the World Health Organization’s International Classification of Functioning, Disability, and Health with key oncological attributes of body image disturbances that seek to render explicit psychological mechanisms underlying impairments, limitations, and restrictions. Emphasizing the use of a standard framework for the assessment of functioning is essential, especially in understudied areas. Through this perspective, further insight is provided for the methodological and biopsychosocial assessment of functioning and body, and implications for clinical inquiry and practice are proposed for the advancement of cancer survivor care.

scholarly journals Physical Therapy Exercises for Sleep Disorders in a Rehabilitation Setting for Neurological Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (9) ◽  
pp. 1176
Author(s):  
Marco Tramontano ◽  
Sara De De Angelis ◽  
Giovanni Galeoto ◽  
Maria Carmela Cucinotta ◽  
Danilo Lisi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Sleep Disorders ◽  
Neurological Disorders ◽  
Human Life ◽  
Meta Analysis ◽  
Well Being ◽  
Wide Range ◽  
Neurological Patients ◽  
Present Systematic Review

Background: Sleep occupies one-third of human life and is essential for health and for emotional, physical, and cognitive well-being. Poor or insufficient sleep is associated with a wide range of dysfunctions that involve different body systems, such as the endocrine, metabolic, and immune systems, thus compromising the higher cortical functions, cognitive performance, mood, and post-physical activity recovery. The present systematic review and meta-analysis aimed to explore the effectiveness of physical therapy exercises on sleep disorders in patients with neurological disorders. Our systematic review identified 10 articles that investigated the effects of physical therapy on sleep disorders in patients with neurological disorders, 6 of which were included in the meta-analysis. Results suggest that physical therapy exercises are a safe and useful strategy for managing sleep disorders in neurorehabilitation.

scholarly journals Physical Activity to Stay Fit

2020 ◽  
Author(s):  
Arkierupaia Shadap
Keyword(s):  
Physical Activity ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Well Being ◽  
World Health ◽  
Beneficial Effects ◽  
Bodily Movement ◽  
Wide Range ◽  
Healthy Body Weight ◽  
Health Organization

AbstractPhysical activity is any bodily movement produced by skeletal muscles that require energy expenditure. According to World Health Organization, regular physical activities such as walking, cycling, doing the household work, etc., make an individual feel good and it has significant benefits for health. One of the vital elements for healthy bones at every age is exercise. Exercise lowers the blood pressure, slightly decreases the levels of total- and low-density lipoprotein—the bad cholesterol, and increases the levels of high-density lipoprotein—the good cholesterol. Regular physical activity and exercise help in maintaining the healthy body weight, decreasing stress, apprehension, and preventing depression. Exercising can also possibly help in delaying the effects of Alzheimer’s disease and other forms of dementia. Strong evidence shows that physical activity has a wide range of beneficial effects for both physical and mental well-being.

scholarly journals Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

2020 ◽  
Vol 17 (18) ◽  
pp. 6652
Author(s):  
Liz Green ◽  
Kathryn Ashton ◽  
Nerys Edmonds ◽  
Sumina Azam
Keyword(s):  
Impact Assessment ◽  
Health Impact Assessment ◽  
Well Being ◽  
Health Impact ◽  
World Health ◽  
Flexible Tool ◽  
Support Unit ◽  
Wide Range ◽  
The Impact ◽  
Health And Well Being

Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise because of it. In 2018, the HIA support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. It followed a five-step process for HIA and utilised a wide range of evidence sources and health intelligence including both quantitative and qualitative evidence. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers. It does not concentrate on the findings of the HIA in detail, but focusses on what worked and any challenges encountered. It has been used to progress the practice of HIA in Wales and demonstrates the value of HIA as a method to inform and influence complex decisions.

scholarly journals Effect of a low-FODMAP diet for the management of functional abdominal pain disorders in children: a study protocol for a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Agata Stróżyk ◽  
Andrea Horvath ◽  
Jane Muir ◽  
Hania Szajewska
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Controlled Trial ◽  
Well Being ◽  
World Health ◽  
Reliable Change Index ◽  
Functional Abdominal Pain ◽  
Regular Diet ◽  
Randomized Controlled ◽  
Fodmap Diet

Abstract Background Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared with a regular diet for the management of children with FAPDs. Methods We will perform a randomized, quadruple-blinded, controlled trial. Seventy-four children aged 8 to 18 years with a FAPD (Irritable Bowel Syndrome or Functional Abdominal Pain-Not Otherwise Specified), diagnosed according to the Rome IV criteria, will be randomly allocated to receive either a low-FODMAP diet or a regular diet for 4 weeks. The primary outcome will be the percentage of the responders, defined as the participants who have at least 30% improvement in abdominal pain intensity on a Visual Analogue Scale (VAS) during the last week of the trial compared with baseline, that is at least equal to the Reliable Change Index (≥ 25 mm change on VAS). Other outcomes will include changes in stool consistency, abdominal pain frequency, total scores on the Gastrointestinal Symptom Rating Scale, KIDSCREEN-10 Index and World Health Organization Five Well-Being Index, child’s school attendance and parents’ work absenteeism, and BMI-for-age z-score. Compliance, tolerability of the low-FODMAP diet, and adverse events also will be evaluated. Each FAPD subtype will be assessed separately. Discussion There is a need for high-quality evidence regarding the dietary management of children with FAPDs. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness, if any, of a low-FODMAP diet for the management of FAPDs in the pediatric population. The findings of this RCT will assist with the development of guidelines and influence the direction of further research. Trial registration NCT04528914 Data and protocol version identifier: 24/08/2020

Scoping review of outcome measures used in telerehabilitation and virtual reality for post-stroke rehabilitation

2016 ◽  
Vol 23 (6) ◽  
pp. 567-587 ◽  
Author(s):  
Mirella Veras ◽  
Dahlia Kairy ◽  
Marco Rogante ◽  
Claudia Giacomozzi ◽  
Silvia Saraiva
Keyword(s):  
Virtual Reality ◽  
Outcome Measures ◽  
Scoping Review ◽  
Stroke Rehabilitation ◽  
Data Extraction ◽  
Controlled Trial ◽  
International Classification Of Functioning ◽  
Cochrane Central Register ◽  
Wide Range ◽  
Evidence Database

Introduction Despite the increased interest in telerehabilitation (TR), virtual reality (VR) and outcome measures for stroke rehabilitation, surprisingly little research has been done to map and identify the most common outcome measures used in TR. For this review, we conducted a systematic search of the literature that reports outcome measures used in TR or VR for stroke rehabilitation. Our specific objectives included: 1) to identify the outcome measures used in TR and VR studies; and 2) to describe which parts of the International Classification of Functioning are measured in the studies. Methods We conducted a comprehensive search of relevant electronic databases (e.g. PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, PSYCOINFO, The Cochrane Central Register of Controlled Trial and the Physiotherapy Evidence Database). The scoping review included all study designs. Two reviewers conducted pilot testing of the data extraction forms and independently screened all the studies and extracted the data. Disagreements about inclusion or exclusion were resolved by consensus or by consulting a third reviewer. Results In total, 28 studies were included in this scoping review. The results were synthesized and reported considering the implications of the findings within the clinical practice and policy context. Discussion This scoping review identified a wide range of outcome measures used in VR and TR studies and helped identify gaps in current use of outcome measures in the literature. The review also informs researchers and end users (i.e. clinicians, policymakers and researchers) regarding the most appropriate outcome measures for TR or VR.

scholarly journals Acceptability and outcomes of transdiagnostic guided self-help bibliotherapy for internalizing disorder symptoms in adults: Results of a fully remote nationwide open trial

2021 ◽  
Author(s):  
Lorenzo Lorenzo-Luaces ◽  
Jacqueline Howard ◽  
Robinson De Jesús-Romero ◽  
Allison Peipert ◽  
John Buss ◽  
...  
Keyword(s):  
Internalizing Symptoms ◽  
Controlled Trial ◽  
Well Being ◽  
The United States ◽  
Retention Rates ◽  
World Health ◽  
Self Help ◽  
Cluster Randomized ◽  
Health Organization ◽  
Internalizing Disorder

Doing What Matters in Times of Stress (DWM) is a transdiagnostic five-module guided self-help (GSH) intervention developed by the World Health Organization. %The original DWM included group guidance in-person. %It appeared efficacious in pilot trials and a cluster randomized-controlled trial. In a sample of individuals recruited from across the United States, we studied the feasibility and acceptability of an adaptation of DWM in which guidance was provided individually and remotely. We assessed internalizing symptoms, psychological well-being, work and social functioning, usability of the intervention, and emotion regulation over the course of six weeks. A total of 344 individuals started our baseline screening, and 215 completed it. Of those screened, 74% (n=159) qualified for the intervention. We reached most participants who qualified (67%, n=107) via phone to schedule a GSH session. Most of those scheduled attended a study session (84%, n=90), and most of those who attended a session completed more than half the treatment (83%, n = 75). Retention rates were comparable to meta-analytic estimates of dropout rates in GSH-CBT. Participants showed improvement on the K6, WHO5, WSAS, and ERQ subscales. Baseline acceptability on the SUS was high but did not improve over time. DWM is a freely available, seemingly efficacious transdiagnostic intervention for internalizing disorder symptoms.

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