A therapy-led, multidisciplinary programme for treatment-resistant functional fixed dystonia

2020 ◽  
Vol 13 (7) ◽  
pp. e235213
Author(s):  
Yvonne Hsieh ◽  
Shaunak Deshpande
Keyword(s):  
Poor Prognosis ◽  
Biopsychosocial Model ◽  
Outcome Measurement ◽  
Full Range ◽  
Motor Symptoms ◽  
Treatment Resistant ◽  
Range Of Movement ◽  
Routine Outcome Measurement ◽  
Functional Neurological Disorder ◽  
Fixed Dystonia

Functional neurological disorder (FND) describes various neurological symptoms that are not explained by an organic aetiology. The condition has a poor prognosis. Despite this, there is sparse research that informs clinical interventions for FND, particularly when treating functional fixed dystonia. Our article has outlined an intervention for a patient with a treatment-resistant functional fixed dystonia that was informed by a biopsychosocial model, which aimed to rehabilitate the patient’s functional motor symptoms. This led to favourable outcomes including restoring full range of movement in the patient’s right foot and improvements in routine outcome measurement scores. The patient also described the programme as life-changing and was able to re-engage in meaningful and purposeful activities.

scholarly journals Service user and clinician perspectives on the use of outcome measures in psychological therapy

2015 ◽  
Vol 8 ◽  
Author(s):  
Graham R. Thew ◽  
Louise Fountain ◽  
Paul M. Salkovskis
Keyword(s):  
Clinical Practice ◽  
Service User ◽  
Outcome Measurement ◽  
Psychological Therapy ◽  
Service Development ◽  
Service Users ◽  
Routine Outcome Measurement ◽  
Episode Of Care ◽  
Wide Range ◽  
Clinician Perspectives

AbstractWhile the benefits of routine outcome measurement have been extolled and to some degree researched, it is surprising that service user opinions on this common therapy practice have largely not been investigated. This study aimed to assess service users’ experiences of completing measures during psychological therapy, with a view to exploring how therapists can maximize how helpful measures are in therapy. Fifteen participants completed surveys about the use of measures in their current episode of care. Ten clinicians also completed a survey about their use of, and views about, measures. Results showed that despite mixed experiences in how measures were explained and used, service users showed generally favourable attitudes towards their use in therapy, with them being perceived as most helpful when well integrated into sessions by their therapists. Clinicians reported using a wide range of measures, and generally endorsed positive beliefs about measures more strongly than negative ones. Implications for clinical practice, service development, and further research are discussed.

Routine Outcome Measurement binnen PsyQ: normering van de 4 K’s

2009 ◽  
Vol 29 (4) ◽  
pp. 243-253 ◽  
Author(s):  
I P A M Huijbrechts ◽  
M Appelo ◽  
C W Korrelboom ◽  
Colin van der Heiden ◽  
E H Bos
Keyword(s):  
Outcome Measurement ◽  
Routine Outcome Measurement

Shoulder examination: a systematic approach

2021 ◽  
pp. 1-15
Author(s):  
Akib M Khan ◽  
Angelos Assiotis ◽  
Mazin S Ibrahim ◽  
Andrew R Sankey
Keyword(s):  
Rotator Cuff ◽  
Systematic Approach ◽  
Healthcare Professionals ◽  
Full Range ◽  
Range Of Movement ◽  
Systematic Examination ◽  
Complex Joint ◽  
Different Levels ◽  
Shoulder Examination

The shoulder is a complex joint with static and dynamic stabilising structures working synchronously. These allow a full range of movement while preserving stability of the joint. Patients may present with pain, stiffness, weakness, deformity or instability. The authors suggest a systematic examination sequence to ensure that important pathology is not overlooked. Adopting this approach allows common pathologies, including tears of the rotator cuff, impingement and tendinopathy, to be easily identified. This shoulder examination sequence may be used by all healthcare professionals and can also act as a revision aid for those undergoing exams in this field, at different levels of training.

scholarly journals Dynamics of the IFT machinery at the ciliary tip

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Alexander Chien ◽  
Sheng Min Shih ◽  
Raqual Bower ◽  
Douglas Tritschler ◽  
Mary E Porter ◽  
...  
Keyword(s):  
Basal Body ◽  
Full Range ◽  
Intraflagellar Transport ◽  
Feedback Mechanism ◽  
Conventional Imaging ◽  
Range Of Movement ◽  
Anterograde Transport ◽  
Traffic Jam ◽  
Negative Feedback Mechanism ◽  
Cilia And Flagella

Intraflagellar transport (IFT) is essential for the elongation and maintenance of eukaryotic cilia and flagella. Due to the traffic jam of multiple trains at the ciliary tip, how IFT trains are remodeled in these turnaround zones cannot be determined by conventional imaging. Using PhotoGate, we visualized the full range of movement of single IFT trains and motors in Chlamydomonas flagella. Anterograde trains split apart and IFT complexes mix with each other at the tip to assemble retrograde trains. Dynein-1b is carried to the tip by kinesin-II as inactive cargo on anterograde trains. Unlike dynein-1b, kinesin-II detaches from IFT trains at the tip and diffuses in flagella. As the flagellum grows longer, diffusion delays return of kinesin-II to the basal body, depleting kinesin-II available for anterograde transport. Our results suggest that dissociation of kinesin-II from IFT trains serves as a negative feedback mechanism that facilitates flagellar length control in Chlamydomonas.

Trends and New Advances on Wearable and Mobile Technologies for Parkinson's Disease Monitoring and Assessment of Motor Symptoms

2018 ◽  
pp. 1388-1412
Author(s):  
Jorge Cancela ◽  
Matteo Pastorino ◽  
Maria Teresa Arredondo Waldmeyer
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Full Range ◽  
Mobile Technologies ◽  
Daily Activities ◽  
Disease Monitoring ◽  
Motor Symptoms ◽  
Different Dimensions

The aim of this work is to analyze the trends and new advances carried out in the last decades in the field of Parkinson's disease monitoring and management and more specifically regarding wearable and mobile technologies. The challenges of such technologies is to monitor, to assess and to manage the full range of PD symptoms through monitoring and testing routines while not hampering the patient's daily activities, identifying the correlation between the different dimensions affecting the severity of symptoms and the evolution of the disease and enabling the clinician to manage more efficiently the patient by providing timely indications on the effectiveness of the therapy and suggestions on therapy changes.

Review of Outcome Domains in European Mental Healthcare

2016 ◽  
Vol 33 (S1) ◽  
pp. S480-S480
Author(s):  
I. Großimlinghaus
Keyword(s):  
Outcome Measures ◽  
Outcome Measurement ◽  
Full Range ◽  
Mental Healthcare ◽  
Well Being ◽  
Health Service Provision ◽  
Process Indicators ◽  
Competing Interest ◽  
Development Evaluation ◽  
Mental Health Service Provision

IntroductionQuality in mental healthcare is a complex, multifaceted construct. It can be categorized into structures, processes and outcomes. In the past decade, there have been many initiatives on the assurance and improvement of process quality through the development, evaluation and implementation of process indicators for several important process domains including, for example, continuity and coordination of care. Moreover, outcome measurement, focusing on the extend to which intended outcomes of mental health service provision are achieved, is receiving growing interest and should be pursued through a systematic approach.ObjectivesSystematic compilation of outcome domains in mental healthcare.AimsIdentification of the full range of outcome domains in mental healthcare.MethodsSystematic literature review on outcome domains in mental healthcare.ResultsA whole range of outcome domains can be identified and categorized onto a continuum ranging from ‘traditional’, objective outcome domains, such as mortality and symptomatology, to more subjective outcome domains, such as quality of life and well-being. Moreover, outcome measures in different outcome domains can be assessed taking different perspectives into account, including either the provider or the patient.ConclusionsIn order to develop and implement systematic outcome measurement in mental healthcare, a first step is the identification and systematization of outcome domains in mental healthcare. This will provide a basis for identifying important outcome domains from the perspectives of both, patients and professionals. In a next step, appropriate and important outcome measures can be identified.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Controversies In The Surgical Management Of Shoulder Instability: Associated Soft Tissue Procedures

2017 ◽  
Vol 11 (1) ◽  
pp. 989-1000 ◽  
Author(s):  
Santos Moros Marco ◽  
José Luis Ávila Lafuente ◽  
Miguel Angel Ruiz Ibán ◽  
Jorge Diaz Heredia
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Shoulder Instability ◽  
Full Range ◽  
Rotator Interval ◽  
Range Of Movement ◽  
Slap Repair ◽  
Rotator Cuff Injuries ◽  
Complex Anatomy ◽  
Pubmed Database

Background:The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology.Methods:A review of articles related to shoulder anatomy and soft tissue procedures that are performed during shoulder instability arthroscopic management was conducted by querying the Pubmed database and conclusions and controversies regarding this injury were exposed.Results:Due to the complex anatomy of the shoulder and the large range of movement of this joint, a wide variety of anatomic injuries and conditions can lead to shoulder instability, specially present in young population. Recognizing and treating all of them including Bankart repair, capsule-labral plicatures, SLAP repair, circumferential approach to pan-labral lesions, rotator interval closure, rotator cuff injuries and HAGL lesion repair is crucial to achieve the goal of a stable, full range of movement and not painful joint.Conclusion:Physicians must be familiarized with all the lesions involved in shoulder instability, and should be able to recognize and subsequently treat them to achieve the goal of a stable non-painful shoulder. Unrecognized or not treated lesions may result in recurrence of instability episodes and pain while overuse of some of the techniques previously described can lead to stiffness, thus the importance of an accurate diagnosis and treatment when facing a shoulder instability.

Brief scale for measuring the outcomes of emotional and behavioural disorders in children

1999 ◽  
Vol 174 (5) ◽  
pp. 413-416 ◽  
Author(s):  
Simon G. Gowers ◽  
Richard C. Harrington ◽  
Anna Whitton ◽  
Paul Lelliott ◽  
Anne Beevor ◽  
...  
Keyword(s):  
Outcome Measurement ◽  
Reliability And Validity ◽  
Child And Adolescent ◽  
Field Trials ◽  
Outcome Data ◽  
Written Feedback ◽  
Behavioural Disorders ◽  
Routine Outcome Measurement ◽  
Measure Change ◽  
Independent Rating

BackgroundFollowing the development of a child and adolescent version of the Health of the Nation Outcome Scales (HoNOSCA), field trials were conducted to assess their feasibility and acceptability in routine outcome measurement.AimsTo evaluate the reliability, validity and acceptability of HoNOSCA in routine outcome measurement.MethodFollowing training, 36 field sites provided ratings on 1276 cases at one time point and outcome data on 906. Acceptability was assessed by way of written feedback and at a debriefing meeting.ResultsHoNOSCA demonstrated satisfactory reliability and validity characteristics. It was sensitive to change and its ability to measure change accorded with the clinicians' independent rating. HoNOSCA was reasonably acceptable to clinicians' from a range of disciplines and services.ConclusionsProvided that training needs can be met, HoNOSCA represents a satisfactory brief outcome measure which could be used routinely in child and adolescent mental health services.

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