scholarly journals Results of the Belgian Sentinel Network of general practitioners on the involvement of therapists in stroke rehabilitation

2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Silke Francois ◽  
Viviane Van Casteren ◽  
Katrien Vanthomme ◽  
Liesbeth Borgermans ◽  
Dirk Devroey
Keyword(s):  
Nursing Home ◽  
Stroke Rehabilitation ◽  
Occupational Therapists ◽  
Critical Event ◽  
Rehabilitation Services ◽  
Speech And Language ◽  
Language Therapy ◽  
Stroke Patients ◽  
Sentinel Network ◽  
Sentinel Practices

This study examines which therapists are involved in the rehabilitation of stroke survivors in Belgium at different points in time. A nationwide registration of stroke patients was provided by 199 and 189 family physicians working in sentinel practices for the years 2009 and 2010 respectively. 326 patients who were diagnosed with stroke were included. Patients with paralysis/paresis received significant more physiotherapy after one month (63%) compared to non-paralysed patients (38%) (P=0.005). Residing in a nursing home was associated with higher proportions of patients receiving physiotherapy, both after one (P=0.003) and six (P=0.002) months. 31% of patients with aphasia were treated by a speech and language therapist after one month, which decreased after six months to 20%. After six months, the patients in a nursing home received significant more often speech and language therapy (P=0.004), compared to patients living at home. The proportion of patients receiving stroke rehabilitation services provided by physiotherapists, speech/language therapists and occupational therapists is rather low, especially 6 months after the critical event.

RecoverNow: A patient perspective on the delivery of mobile tablet-based stroke rehabilitation in the acute care setting

2018 ◽  
Vol 14 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Karen Mallet ◽  
Rany Shamloul ◽  
Michael Pugliese ◽  
Emma Power ◽  
Dale Corbett ◽  
...  
Keyword(s):  
Acute Care ◽  
Stroke Rehabilitation ◽  
Care Setting ◽  
Hand Function ◽  
Occupational Therapists ◽  
Fine Motor ◽  
Stroke Patients ◽  
Acute Setting ◽  
Cognitive Therapies ◽  
Mobile Tablets

Background/aim We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. Methods Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration. Results Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it. Conclusion Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. Patients in the acute setting prefer to focus on communication and hand therapies, are willing to begin within days of their stroke and may require assistance with the tablets.

scholarly journals 170 Admissions to a Stroke Unit in an Irish Rehabilitation Hospital: A Review from Speech and Language Therapy

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Niamh Ní Dhufaigh ◽  
Marie Haughey ◽  
Cliodhna Gillen
Keyword(s):  
Stroke Rehabilitation ◽  
Rating Scale ◽  
Communication Disorders ◽  
Functional Independence ◽  
Speech And Language ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Research Education ◽  
Post Stroke ◽  
Communication Difficulties

Abstract Background Communication disorders and dysphagia are debilitating sequelae associated with stroke. Speech and Language Therapy (SLT) has a pivotal role in stroke rehabilitation, and in improving outcomes. The research into dysphasia, dysphagia, and dysarthria post-stroke is extensive. In comparison, the research into cognitive-communication difficulties post-stroke is still emerging. Cognitive-communication difficulties (CCDs) are communication impairments resulting from underlying cognitive deficits due to neurological impairments1. The aim of this audit was to review SLT referrals in an Irish Stroke Rehabilitation Unit. Methods Single-centre retrospective review of all stroke admissions from January to December 2018. Communication outcomes were assessed using the Functional Independence Measure and Functional Assessment Measure (FIM+FAM)2 a 7-point disability rating scale. Standard Bayesian statistics were employed for analysis. Results SLT received referrals for 66% (n=41) of all stroke admissions (n=62). Mean age was 68 years (SD+/-14), compared with 70 years (SD+/-14) for patients not referred. 65% were female and 35% male. Patients requiring SLT had significantly longer length of stay (p=0.0072). 83% of referrals were for communication, 12% dysphagia, and 5% inappropriate. Of communication referrals, primary diagnoses were as follows: 17.5% dysarthria (n=6), 26.5% dysphasia (n=9) and 56% CCD (n=19). Patients with dysphasia showed greater improvement in FIMFAM scores (x̄=1.3) than those with CCD (x̄=0.9) or dysarthria (x̄=0.7). Patients with CCD comprised the largest cohort who required SLT on discharge (68%). Conclusion CCDs are highly prevalent and represented the largest subtype of communication disorders in this cohort. FIMFAM scores appear useful in assessing CCDs however they display insufficient sensitivity in capturing change within this population. This audit highlights the need for further interdisciplinary research, education and training into cognitive-communication difficulties with post-stroke populations.

scholarly journals What is Important in E-health Interventions for Stroke Rehabilitation? A Survey Study among Patients, Informal Caregivers, and Health Professionals.

2018 ◽  
Vol 10 (1) ◽  
pp. 15-28 ◽  
Author(s):  
Manon M. Wentink ◽  
Leti Van Bodegom-Vos ◽  
Berber Brouns ◽  
Henk J. Arwert ◽  
Thea P.M. Vliet Vlieland ◽  
...  
Keyword(s):  
Health Professionals ◽  
Stroke Rehabilitation ◽  
Physical Therapists ◽  
Informal Caregivers ◽  
Occupational Therapists ◽  
Survey Study ◽  
User Requirements ◽  
Stroke Patients ◽  
The Mean ◽  
Insight Into

Incorporating user requirements in the design of e-rehabilitation interventions facilitates their implementation. However, insight into requirements for e-rehabilitation after stroke is lacking. This study investigated which user requirements for stroke e-rehabilitation are important to stroke patients, informal caregivers, and health professionals. The methodology consisted of a survey study amongst stroke patients, informal caregivers, and health professionals (physicians, physical therapists and occupational therapists). The survey consisted of statements about requirements regarding accessibility, usability and content of a comprehensive stroke e-health intervention (4-point Likert scale, 1=unimportant/4=important). The mean with standard deviation was the metric used to determine the importance of requirements. Patients (N=125), informal caregivers (N=43), and health professionals (N=105) completed the survey. The mean score of user requirements regarding accessibility, usability and content for stroke e-rehabilitation was 3.1 for patients, 3.4 for informal caregivers and 3.4 for health professionals.  Data showed that a large number of user requirements are important and should be incorporated into the design of stroke e-rehabilitation to facilitate their implementation. 

scholarly journals The International Classification of Functioning, Disability and Health (ICF) in neurorehabilitation in Austria. Comparison of the healthprofessions occupational therapy, speech-and language therapy and physiotherapy / Die Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit in der Neurorehabilitation in Österreich. Vergleich der Berufsgruppen Ergotherapie, Logopädie und Physiotherapie

2017 ◽  
Vol 4 (2) ◽  
pp. 137-146
Author(s):  
Hannes Aftenberger ◽  
Gabriele Schwarze ◽  
Beate Salchinger ◽  
Angelika Rother
Keyword(s):  
Occupational Therapists ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Speech And Language ◽  
Language Therapy ◽  
Internationale Klassifikation Der Funktionsfähigkeit ◽  
Rehabilitation Facilities ◽  
Behinderung Und Gesundheit

Abstract Introduction The International Classification of Functioning Disability and Health (ICF) provides the language and a framework applying a unified and standardized form to describe health and conditions related to health. Teams who work in an interdisciplinary and multi professional way, as it is the case in neuro rehabilitation, can profit from integrating the ICF. The aim of this paper was to show how well implemented the ICF is in Austria with occupational therapists, speech and language therapists and physiotherapists working in neuro rehabilitation. Methods The present paper is a follow-up project of the APPEAR study. An extended questionnaire, which has been sent to 109 therapists working in Austrian neurologic rehabilitation facilities forms the basis for the results presented here. Results 64 questionnaires were returned from occupational therapists, speech and language therapists and physio therapists and were used for evaluation. 50% of the therapists who answered the questionnaire (n=25) stated that the ICF has already been implemented in their institution. Therapists often applied ICF (n=35) when using common documentation systems. Additionally, therapists consider the ICF an aid to support interdisciplinary and multi professional work. The therapists also stated (n=27) that they are not satisfied with the ICF when inpatients become outpatients. Conclusions Many therapists answering the questionnaire consider the ICF an important tool for optimizing the rehabilitation process. Barriers contributing to hindering an implementation of the ICF should be eliminated in the future. In order to achieve that aim, institutions should provide time and financial resources to further the education of their employees.

‘Deeply Troubling Questions’: The Teaching of Ethics in Undergraduate Courses

1993 ◽  
Vol 56 (11) ◽  
pp. 401-406 ◽  
Author(s):  
Rosemary E Barnitt
Keyword(s):  
Professional Practice ◽  
Ethical Issues ◽  
Occupational Therapists ◽  
Postal Survey ◽  
Speech And Language ◽  
Language Therapy ◽  
Moral Issues ◽  
Speech And Language Therapy ◽  
Ethics Teaching ◽  
The Uk

‘The professional is always at risk if the practice has not developed an ethical discipline.’ Ethical issues are challenging the providers of health care in the UK. Occupational therapists, physiotherapists and speech and language therapists cannot detach themselves from this development, and clinicians are confronted by a variety of moral issues while delivering patient care. A postal survey of all undergraduate courses in occupational therapy, physiotherapy and speech and language therapy in the UK was undertaken to find out how the teaching of ethics and moral reasoning was tackled in these programmes. It was discovered that the teaching of ethics was not a particularly well developed aspect of many courses, and that there was some uncertainty about what, how and when the topic of ethics should be addressed. A strong theme that emerged was the need for integration of ethics teaching with professional studies so that ethics was not seen as just an academic subject. There was little agreement over procedures for giving codes of professional practice to the students. Some examples of innovative practice with regard to both these issues are given.

Abstract T P119: Challenges Associated with Access to Stroke Rehabilitation for Patients with Cognitive Impairment in Toronto

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Elizabeth Linkewich ◽  
Nicola Tahair ◽  
Michelle Donald ◽  
Sylvia Quant
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Stroke Rehabilitation ◽  
Best Practice ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Services ◽  
Cognitive Screening ◽  
Stroke Patients ◽  
Referral Decisions ◽  
Rehabilitation Facilities

Background: Cognitive Impairment (CI) affects up to 60% of stroke survivors and is associated with poorer recovery and decreased function. Toronto clinicians report limited access to inpatient rehabilitation for stroke patients with CI. Purpose: To inform system planning that aligns with best practice for stroke patients with CI, the Toronto Stroke Networks examined: 1) access to inpatient rehabilitation services for stroke patients with CI; 2) facility differences with respect to referral decisions; and 3) the frequency of documented standardized cognitive screening (SCS) in inpatient rehabilitation referrals. Methods: Data were abstracted from the E-Stroke Rehab Referral System for fiscal years 2012-2014. Initial high intensity rehabilitation (HIR) referrals for 5 rehabilitation facilities in Toronto were analyzed to examine: percentage of referrals accepted, declined, and declined due to CI, and percentage of referrals reporting SCS in referral documentation. These data were further stratified by facility. A survey of cognitive rehabilitation was completed across 6 rehabilitation facilities. Results: There are no cognitive rehabilitation services that cater specifically to stroke patients reported in Toronto. Of the total number of HIR referrals (n=5005), 68.3% of initial referrals were accepted and 18.2% declined. Of the declined referrals (n=910), 17.5% were declined due to CI with variability across the 5 rehabilitation facilities ranging from 0.6 to 46.5%. Further, when examining referrals that were pending a decision or declined due to CI (n=508), 78.5% (range 48-100%) of these referrals across, 10 referring acute care facilities, had no documented SCS. Conclusions: Stroke patients with CI do not have adequate or consistent access to stroke rehabilitation across sites within Toronto. Additionally, there is a lack of documented SCS in rehabilitation referrals, which could impact access to rehabilitation. This work will further inform educational initiatives that support increased access to inpatient rehabilitation for persons with stroke and CI.

scholarly journals Communication rehabilitation in sub-Saharan Africa: A workforce profile of speech and language therapists

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Karen Wylie ◽  
Lindy McAllister ◽  
Bronwyn Davidson ◽  
Julie Marshall
Keyword(s):  
Linguistic Diversity ◽  
Sub Saharan Africa ◽  
Rehabilitation Services ◽  
Speech And Language ◽  
Language Therapy ◽  
Education Experience ◽  
Communication Disabilities ◽  
Recent Graduates ◽  
University Level ◽  
Sub Saharan

Background: There is an urgent global need to strengthen rehabilitation services for people with disabilities. In sub-Saharan Africa, rehabilitation services for people with communication disabilities continue to be underdeveloped. A first step in strengthening services for people with a communication disabilities is to understand the composition and conditions of the current workforce.Objectives: This research describes a sample of the speech and language therapists (SLTs) working in SSA (excluding South Africa). This study explores the characteristics of this workforce, including their demographics, education, experience and geographical stability.Method: A mixed-methods survey was used to collect data from SLTs within Anglophone countries of SSA. Completed surveys were received from 33 respondents working in 44 jobs across nine countries. Analysis included descriptive and non-parametric inferential statistics. This study reports on a subset of descriptive and quantitative data from the wider survey.Results: A background profile of SLTs across the region is presented. Results indicated that the workforce of SLTs comprised a mix of local and international SLTs, with university-level education. Local SLTs were educated both within and outside of Africa, with more recent graduates trained in Africa. These data reflected the local emergence of speech and language therapy training in SSA.Conclusion: This sample comprised a mix of African and international SLTs, with indications of growing localisation of the workforce. Workforce localisation offers potential advantages of linguistic diversity and stability. Challenges including workforce support and developing culturally and contextually relevant SLT practices are discussed.

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