Students or medical professionals: whose knowledge improved after social-medicine training? Results from a quasi-experimental evaluation study

Purpose Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students’ knowledge changes after social medicine training. Methods This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. Results All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. Conclusions Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups’ knowledge levels.

Rehabilitation of COVID 19 Patients, Bangladesh Perspective

The global outbreak of COVID 19 has created an unprecedented challenge to the society. America, Europe and India were catastrophic sufferers from this virus next to China. They had highest number of daily morbidity and mortality in the global context. Bangladesh is facing terrible experiences of dealing with this pandemic and making a tremendous turmoil in health and economic sector. Our healthcare system is overburdened with critically ill patients. Disability arising out of neurological, pulmonary, neuromuscular, and cognitive complications, need to be addressed by rehabilitation professionals. Many patients presenting with COVID-19 will have no specific airway clearance needs.There have been no reports of COVID-19 positive patients having high secretion loads that would require intensive chest physiotherapy or postural drainage. In Bangladesh in ICU settings physiatrist or physiotherapists are not directly involve in respiratory care management. In mild to moderate cases advice about a post-acute care breathing exercises, other musculoskeletal exercises, bed positioning and pressure sore care are helpful. In Bangladesh medical care facilities are not adequate in corona care hospitals especially in peripheral medical college or hospital. Many patients are dying of shortage in oxygen supplies and lack of availability of ICU. Post discharged plans of comprehensive rehabilitation are grossly neglected in discharged certificate. Our national guidelines on corona management do not have any instructions on rehabilitation management at any point. The objectives of this fast review article on corona pandemic are to highlight the global scenario and our limitations in the rehabilitation management of COVID 19 patients particularly post discharged patients and patients with long COVID complications. J Bangladesh Coll Phys Surg 2022; 40: 52-56

Informing School Rehabilitation Professionals

The importance of appropriate use of test accommodations has drawn researchers to look closely for empirical evidence that supports the appropriateness and effectiveness of current accommodation practices over the last three decades. To inform teacher candidates enrolled in special education courses as well as school rehabilitation professionals who may or may not be new to the field, this chapter synthesizes research findings on the effectiveness of major accommodation categories and discusses how to make valid decisions for students with diverse special learning needs.

Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Background: Patients often need the use of their arms to assist with functional activities, but after median sternotomy, pushing is frequently limited to less than 4.5 kg. No method exists to objectively measure arm weight bearing in clinical settings. This project aimed to design, construct, and test a walker for patients recovering from median sternotomy to prevent excessive bone stress during ossification. Methods: First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) Walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. Results: The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. Conclusions: The innovative CFM Walker will help patients with restricted upper extremity weight bearing, especially elderly adults, recover safer and faster in the future.

A dire need for recruitment of rehabilitation professionals for provision of geriatric care

This editorial is an introspection of recruitment of rehabilitation professionals. The rapid surge in Pakistan’s population has highlighted the dearth and demand of rehabilitation professionals. This has also highlighted the largely ignored geriatric care. Hence, it is imperative that the need of recruitment of rehabilitation professionals especially keeping in view the geriatric population.

The effect of new scalp acupuncture on qi, 5 elements and acupuncture of meridians in patients with chronic stroke – pilot study

Introduction. Individuals affected by stroke often lead to loss of autonomy, dependence in activities of daily living, and social disruption, possibly leading to a reduced quality of life. Most survivors present residual sensory-motor deficits that interfere with the performance of functional activities. Reducing complications and improving the functional recovery of these individuals is an important starting point for rehabilitation professionals. Objective. To analyze the effect of the new Yamamoto scalp acupuncture (SA) YNSA on Qi, 5 elements and acupuncture of meridians in chronic stroke patients. Method. This is a quasi-experimental pilot study composed of nine chronic stroke patients. All participants diagnosed with chronic stroke aged from 38 to 79 years underwent energetic electrodiagnosis. Patients received a SA session on the contralateral hemisphere of the damaged side corresponding to the motor and sensory area for 30 minutes. The Shapiro-Wilk test was applied, followed by the paired t-test. Results: There was a significant reduction in the Yin, Fire (Pericarium) and Fire (heart). The following organs and viscera also presented a reduction: lung, right pericardium, left small intestine, and right spleen. Conclusions. It is concluded that AE YNSA can promote Qi balance, reduction in the fire element and reduction in the action of some acupuncture meridians in chronic stroke patients in the analysed sample.

Lessons Learned by Rehabilitation Counselors and Physicians in Services to COVID-19 Long-Haulers: A Qualitative Study

Coronavirus disease (COVID-19) may cause long-lasting adverse consequences after acute recovery, including functional limitations and reduced work capacity. Individuals with long-lasting complications of COVID-19 are known as long-haulers. There is a knowledge gap on how COVID-19 complications affect return-to-work (RTW) efforts. We aimed to describe the challenges that long-haulers encounter when RTW from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in outpatient rehabilitation centers participated in focus groups. Participants discussed challenges in working with long-haulers, including personal attributes, post-COVID-19 symptoms and complications, uncertain recovery and unpredictable outcomes, limited health care accessibility and support, and unsupportive work environments. Participants provide individualized services to meet long-haulers’ diverse needs as they do for all persons with disabilities, although they expressed uncertainty due to the variable disease course and risk of infection. Modifying workplace policies, especially gradual RTW, were frequently mentioned accommodations. The findings highlight the RTW issues of long-haulers. We provide recommendations on increasing awareness of the challenges and job accommodations of long-haulers.

Engineering a Clinical Force Measuring Walker for Patients Recovering from Median Sternotomy

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.