Rehabilitation

BACKGROUND: Aortic stenosis (AS) is the most common valvular disease in western countries. Unless treated, it is associated with a poor prognosis. Surgical aortic valve replacement, the gold-standard approach, aims to increase survival and improve quality of life. In recent years, though, transcatheter aortic valve implantation (TAVI) has become the treatment of choice in elderly, high-risk patients who are denied open surgery. To date, however, little is known about their personal psychological experience after undergoing TAVI...

INTRODUCTION: Subjective memory complaints (SMCs) among stroke patients are common. To date, reports on SMCs using the Subjective Memory Complaint Questionnaire (SMCQ) are limited. We provided descriptive information on SMCs using the SMCQ alongside objective neuropsychological function assessment in stroke patients and established the sensitivity of SMCQ for post-stroke dementia. METHODS: In total, 419 consecutive stroke patients who were admitted to a stroke unit for younger populations (age <65 years) at a rehabilitation hospital from June 1, 2014, to January 1, 2020, were reviewed...

Background Panda Rope Bridge Technique (PRBT) was an new minimally invasive technique consisted of two bridge anchors (proximal anchors at calcaneus and distal anchors at myotendinous junction) and strong ropes (threads of the suture anchors) stretched between them, which was suitable for early accelerated rehabilitation of Achilles tendon rupture. However, the optimal knot configuration with PRBT was unknow. The purpose of this study was identify minimum number of half hitches necessary to maintain knot security for PRBT...

The author relates his 40 years of experience in the field of functional surgery of the tetraplegic upper limb (FSTUL). After having introduced and developed this specialty in France, he disseminated it to various countries where he saw a large number of patients and acquired extensive experience. He presents his personal progression and discusses the recent therapies in this field. FSTUL is a personalize surgery, with each case being unique. It must, first and foremost, take into consideration the real wishes of a motivated and well-informed patient and consider the type of spinal cord injury (not only the upper level of the lesional segment but also the extent of the sub-lesional segment)...

Clostridioides difficile is one of the most important healthcare-associated pathogens. Recently, several new 027-like types have been found that all belong to the multilocus sequence typing (MLST) Clade 2. We report a rapidly spreading outbreak of C. difficile infections (CDI) due to a newly identified PCR ribotype (RT) 181 in a Rehabilitation Centre (RC). Genomic analysis revealed the outbreak strain, not previously identified in Greece, belonged to clade 2, sequence type (ST) 1 and had a 18bp deletion in tcdC at position 311 together with a single nucleotide deletion at position 117, similarly to RT 027...

PURPOSE: The objective of this study was to examine the feasibility of an 8-week walking training programme using a novel assistive gait training device in individuals with chronic spinal cord injury (SCI). METHODS: This study was a pilot, single group, pretest-posttest study design. Participants received walking training, 3 sessions a week for 8 weeks. Participants were trained on a treadmill using a novel assistive gait training device. Feasibility data about recruitment, retention, compliance, and participants' performance, and participants' perception were collected throughout the study period...

INTRODUCTION: A spinner knob attached to the steering wheel enables one-handed driving. However, changes in steering performance and muscle activity of the upper extremity based on the differences in the position of the knob are unknown. AIM: To quantify changes in steering performance and their muscle activity according to the position of the knob. METHOD: Twenty right-handed healthy men with a mean age of 30.9 years participated in the study...

PURPOSE: Comprehensive and efficient home safety assessments are needed to provide quality interventions for community living. This study explores early career and experienced home evaluator perspectives on content and usability of HESTIA, a home safety assessment app. METHOD: Four early career and five experienced practitioners rated the HESTIA app using the uMARS usability evaluation and then participated in focus groups. Data were analysed using a key concept analytic approach...

Pathologies in peri-implant tissues are common and may disturb long-term implant supported rehabilitation. We aimed to evaluate the occurrence of such peri-implant diseases and their associated factors in this study. Peri-implantitis and mucositis were diagnosed based on clinical and radiological findings. Statistical analysis was performed with the X2 and logistic regression. Peri-implant mucositis and peri-implantitis were observed in 43.4% and 13.8% of patients with implants evaluated, respectively. Univariate analysis found associations with systemic changes (p=0...

The insertion of zygomatic implants is a challenging surgery and requires special care and great precision. Piezoelectric surgery offers several advantages, since it provides a more precise bone cutting with an improved intraoperative visibility and a low temperature increase.The aim of this case-control study was to evaluate if the use of ultrasonic instruments for zygomatic implant surgery can be as effective as standard drilling instruments in terms of clinical outcomes. Ninety-two patients with atrophic maxilla were included in the study...

PURPOSE: Three facilities, involved in introducing a model of Allied Health Assistant (AHA) delegated dysphagia screening, examined barriers and facilitators to service implementation. MATERIALS AND METHODS: The 3 facilities varied in size, services and location. AHAs ( n  = 4) and speech-language therapists (SLTs; n  = 4) directly involved in implementation at each site completed semi-structured interviews exploring the implementation experience. Analysis was guided by the Consolidated Framework for Implementation Research (CFIR)...

This study aimed to determine the influence of participation in a designated acquired brain injury (ABI) transitional rehabilitation service (ABI TRS) on outcome, in the context of a historical comparison group (HIST). Design : A cohort study, with retrospective comparison. Participants : 187 persons with ABI. Measures : The Depression, Anxiety and Stress Scale (DASS-21), Mayo-Portland Adaptability Index (MPAI-4) and Sydney Psychosocial and Reintegration Scale (SPRS) were completed at discharge and 3 months after discharge...

BACKGROUND: Low motivation is a common problem after acquired brain injury (ABI) and can persist for years after injury. Little is known, however, about perspectives of motivation with respect to engaging in the community, many years after ABI. PURPOSE: To explore the client with ABI perspective of motivation and engagement in individuals based in community ABI programs. METHOD: Interpretive description methods were utilized. Semi-structured interviews were conducted with 21 individuals with an ABI...

While the beneficial effects of secondary prevention of cardiovascular disease are undisputed, implementation remains challenging. A gap between guideline-mandated risk factor targets and clinical reality was documented as early as the 1990s. To address this issue, research groups in the Netherlands have performed several major projects. These projects address innovative, multidisciplinary strategies to improve medication adherence and to stimulate healthy lifestyles, both in the setting of cardiac rehabilitation and at dedicated outpatient clinics...

PURPOSE OF REVIEW: To review the epidemiology, pathogenesis, diagnosis using emerging imaging modalities, management strategy, and prevention of recurrent spontaneous coronary artery dissection (SCAD) and provide a more extensive review of the current data. RECENT FINDINGS: SCAD generally affects women without conventional cardiovascular risk factors. Diagnosis and management of SCAD are challenging due to heterogeneity, undefined mechanisms, differing phenotypes, and a lack of strong clinical evidence...

PURPOSE: To present surgical outcomes following intraocular lens (IOL) implantation in combination with lensectomy and vitrectomy for the treatment of persistent fetal vasculature (PFV). METHODS: This interventional case series included 19 eyes from 19 patients with unilateral combined PFV. Limbal lensectomy, capsulotomy, anterior vitrectomy, dissection of the retrolental membrane and stalk, and in-the-bag or in-the-sulcus IOL implantation were performed for the treatment of visually significant lenticular opacity with the presence of a retrolental fibrovascular membrane and stalk, in an eye with sufficient capsular support...

The co-occurrence of schizophrenia and substance use disorder (SUD) is clinically challenging and increasingly prevalent. This study compares trends in hospitalization characteristics of chronic psychotic patients with and without SUD in Israel, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000. The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorders, hospitalized in 1991-2016 (at least once in 2010-2015)...

INTRODUCTION: This study aimed to analyze the clinical and radiological outcomes of early weight-bearing and rehabilitation after open reduction and internal fixation (OR/IF) of calcaneal fracture. MATERIALS AND METHODS: This retrospective study was conducted on 78 patients with unilateral calcaneal fracture who underwent OR/IF. A mean follow-up period was 45.8 months (range 12-135). Two weeks after surgery, the range of motion (ROM) exercise was started, brace or heel off shoe was applied, and forefoot weight-bearing was allowed...

Walking onto a stationary platform that had been previously experienced as moving generates a locomotor after-effect-the so-called 'broken escalator' phenomenon. The motor responses that occur during locomotor after-effects have been mapped theoretically using a hierarchal Bayesian model of brain function that takes into account current sensory information that is weighted according to prior contextually-relevant experiences; these in turn inform automatic motor responses. Here, we use the broken escalator phenomenon to explore motor learning in patients with functional gait disorders and probe whether abnormal postural mechanisms override ascending sensory information and conscious intention, leading to maladaptive and disabling gait abnormalities...

PURPOSE: This study aimed to evaluate acute and subacute hemodynamic responses and perception of effort in individuals with CCC submitted to different IMT protocols. MATERIALS AND METHODS: This was a randomized cross-over trial conducted on CCC subjects with systolic left ventricular dysfunction (<45% left ventricular ejection fraction) without or with heart failure (stages B2 and C, respectively). Twenty-one participants performed two IMT protocols, one targeting 60% maximal inspiratory pressure with 3 × 10 repetitions (MIP60) and the other targeting 30% maximal inspiratory pressure (MIP30) with 3 × 20 repetitions with a 2 min recovery between sets for both...