1,721,068 research outputs found
Rehabilitation of severe brain injury in Italy: the giscar study preliminary results
No full textIn rappresentanza del Gruppo GISCAR (Studio Multicentrico)
IF: 1.12
L'idrochinesiterapia termale nel trattamento della lombalgia: una revisione sistematica
No full textSono stati utilizzati sette differenti motori di ricerca: Pubmed, Biological
abstracts, Cochrane, Embase, Bandolier, Pedro,e Cinahal e le
seguenti parole chiave: Thermal Hydrother or Balneother or Spa or
Aquatic therap or aquatic exercise AND Low back pain or Lumbago.
È stato posto come limite la ricerca di trials clinici randomizzati controllati
o non e sono state escluse precedenti reviews.
Misurazioni principali del risultato: intensità e durata del dolore,
scale di qualità della vita fisica e psicologica, scale sulla disabilità,
mobilità articolare, uso di farmaci antinfiammatori o analgesici, scale
funzionali
Early rehabilitation treatment in severe head injury
No full textBackground: Acute phase rehabilitation for adults with traumatic brain injury (TBI) takes place during coma and arousal states. Specific aims are to prevent orthopaedic and visceral complications (e.g. atelectasis, pressure sore, contractures, etc), and to provide sensory stimulations with the hope of accelerating arousal. The aim of this study was to evaluate the efficacy of TBI rehabilitation during acute care.
Method: From medical record we reviewed the courses of 78 severe TBI treated in acute care setting in our hospital between 1998 and 2001 that used an early rehabilitation intervention program (physical mobilization, preventive work for bedsores and contractures, sensory stimulation, respiratory rehabilitation, etc.) for patients with TBI. In all patients we have investigated demographic characteristic (age, sex, etc), admission and discharge measures of severity of TBI Glasgow Coma Scale (GCS), Rancho Los Amigos (RLA) scale, length of coma, neuroradiological findings, ventilation days, tracheotomy, neurosurgeries and associated injured.
Main outcome measure: Length of acute care stay and cognitive change level.
Results: We have analysed the relative outcomes in 2 groups: those with early initiation of rehabilitation (<10 days post-injury) versus those whose rehabilitation began later (≥10 days post injury). The patients who began rehabilitation early have reported a significantly shortened length of hospital stay (22 versus 40 days) as well as better functional outcome at discharge. In fact the RLA level at discharge from the acute centre was not statistically significant between the 2 groups (p=0.5), however the cognition was better in the patients undergoing early rehabilitation. For patients admitted in coma, the duration had a mean length of 30 days for the early rehabilitation group contrasted with 44 days for the delayed group. No statistically relationship was found in the other variables (neuroradiological findings, ventilation days, tracheotomy, surgeries and associated injured) between the groups.
Conclusions: The overall conclusion from this study is that rehabilitation treatment in acute care setting is useful and significantly related with the outcome when it is initiated early. In fact, if the rehabilitation approach is initiated precociously it can reduce length of stay and cost in acute care setting patients after TBI
Flow resistive properties of tracheostomy tubes and impact of external work of breathing in respiratory rehabilitation after traumatic brain injury
No full textBackground: The tracheostomy is, usually, performed in order to facilitate the suctioning of bronchial secretions so preventing atelectasis, pneumonia and increased V/Q mismatching. Nevertheless, the presence of a tracheostomy tube determines an extra burden for the respiratory muscle that could be crucial in order to maintain an adequate spontaneous ventilation. Therefore, we undertook this study to measure the impact of tracheostomy tubes on resistive external work of breathing.
Method: We measured, in vitro, the resistive properties of tracheostomy tubes (Shiley-Mallinkrodt Medical Italy), size 8-6 (internal diameter 7,6 mm and 6,4mm, length 81 and 78 mm, respectively), fenestrated and normally manufactured. We connected each cannula to the ‘Y’ piece of the inspiratory limb of the respiratory circuit and measured for each tube, different in size and characteristics, the drop in pressure, using the pressure transducer and pneumotacograph of the ventilator, along flow axis at different constant flow (0.5-1.0-1.2 L/s). By dividing the drop in pressure by the relative constant flow, we obtained the flow resistance (R) (cm H2O/L/s).
Results:
8 normal 8 fenestrated
Flow (L/s) R (cmH2O/L/s) Flow (L/s) R (cmH2O/L/s)
0.5 1.5 0.5 0.75
1.0 3.82 1.0 3.15
1.2 5.0 1.2 4.12
6 normal 6 fenestrated
Flow (L/s) R (cmH2O/L/s) Flow (L/s) R (cmH2O/L/s)
0.5 2.85 0.5 2.45
1.0 9.45 1.0 8.25
1.2 11.2 1.2 10.0
Conclusion: We can conclude that at high flow (1.0-1.2) Pres (R•Flow) (resistive pressure) is substantial, particularly with tubes of small size and the pressure the respiratory muscles have to generate to overcome the flow resistance offered by the tracheostomy tubes is higher in normally manufactured tubes than in fenestrated tubes with the same internal diameter; consequently external work performed by the patient is enhanced. This conclusion is very important in pulmonary rehabilitation treatment, during acute phase when there are TBI patients with tracheotomy and placement of a tracheotomy tube
Il trattamento riabilitativo nelle gravi cerebrolesioni vascolari in fase acuta: uno stadio preliminare
No full textIter riabilitativo del paziente con grave cerebrolesione in fase acuta. nostra esperienza
No full textLa grave cerebrolesione acquisita viene definita come un danno
encefalico di diversa eziologia (traumatica, ipossica, emorragica,
ischemica) con Glasgow Coma Scale (GCS) minore di 8 e tale da
produrre coma di durata maggiore di 24 ore associato o meno a
segni di danno encefalico focale. Scopo di questo preliminare studio osservazionale è, pertanto,
quello di analizzare le esigenze riabilitative dei pazienti nella fase
acuta e di verificare gli effetti del trattamento attualmente proposto. In questo studio sono stati reclutati 97 pazienti, 66 maschi e 31
femmine, di età media 54,5 anni (range 16-86 anni) che tra Aprile
2002 e Dicembre 2003 sono stati consecutivamente ricoverati con
diagnosi d’ingresso di “Grave Cerebrolesione Acquisita” nei Reparti
di Terapia Intensiva e Rianimazione dell’Azienda Ospedaliera di
Padova. In conclusione riteniamo che le complesse condizioni dei pazienti
che subiscono una grave cerebrolesione richiedano un approccio
riabilitativo multidisciplinare così come auspicato in letteratura1. Per
quanto osservato risulta che tale approccio sia ancora carente nella
nostra realtà, anche se potrebbe essere fondamentale nel ridurre le
complicanze secondarie all’allettamento che come noto rappresentano
un importante ostacolo alla riabilitazione nelle fasi successiv
Utilità di un precoce intervento riabilitativo nei soggetti con disfagia orofaringea in esiti di stroke.
No full textCon questo studio ci siamo proposti di valutare in un campione
di soggetti disfagici in esiti di primo ictus cerebrale per un periodo
di 3 mesi i seguenti aspetti: a) l’incidenza di infezioni polmonari, b)
l’epoca di comparsa dell’infezione rispetto all’evento acuto, c) i
segni clinici maggiormente predittivi di aspirazione e di complicanze
polmonari, d) tempi di recupero dell’autonomia deglutitoria
Effect on Hip Osteoarthritis of Mud Bath and Underwater Exercises: A Randomized Controlled Trial
No full textObjective: To compare the efficacy of an approach combining thermal therapy (mud pack and spa bath treatment) and underwater exercising (TT-UE) with conventional therapy, in patients with primary osteoarthritis (OA) of the hip. Design: Single-blind, randomized controlled trial. Setting: Thermal-rehabilitation center. Participants: 63 outpatients randomly assigned to the TT-UE (n= 34) and conventional therapy (n=29). Intervention: The TT-UE group underwent a 12-day cycle of mature mud pack application, bathing in natural mineral thermal water rich in bromine-iodine, massage therapy according to the standard protocol, and underwater exercises (eg, mobilization, hip traction, muscle strengthening), in a spa pool (≈50min/d), at a thermal facility of the Euganean Basin (Padua, Italy). The conventional therapy group was treated for the same number of sessions with traditional rehabilitation that included magnetotherapy, electrotherapy, and therapeutic exercises (mobilization, axial traction of the hip, functional re-education). During the treatment period, all patients stayed in the treatment center. Main Outcome Measures: Range of motion (ROM) (with IncliMed goniometer), Western Ontario and McMaster University Osteoarthritis (WOMAC) Index, and nonsteriodal anti-inflammatory drug (NSAID) consumption. Results: Findings were based on comparison of 2 groups matched for clinical and initial degree of impairment. In the TT-UE group, ROM significantly increased for flexion, abduction, and internal rotation (P range, .040−.011), WOMAC pain, stiffness, and physical function scores were significantly lower (P range, .001−.001) at the end of treatment, and the effects persisted at 3-month follow-up. In addition, analgesic and NSAID consumption during follow-up was higher in the TT-UE group, but not significantly so (P=.09). Conclusions: The patients with OA of the hip who received thermal therapy in combination with underwater exercising showed greater reductions in pain, motor impairment, and improvements in functional abilities, and these benefits persisted over tim
Community integration and life satisfaction after traumaticbrain injury
No full textBackground: The community integration questionnaire (CIQ) was designed to assess home integration, social integration and productive activity in persons with acquired brain injury. The purpose of this study was to describe the relationship of the degree of community integration to the life satisfaction of persons with traumatic brain injury (TBI).
Design: retrospective study of patients with TBI studied 1 and 2 years after injury.
Method: Fifty-two patients admitted for rehabilitation setting, mean age 32.5 years, with a primary diagnosis of TBI, consented to participate, and interviewed 1 and/or 2 years after injury. To all the subjects recruited was administered over the phone questionnaire that measured the aspects of community integration and life satisfaction. Community integration was assessed using the CIQ, instead life satisfaction was assessed with Life Scale. Analysis approaches included Sperman’s Rho.
Results: After one year a significant relationship (p<0.05) was found between life satisfaction and social integration and between life satisfaction and home integration (p<0.01, but no significant relationship was found with the other component of CIQ (productive activity). No significant association was found between the total CIQ scores and life satisfaction. After 2 years no statistically significant relationship were found between CIQ (total and their components) and life satisfaction.
Conclusion: Our work suggests the need for rehabilitation programs to provide long-term assistance with community-based social integration in persons with TBI
Deep venous trombhosis: incidence in neurological patiensts on admission to rehabilitation program
No full text- …
