Rehabilitation after fracture
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
The purpose of this chapter is to present the key principles and components of a post-fracture rehabilitation program for geriatric patients. This includes a review of the main components of a rehabilitation assessment in an older adult patient, the key elements of a rehabilitation program including the healthcare practitioners involved in the rehabilitation process, the continuum of rehabilitation care post-fracture, including the rehabilitation facilities where post-fracture rehabilitation can occur, and other considerations during rehabilitation. It is beyond the scope of this chapter to discuss the rehabilitation program for all types of fractures, however the key principles and components of a post-fracture rehabilitation program are reviewed. A rehabilitation program should be tailored to each individual patient. It should also be recognized that a formal structured rehabilitation program is not necessary for all geriatric fracture patients merely because of their age. However, as older individuals tend to be at greater risk for functional compromise, even a minor fracture may offer an opportunity for a thorough geriatric assessment and initiation of preventive measures (e.g. osteoporosis evaluation and falls prevention).
Functional Rehabilitation
James Crossley in Functional Exercise and Rehabilitation, 2021
A functional trainer can manage persistent pain by: Regulating emotional responses to movementTaking time to ‘explain pain’Helping to manage painful activities Training should expose clients to pain patterns whilst avoiding triggering pain, by applying: Graded exposureIntelligent variation Exercise can be prescribed to address sensor-motor dysfunctions resulting from persistent pain, including: Mapping drillsInhibition exercisesActivation exercises These drills can be incorporated into a functional exercise program. Details on how to structure a rehabilitation program are presented later in this section.
Neurologic Disorders in Documentary Film
Eelco F.M. Wijdicks in Neurocinema, 2014
Documentaries on rehabilitation in coma are virtually nonexistent. Filmed over the course of one year, Coma profiles four young patients with catastrophic traumatic head injury who were treated at the Center for Head Injuries at the JFK Medical Center in Edison, New Jersey. Though better than previous media portrayals of this topic, the documentary has shortcomings. The film shows hopeful families and friends deeply and compassionately involved with the care of their loved one, but the uncensored surreal abundance of pity, sorrow, and loneliness that continues for more than 100 unrelenting minutes makes the film hard to watch. Another problem is the title. Eventually, three of the four patients emerge from what appears to be a coma. Perhaps a more appropriate, although less appealing, title would be “Coping with a Catastrophic Head Trauma.” Another issue is that the mise-en-scène is essentially in the neurorehabilitation center. This would normally be an unlikely setting because most centers see only a small proportion of patients with catastrophic neurologic injury. In fact, only patients who have recovered qualify for a rehabilitation program.
Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation
Published in Disability and Rehabilitation, 2022
Charlie Giurleo, Amanda McIntyre, Anna Kras-Dupuis, Dalton L. Wolfe
This practice was implemented at Parkwood Institute, a tertiary care rehabilitation hospital in London, Ontario, Canada. Parkwood Institute has 15 beds in its Regional Rehabilitation Program for individuals with SCI. The SCI program is specifically designed for patients who have experienced traumatic or non-traumatic SCI or peripheral nerve disorders with similar functional presentations. The program is open to persons 16 years of age or older and services Erie St. Claire and South Western Ontario regions. More specifically, this area encompasses 11 counties, a landmass over 28 000 km2 with a combined population of over 1.6 million residents. Approximately 80–100 individuals receive SCI in-patient rehabilitation care at the hospital per year. The rehabilitation program is interdisciplinary and delivered via several clinician groups, including physicians, nurses, physical therapists, occupational therapists, social workers, speech-language pathologists, psychologists, therapeutic recreation specialists, dieticians, respiratory therapists, spiritual care practitioners, and others.
Children sustaining a severe acquired brain lesion before age 3 years: a follow-up study at 1 year from insult
Published in Brain Injury, 2019
Monica Recla, Susanna Galbiati, Valentina Pastore, Katia Colombo, Alessandra Bardoni, Francesca Formica, Sandra Strazzer
On the whole, however, our study suggested that our patients benefited from the rehabilitation program. In line with the literature (23), our programme provides a multidisciplinary comprehensive model of care, including specific training for patients and also family support programs, addressing psychoeducational issues and discharge planning. At T1, we found an improvement in the clinical and cognitive picture of our sample. The mean LOCFAS level of the full sample increased significantly (LOCFAS level = IV), meaning that the patients’ cognitive-behavioural picture had improved. Visual and hearing problems improved, too, and the number of patients who could not be evaluated for speech skills decreased. The most common motor diagnosis remained tetraparesis followed by hemiparesis, so our patients presented with a rather severe level of impairment and needed specific assistance for transfer or special aids for daily living.
Rehabilitation strategies enhancing participation in shopping malls for persons living with a disability
Published in Disability and Rehabilitation, 2018
Christine Alary Gauvreau, Dahlia Kairy, Barbara Mazer, Andréanne Guindon, Guylaine Le Dorze
Rehabilitation clinicians and persons living with a disability were recruited for this study. Participating clinicians worked in a rehabilitation program offering services to persons living with a physical disability. Inclusion criteria for persons living with a disability included having a physical disability (including motor and/or language difficulties) and having received rehabilitation services. There were no exclusion criteria. Clinicians were recruited through their clinical programs, or through the RehabMaLL CoP. For the latter, recruitment letters were directly sent to members via email. In total, 20 clinicians were contacted. One did not answer and three were not available to participate. People living with a disability were recruited through the rehabilitation centers’ research department. When they were interested in participating and gave permission to be contacted by the researcher, they were then called or met and given further details about the project. People living with a disability were also recruited via the RehabMaLL CoP. In total, 12 persons with a disability were approached. One could not be reached, two refused to participate and three were not available. Purposive sampling was used; recruited participants had to have a special interest or expertise regarding the use of shopping malls in rehabilitation. More specifically, using “stakeholder sampling” allowed the inclusion of participants with various experiences, such as professionals and persons living with a disability, involved in the specific context of rehabilitation [24].
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