Comprehensive Tool to Assess Oral Feeding Support for Functional Recovery in Post-acute Rehabilitation

Objective

To determine the influence of the Kuchi-kara Taberu (KT) index on rehabilitation outcomes during hospitalized convalescent rehabilitation.

Aquatic Therapy for a Child with Type III Spinal Muscular Atrophy: A Case Report

ABSTRACT

Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by degeneration of alpha motor neurons. This case report describes an aquatic therapy program and the outcomes for a 3-year-old girl with type III SMA. Motor skills were examined using the 88-item Gross Motor Function Measure (GMFM), the Peabody Developmental Motor Scales (PDMS-2), and the GAITRite system. The child received aquatic therapy twice per week for 45-min sessions, for 14 weeks. The intervention included aquatic activities designed to improve gross motor skills and age-appropriate functional mobility. The GMFM total score improved by 11% following the intervention. The Standing Dimension score improved by 28% and the Walking, Running, and Jumping Dimension score improved by 18%. The gross motor quotient for the PDMS-2 improved from 66 to 74. The child's gait showed improvement in walking velocity, stride length, and single-limb support time as a percentage of the gait cycle. The outcomes of this case report demonstrate the successful improvement of gross motor function and gait in a 3-year-old child with SMA. This study provides clinical information for therapists utilizing aquatic therapy as a modality for children with neuromuscular disorders.     

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

ABSTRACT

Collaborative goal setting between clinicians and clients/families is considered a fundamental component of the pediatric rehabilitation process. However, truly client-centered goal setting is not without its challenges. The purpose of this paper is to highlight theoretical concepts relevant to rehabilitation goal setting, review clinical studies directly evaluating relationships between goal setting and pediatric rehabilitation outcomes, and provide recommendations to facilitate collaborative goal processes. Four theoretical frameworks were identified that may lie behind and help explain the effectiveness of collaborative goal setting. The four relevant outcome studies found in the review revealed that individualized goal setting is an important component of the intervention, engages families more actively in therapy, and is associated to some extent with positive outcomes. The evidence suggests that the impact of fully collaborative goal setting is sufficiently positive to support investment of organizational and individual time, energy, and resources to make it an integral part of the rehabilitation process.     

Considerations in Seating and Positioning Severely Disabled Drivers

Seating and positioning methods and products have taken a lead in clinical intervention with the disabled client. The seating clinician has emerged as an important member of the rehabilitation team working toward maximizing independence and function of the clients they serve. Seating and positioning interventions have proven to be very effective in stabilizing the client's trunk and torso, making it possible to achieve the once impossible task of driving a motor vehicle. The areas of acceleration deterioration, improved head height, and design of a secure wheelchair base are all concerns for the rehabilitation team working on driving. Addressing these issues early in the driver rehabilitation program can maximize successful outcomes and create a safer driving environment.     

Responding to Employment Needs

Abstract

This article reports on a study investigating employment-related support to individuals with HIV/AIDS from the perspective of service providers. Surveys were completed by AIDS Service Organizations (ASOs) and Vocational Rehabilitation (VR) administrators and counselors that examined the extent to which support around employment was provided, the type of work-related services delivered, and outreach practices offered to this population. Findings indicated that although employment is becoming an increasingly important concern to this population, service providers have a limited capacity to respond to such needs. Strategies are presented for social workers and other professionals to consider as they work to support individuals with HIV/AIDS with employment-related concerns.     

Functional electrical stimulation for the upper limb in tetraplegic spinal cord injury: a systematic review

Abstract

Technological advances have helped to improve functional ability in spinal cord injury survivors. The aim of this study is to systematically review the evidence for functional electrical stimulation (FES) on functional tasks involving the upper limb in people with spinal cord injuries. The authors systematically searched from September 2009 to September 2014 in relevant databases using a combination of keywords covering spinal cord injury and FES. Studies were selected using pre-determined criteria. The search yielded 144 studies. Only five studies met the inclusion criteria. All five reported improvements immediately and at follow-up in functional ability as a result of FES or FES combined with conventional therapy. There is some preliminary evidence that FES may reduce disability due to upper limb-related activity limitations in tetraplegic spinal cord injury. Further work needs to examine the role of FES in more detail and in combination with other treatments.     

Experiences of returning to work after acquired brain injury

The purpose of this qualitative study was to explore experiences of returning to work after rehabilitation, from the viewpoint of people with acquired brain injury. A purposive sampling of eight informants was made, and data were collected through personal interviews with open questions. The data were then analysed through qualitative content analyses in five steps, resulting in four main categories of experiences: “A new person”, “Stimulants and fellowship”, “Understanding and support”, and “To reach insight” with appurtenant sub-categories. The overarching theme was “Returning to work after acquired brain injury is a long process”. The conclusion of this study is that returning to work after acquired brain injury requires motivated individuals, flexible work, accommodating labour management, and prolonged environmental support. This study also shows that the informants need support for a long period of time to reach a balance and to obtain a functional working role. In order to achieve this, client-centred rehabilitation, professional teamwork, and longer follow-up periods than those of today are required.     

Rehabilitation and orthotic management of congenital and acquired meromelia in the lower limbs of children

Children with limb deficiencies or amputations of the lower extremities should be enabled to stand or walk according to their state of development, because standing and walking are among the most important preconditions for the best possible integration. Supplying them with a prosthesis, orthosis and orthoprosthesis is therefore indispensable for rehabilitation. While a prosthesis replaces parts of the extremities, an orthosis stabilizes the existing extremity. Orthoprostheses compensate longitudinal malformations, have a supporting effect, allow growth to be controlled and compensate for shortening. Just as important as the remedy is early medical treatment. The medical team taking care of the patient works out a treatment plan where responsible cooperation with the parents is of utmost importance. The focus of all efforts is, of course, the handicapped child. Examples are used to demonstrate the course of successful rehabilitation of children and adolescents with damaged limbs. Equally the psychological situation of the parents and child is taken into consideration.