scholarly journals Short- and Long-Term Efficacy of Intensive Rehabilitation Treatment on Balance and Gait in Parkinsonian Patients: A Preliminary Study with a 1-Year Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Giuseppe Frazzitta ◽  
Gabriella Bertotti ◽  
Davide Uccellini ◽  
Natalia Boveri ◽  
R. Rovescala ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Berg Balance Scale ◽  
Pharmacological Therapy ◽  
Timed Up And Go ◽  
Rehabilitation Treatment ◽  
End Of Treatment ◽  
Short And Long Term ◽  
One Year ◽  
Intensive Rehabilitation

Parkinson’s disease (PD) is a neurodegenerative disease in which gait and balance disturbances are relevant symptoms that respond poorly to pharmacological treatment. The aim of this study was to investigate whether a 4-week inpatient multidisciplinary intensive rehabilitation treatment (MIRT) is effective in improving balance and gait and whether improvements persist at a one-year followup. We studied 20 PD inpatients (stage 3 Hoehn-Yahr) who underwent a MIRT. Outcome measures were UPDRS items for balance (30), falls (13), and walk (29), Berg Balance Scale, six-minute walking test, Timed Up and Go Test, and Comfortable-Fast gait speeds. Patients were evaluated at admission, at the end of the 4-week treatment, and at a 1-year followup. Pharmacological therapy was unchanged during MIRT and follow-up. All outcome measures improved significantly at the end of treatment. At 1-year follow-up control, UPDRS walk and Comfortable-Fast gait speeds still maintained better values with respect to admission (P=0.009,P=0.03,andP=0.02, resp.), while the remaining scales did not differ significantly. Our results demonstrate that the MIRT was effective in improving balance and gait and that the improvement in gait performances was partially maintained also after 1 year.

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

Rehabilitation of the Institutionalized Patient: Description of a Programme and Follow-up of 60 Patients

1977 ◽  
Vol 130 (5) ◽  
pp. 484-488 ◽  
Author(s):  
G. H. B. Baker ◽  
T. J. Woods ◽  
J. A. Anderson
Keyword(s):  
Psychiatric Hospital ◽  
Social Worker ◽  
Medical Staff ◽  
Community Based ◽  
Rehabilitation Unit ◽  
High Incidence ◽  
Bus Driver ◽  
One Year ◽  
Intensive Rehabilitation

SummaryThe programme in an intensive rehabilitation unit in a large psychiatric hospital is described. Features include the use of non-medical staff as primary therapists, the use of a mini-bus to facilitate regular visits by patients to their home areas, the inclusion of the mini-bus driver on weekly staff conferences, the use of sociodrama, the re-organization of hospital money payments to patients, the promotion of relations with community-based facilities through occasional ‘teach-in’ days, and a special liaison social worker providing intensive follow-up after discharge. Rehabilitation was prolonged (average stay about one year) and about half of those selected for rehabilitation from the long-stay wards were discharged. Follow-up showed that these patients benefited from discharge, in spite of a relatively high incidence of psychopathology and of social problems. Those transferred back to long-stay wards showed increased institutionalization.

Acupuncture for Chronic Neck Pain - a Cohort Study in An Nhs Pain Clinic

2004 ◽  
Vol 22 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Patrick Blossfeldt
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Chronic Neck Pain ◽  
Pain Clinic ◽  
Patient Treatment ◽  
Successful Outcome ◽  
End Of Treatment ◽  
Long Term Follow Up ◽  
One Year

The study investigates the outcome of acupuncture for chronic neck pain in a cohort of patients referred to an NHS chronic pain clinic. One hundred and seventy two patients were selected for acupuncture over a period of 6.5 years. Treatment was given by a single acupuncturist and consisted of a course of needle acupuncture for an average of seven sessions per patient. Treatment outcome was measured by an oral rating scale of improvement at the end of treatment and at follow up six months and one year after treatment. Nineteen patients were withdrawn from treatment for various reasons, two for adverse events. One hundred and fifty three patients were evaluated, of whom 68% had a successful outcome from acupuncture, reporting an improvement in pain of at least 50%. The success rate was higher in patients with a short duration of pain: 85% in patients with pain for up to three months and 78% with pain for up to six months. Long-term follow up showed that 49% of the patients who completed treatment had maintained the benefit after six months, and 40% at one year. The results indicate that acupuncture can be an effective treatment for selected patients with chronic neck pain.

scholarly journals One-Year Follow-Up of Spa Treatment in Older Patients with Osteoarthritis: A Prospective, Single Group Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jolanta Zwolińska ◽  
Aneta Weres ◽  
Justyna Wyszyńska
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Mineral Waters ◽  
Spa Therapy ◽  
Spa Treatment ◽  
Short And Long Term ◽  
One Year

Introduction. Few studies evaluated the effects of spa therapy on pain perception and quality of life in older people with osteoarthritis. Therefore, the aim of the study was to evaluate the short- and long-term effects of spa therapy on quality of life and pain in patients aged 60 years and older with osteoarthritis. Materials and Methods. 70 patients with generalized osteoarthritis were enrolled in the study. Spa treatment lasted 3 weeks (15 days of treatment) and was applied during a session lasting 120 to 150 minutes a day. All the patients benefited from kinesiotherapy, physical agent modalities, massage, peloid therapy, hydrotherapy with mineral waters, and crenotherapy. Visual Analogue Scale (VAS) for pain, the Laitinen scale, and WHOQOL-BREF questionnaire were used to assess the condition of the patients. The examinations were performed three times: at the beginning of the spa treatment, after three months, and one year after the first examinations. Results. Statistically significant improvements were observed in pain (VAS) between consecutive assessments (p <.001). Laitinen scale also reported beneficial, statistically significant changes in the level of pain (p <.001). The WHOQOL-BREF questionnaire reported a statistically significant improvement in the domain of social relations in 2-3 and 1-3 periods (p = .025 and p = .011, resp.). A significant improvement was recorded in the domain of environment between 2-3 and 1-3 periods (p <.001). Conclusion. Spa treatment reduced the level of pain in majority of the patients in short- and long-term follow-up and contributed to improving the quality of life in the domain of social relations and environment. To confirm the results of this study, there is a need for a randomized controlled trial comparing spa treatment with usual care in the older population with osteoarthritis. Trial Registration Number. This trial was retrospectively registered on 3 January 2018 with NCT03388801.

scholarly journals Subthreshold Pan-retinal Photocoagulation Using Endpoint Management Algorithm for Severe Non-proliferative Diabetic Retinopathy: A Paired Controlled Pilot Prospective Study

2020 ◽  
Author(s):  
Kunbei Lai ◽  
Hongkun Zhao ◽  
Lijun Zhou ◽  
Chuangxin Huang ◽  
Xiaojing Zhong ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Outcome Measures ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Alternative Treatment Option ◽  
Pan Retinal Photocoagulation ◽  
Risk Of Progression ◽  
One Year ◽  
Retinal Photocoagulation

Purpose: To report the efficacy and safety profile of subthreshold pan-retinal photocoagulation (PRP) using endpoint management (EPM) algorithm compared with conventional threshold PASCAL PRP for the treatment of severe non-proliferative diabetic retinopathy (NPDR). Methods: This was a prospective, single center, paired randomized controlled trial of fifty-six eyes of twenty-eight participants with bilateral symmetric severe NPDR. One eye of the participant was randomly assigned to receive the subthreshold EPM PRP, while the other eye of the same participant received the threshold PASCAL PRP. The primary outcome measures included the difference in the one-year risk of progression to PDR between two groups, and mean changes of the logarithm of the minimal angle of resolution (logMAR) visual acuity (VA). The second outcome measures included central foveal thickness (CFT), one-year risk of progression to PDR, and visual field (VF) parameters. Results: The subthreshold EPM PRP group and the threshold PASCAL PRP group had similar one-year risk of progression to PDR during the 12-month follow-up visits (17.86% vs 14.29%, P>0.05). Slightly decreased VA was found in both groups (0.08 vs 0.09 logMAR VA), however, no statistical difference was found for neither group (P>0.05). Similar results were found for thickened CFT for both groups (23.59μm vs 28.34μm, P>0.05). Specifically, although substantial loss of VF was found in the threshold PASCAL PRP group (P<0.05), no obvious damage to VF was seen in the subthreshold EPM PRP group (P>0.05). Conclusion: The subthreshold EPM PRP is non-inferior to the conventional threshold PASCAL PRP in the treatment of severe NPDR during 12-month follow-up and could be an alternative treatment option for patients with severe NPDR.

scholarly journals Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis

2016 ◽  
Vol 18 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Cinda L. Hugos ◽  
Debra Frankel ◽  
Sara A. Tompkins ◽  
Michelle Cameron
Keyword(s):  
Multiple Sclerosis ◽  
Fall Prevention ◽  
Berg Balance Scale ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Balance Scale ◽  
Scale Scores ◽  
The Impact ◽  
Confidence Scale

Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P &lt; .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P &lt; .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P &lt; .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P &lt; .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS.

scholarly journals Walking Ability Outcome Measures in Individuals with Spinal Cord Injury: A Systematic Review

2021 ◽  
Vol 18 (18) ◽  
pp. 9517
Author(s):  
Isabel Sinovas-Alonso ◽  
Ángel Gil-Agudo ◽  
Roberto Cano-de-la-Cuerda ◽  
Antonio J. del-Ama
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Berg Balance Scale ◽  
Walking Ability ◽  
Walk Test ◽  
Timed Up And Go ◽  
Cord Injury ◽  
Profile Score

Walking function recovery in spinal cord injury (SCI) is tackled through several therapeutic approaches in which precise evaluation is essential. A systematic review was performed to provide an updated qualitative review of walking ability outcome measures in SCI and to analyze their psychometric properties. PubMed, Cochrane, and PEDro databases were consulted until 1 April 2020. Seventeen articles written in English were included. Five of them studied the walking index for SCI, four studied the 10 meter walk test, and two studied the six-minute walk test, the timed Up and go test, and the Berg balance scale. The rest of the articles studied the following metrics: gait profile score, spinal cord injury functional ambulation profile, five times sit-to-stand test, spinal cord injury functional ambulation inventory, spinal cord independence measure (indoors and outdoors mobility items), locomotor stages in spinal cord injury, community balance and mobility scale, and activity-based balance level evaluation scale. The choice of a single or a set of metrics should be determined by the clinician. Based on the results obtained in this review, a combination of outcome measures is proposed to assess walking ability. Future work is required to integrate a more realistic environment for walking assessment.

scholarly journals Balance and Mobility as Predictors of Post-Stroke Cognitive Impairment

2015 ◽  
Vol 5 (2) ◽  
pp. 203-211 ◽  
Author(s):  
Marie Helene Ursin ◽  
Astrid Bergland ◽  
Brynjar Fure ◽  
Audhild Tørstad ◽  
Arnljot Tveit ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Significant Contribution ◽  
Berg Balance Scale ◽  
Exclusion Criteria ◽  
Timed Up And Go ◽  
Logistic Regression Models ◽  
Health Authorities ◽  
Number Of Patients ◽  
Ischaemic Attack

Background: The number of patients with cognitive impairment following stroke is increasing due to the rise in the number of stroke survivors. Health authorities highlight the need for prediction and early diagnostics. The aims of this study were to investigate if balance and mobility may predict cognitive impairment 1 year after stroke. Methods: The participants were patients with first-ever stroke or transient ischaemic attack (TIA). The exclusion criteria were pre-stroke cognitive impairment and dementia. Measurements of balance comprised the Berg Balance Scale (BBS) and the Figure of Eight test (Fig8). Mobility was measured by maximum walking speed and the Timed Up and Go test. Dementia and mild cognitive impairment were merged into a main outcome: cognitive impairment. Unadjusted and adjusted multivariate logistic regression models were performed. Results: One hundred and eighty subjects performed balance and mobility measures at baseline, and 158 participated in the follow-up; 13 died and 9 did not complete the follow-up. Two variables made a significant contribution in the adjusted analyses (Fig8, BBS). The strongest predictor of cognitive impairment was Fig8 with an odds ratio of 1.06. Conclusion: The results of Fig8 and BBS measured in the acute phase of stroke were predictors of cognitive impairment 1 year later in this cohort of first-ever stroke or TIA.

Cognitive-Behavioural Problem Solving in the Treatment of Patients who Repeatedly Attempt Suicide a Controlled Trial

1990 ◽  
Vol 157 (6) ◽  
pp. 871-876 ◽  
Author(s):  
Paul M. Salkovskis ◽  
Chris Atha ◽  
David Storer
Keyword(s):  
Problem Solving ◽  
High Risk ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Behavioural Problem ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
One Year

In a controlled trial, 20 patients at high risk of repeated suicide attempts were randomly allocated to either cognitive-behavioural problem solving or a ‘treatment-as-usual’ control condition. The group practising problem solving improved significantly more than controls on ratings of depression, hopelessness, suicidal ideation and target problems at the end of treatment and at follow-up of up to one year, and there was evidence of an effect on the rates of repetition over the six months after treatment.

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