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Gärtner HS, Shabnam J, Aagesen M, Guldin MB, Vind AB, Marsaa K, Bergenholtz HM, Graven V, Sampedro Pilegaard M, Thuesen J. Combined rehabilitation and palliative care interventions for patients with life-threatening diseases - PREGOAL. A scoping review of intervention programme goals. Disabil Rehabil 2024; 46:2989-2998. [PMID: 37580981 DOI: 10.1080/09638288.2023.2246373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE WHO recommends integrating rehabilitation into palliative care when providing services for people with life-threatening conditions. Recently, there has been increasing interest in exploring how rehabilitation and palliative care approaches could be combined. The aim of this study was to map and discuss the goals of intervention programmes that combine rehabilitation and palliative care. METHODS A scoping review was performed. The electronic databases MEDLINE, EMBASE, and CINAHL were searched for papers published between January 2014 and September 2022. Papers were considered eligible if the participants in question had a life-threatening disease and if interventions included both rehabilitation and palliative care. All study types were included. RESULTS Ten papers describing five interventions were included. Qualitative goals were narratively described, and quantitative goals were analysed according to the International Classification of Functioning, Disability and Health, and the Total Pain framework. Findings showed an overall focus on functioning and quality of life. Further analysis indicated an emphasis on physical and psychological dimensions. Social participation, and the social and spiritual dimensions were rarely evaluated. CONCLUSION This review indicates that goals relative to social participation, the social and spiritual dimensions, and the patient's own goals may well be overlooked as points of orientation for interventions.
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Affiliation(s)
- Henriette Søby Gärtner
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jahan Shabnam
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Public Health, Aarhus University, Aarhus, Denmark
| | - Ane Bonnerup Vind
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristoffer Marsaa
- North Zealand Hospital, University of Copenhagen, Kobenhavn, Denmark
| | - Heidi Maria Bergenholtz
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Zealand University Hospital, Research Support Unit, Koge, Denmark
| | - Vibeke Graven
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marc Sampedro Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
| | - Jette Thuesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Irrgang S, Himmelhaus S, Allek K, Debecker I, Gemperli A, Kynast K, von Reumont A, Scheel-Sailer A. Assessments and interventions on body functions, structures and activity to prepare adults with acute spinal cord injury or disease for participation: a scoping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1272682. [PMID: 38601217 PMCID: PMC11004486 DOI: 10.3389/fresc.2024.1272682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024]
Abstract
Introduction In the acute phase after a spinal cord injury or disease (SCI/D), various therapeutic assessments and interventions are applied with the goal of restoring structures, preventing complications and preparing the patient as best as possible for further activity and finally participation. The goal was to identify and evaluate the available evidence on assessments and interventions for body functions and structures to prepare adults with acute spinal cord SCI/D for activity and participation during the first 14 days. Methods A scoping review was conducted. The search was performed on June 19, 2023 using the databases PubMed, PEDro, Cochrane library and Embase. These were screened for studies including patients with acute SCI/D and physiotherapeutic or occupational therapy assessments and interventions. Only studies in English or German published between 2012 and 2023 were included. Results Twelve publications met the inclusion criteria, namely three systematic reviews, two randomized controlled trials, two observational studies and five clinical practice guidelines. Assessments as the Spinal Cord Independence Measure, as well as exercises such as daily passive mobilization of body structures against contractures were used in the entire population, while others were only applied in subgroups of SCI/D such as the Graded Redefined Assessment of Strength, Sensation and Prehension or functional electrical stimulation with and without additional movements. The methodological quality of the studies found varied greatly from good to very poor. Discussion Heterogeneity in research design and study population as well as lack of high-quality studies do not cover the standard of clinical management in the acute phase and further comprehensive research is needed.
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Affiliation(s)
- Sophie Irrgang
- Health Services and Clinical Care Group, Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sandra Himmelhaus
- Health Services and Clinical Care Group, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Kirstin Allek
- Spinal Cord Injury Center, Zentralklinik Bad Berka, Bad Berka, Germany
| | | | - Armin Gemperli
- Health Services and Clinical Care Group, Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Karen Kynast
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne von Reumont
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Anke Scheel-Sailer
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Center, Nottwil, Switzerland
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Nayiga BK, Abrams SW, Rhayel A, Edward H, Tang A, Kho ME, Sebestien H, Smith-Turchyn J. Exploring the use of rehabilitation in individuals with head and neck cancer undergoing treatment: a scoping review. Disabil Rehabil 2024:1-21. [PMID: 38494954 DOI: 10.1080/09638288.2024.2328810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
Explore the use, characteristics, feasibility, and functional outcomes of rehabilitation interventions used for individuals with head and neck cancer (HNC) during treatment. Searches were conducted in four databases from Jan 2011 to Dec 31, 2022. Included studies had to include adults with HNC undergoing treatment, a rehabilitation intervention, an assessment of functional outcome(s) addressed by the International Classification of Functioning Framework (ICF) and be published in English language. Title and abstract screening, full-text review, and data extraction were completed independently, in duplicate. Descriptive statistics and a qualitative synthesis summarized findings. Twenty-seven studies were included in this review. The majority of studies were randomized controlled trials (70%). Most individuals represented in the included studies were males (92% of all participants) between 50 and 60 years of age. Interventions led by a speech language pathologist (33%) were most commonly described. Sixteen studies (59%) described primary outcomes that fit the ICF "impairment" domain. We identified few studies that explored the use, feasibility, and effectiveness of rehabilitation interventions for individuals with HNC during treatment. Future research should assess the effectiveness of rehabilitation interventions on functional outcomes beyond the ICF body function and structure domain.
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Affiliation(s)
- Brenda Kibuka Nayiga
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Sophia Werden Abrams
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashwak Rhayel
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Holly Edward
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Michelle E Kho
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Hotte Sebestien
- Department of Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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4
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Seijas V, Maritz R, Mishra S, Bernard RM, Fernandes P, Lorenz V, Machado B, Posada AM, Lugo-Agudelo LH, Bickenbach J, Sabariego C. Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models. BMC Health Serv Res 2024; 24:123. [PMID: 38263183 PMCID: PMC10804573 DOI: 10.1186/s12913-023-10387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. METHODS We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. RESULTS We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. CONCLUSIONS We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.
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Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland.
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Satish Mishra
- Disability, Rehabilitation, Palliative and Long-Term Care, Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, WHO Regional Office for Europe, UN City, Marmorvej 51, Copenhagen, 2100, Denmark
| | - Renaldo M Bernard
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, R. XV de Novembro, 1299 - Centro, Curitiba, PR, 80060-000, Brasil
| | - Viola Lorenz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Barbara Machado
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Ana María Posada
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Luz Helena Lugo-Agudelo
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
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Janssen DJA, Bajwah S, Boon MH, Coleman C, Currow DC, Devillers A, Vandendungen C, Ekström M, Flewett R, Greenley S, Guldin MB, Jácome C, Johnson MJ, Kurita GP, Maddocks M, Marques A, Pinnock H, Simon ST, Tonia T, Marsaa K. European Respiratory Society clinical practice guideline: palliative care for people with COPD or interstitial lung disease. Eur Respir J 2023; 62:2202014. [PMID: 37290789 DOI: 10.1183/13993003.02014-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/06/2023] [Indexed: 06/10/2023]
Abstract
There is increased awareness of palliative care needs in people with COPD or interstitial lung disease (ILD). This European Respiratory Society (ERS) task force aimed to provide recommendations for initiation and integration of palliative care into the respiratory care of adult people with COPD or ILD. The ERS task force consisted of 20 members, including representatives of people with COPD or ILD and informal caregivers. Eight questions were formulated, four in the Population, Intervention, Comparison, Outcome format. These were addressed with full systematic reviews and application of Grading of Recommendations Assessment, Development and Evaluation for assessing the evidence. Four additional questions were addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. The following definition of palliative care for people with COPD or ILD was agreed. A holistic and multidisciplinary person-centred approach aiming to control symptoms and improve quality of life of people with serious health-related suffering because of COPD or ILD, and to support their informal caregivers. Recommendations were made regarding people with COPD or ILD and their informal caregivers: to consider palliative care when physical, psychological, social or existential needs are identified through holistic needs assessment; to offer palliative care interventions, including support for informal caregivers, in accordance with such needs; to offer advance care planning in accordance with preferences; and to integrate palliative care into routine COPD and ILD care. Recommendations should be reconsidered as new evidence becomes available.
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Affiliation(s)
- Daisy J A Janssen
- Department of Research & Development, Ciro, Horn, The Netherlands
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sabrina Bajwah
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Michele Hilton Boon
- WiSE Centre for Economic Justice, Glasgow Caledonian University, Glasgow, UK
| | | | - David C Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Albert Devillers
- Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP), Rebecq, Belgium
| | - Chantal Vandendungen
- Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP), Rebecq, Belgium
| | - Magnus Ekström
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund, Sweden
| | | | - Sarah Greenley
- Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | | | - Cristina Jácome
- CINTESIS@RISE, Department of Community Medicine, Health Information and Decision, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Geana Paula Kurita
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Multidisciplinary Pain Centre, Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre and Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Steffen T Simon
- University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Cologne, Germany
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Kristoffer Marsaa
- Department of Multidisease, Nordsjaellands Hospital, University of Copenhagen, Copenhagen, Denmark
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Zampogna E, Ferriero G, Visca D, Patrini M, Negrini S, Arienti C. An overview of Cochrane systematic reviews for pulmonary rehabilitation interventions in people with chronic obstructive pulmonary disease: a mapping synthesis. Panminerva Med 2023; 65:234-243. [PMID: 35904775 DOI: 10.23736/s0031-0808.22.04757-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
INTRODUCTION There is a global unmet need for rehabilitation to meet which the World Health Organization, in collaboration with Cochrane Rehabilitation, is developing the Package of Interventions for Rehabilitation with the aim of identifying rehabilitation interventions relevant to a range of key health conditions, including chronic obstructive pulmonary disease (COPD). The purpose of this paper is to describe the best available evidence on pulmonary rehabilitation interventions for people with COPD. EVIDENCE ACQUISITION An Overview of Cochrane Systematic Reviews (CSRs). Through the search strategy, COPD-related systematic reviews published from January 2009 to November 2021 were identified. Data were extracted on each reported outcome related to an intervention and judgements about the quality of evidence were made, using the GRADE approach. EVIDENCE SYNTHESIS Seventeen reviews were analyzed, for a total of 314 primary studies that included 22,206 participants. CSRs provided information on the effectiveness of rehabilitation on functioning, activity, quality of life, anxiety, depression, mortality, and health care resource utilization. CONCLUSIONS Our findings report that comprehensive pulmonary rehabilitation programs and water exercises improve the exercise capacity and quality of life (QoL) in people with COPD. Different exercise modalities, intensities, and settings for different muscle groups, breathing exercises, and counseling can improve exercise capacity, QoL, dyspnea, hospitalizations, and physical activity. It is uncertain whether breathing exercise, low-intensity exercise, neuromuscular electrical stimulation, and psychological intervention have an effect on exercise capacity, dyspnea, QoL, and physical activity. The protocol was registered on OSF (registration DOI: 10.17605/OSF.IO/8A26Q).
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Affiliation(s)
- Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
| | - Giorgio Ferriero
- Unit of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese Como, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | | | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy -
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
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Fehrmann E, Ebenbichler G, Tüchler K, Habenicht R, Mair P, Fischer-Grote L, Hasenbring M, Kienbacher T. Do the WHO-ICF personal factors "age" and "sex" impact limited activity and restricted participation category profiles differently between younger and older women and men in multimodal chronic back pain rehabilitation? Disabil Rehabil 2023; 45:41-50. [PMID: 35040736 DOI: 10.1080/09638288.2021.2023665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To investigate if the International Classification of Functioning and Health (ICF) context factors "age" and "sex" would impact the disablement and respective improvement with rehabilitation defined with the ICF core set for chronic low back pain (cLBP). Furthermore, associations between limitations/restrictions and measures of body function or quality of life were of interest. MATERIALS AND METHODS One thousand five hundred and twelve employed cLBP patients who completed 6 months of outpatient rehabilitation and for whom complete assessments were available before and after rehabilitation. Rehabilitation comprised of progressive resistance training, psychological counseling, and educational sessions. Main outcome measures were the ICF-activity/participation core categories automatically predicted from random forests and utilizing information from the Roland Morris Disability Questionnaire and Pain Disability Index. RESULTS Generalized linear-mixed models revealed that upon completion of rehabilitation the presence of a limitation within the ICF activity "walking" significantly decreased with significant between-group differences. The category "doing housework" demonstrated gender-specific differences, and both gender- and age-specific differences were observed for work-related participation categories. There were no meaningful associations between ICF limitation/restriction categories and body function measures (point-biserial/Spearman's correlations). CONCLUSIONS The personal factors "age" and "sex" impact some ICF limitation/restriction categories in cLBP; appropriately addressing these personal features could further improve phase III rehabilitation outcome.Implications for rehabilitationConsistent with calls to explore the age and sex/gender influence on health and disease, little is known how these factors affect the disablement of individuals with chronic back pain.The factors "age" and "sex" drive differences in some categories within the ICF activity/restriction categories.If age- and gender-specific features in activities and participation are not appropriately addressed through interventions, rehabilitation outcome may remain suboptimal in cLBP.
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Affiliation(s)
- Elisabeth Fehrmann
- Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria.,Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Krems, Austria
| | - Gerold Ebenbichler
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna Medical University, Vienna, Austria
| | - Kerstin Tüchler
- Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria
| | - Richard Habenicht
- Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Linda Fischer-Grote
- Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria
| | - Monika Hasenbring
- Department of Medical Psychology and Medical Sociology, Ruhr University of Bochum, Bochum, Germany.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Thomas Kienbacher
- Karl Landsteiner Institute of Outpatient Rehabilitation Research, Vienna, Austria
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Negrini S, Kiekens C, Cordani C, Arienti C, DE Groote W. Cochrane "evidence relevant to" rehabilitation of people with post COVID-19 condition. What it is and how it has been mapped to inform the development of the World Health Organization recommendations. Eur J Phys Rehabil Med 2022; 58:853-856. [PMID: 36468825 PMCID: PMC10077960 DOI: 10.23736/s1973-9087.22.07793-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cochrane Rehabilitation developed a series of actions to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. These initiatives constituted the REH-COVER (Rehabilitation COVID-19 evidence-based response) action. In March 2020, the first initiative started in agreement with the European Journal of Physical and Rehabilitation Medicine (EJPRM): the rapid systematic review of all papers relevant to COVID-19 rehabilitation to inform rehabilitation health professionals rapidly. Currently, we are facing the long-term consequences of COVID-19, initially called "long Covid" and now named post COVID-19 condition (PCC), which led to the request by the WHO Rehabilitation Programme for evidence synthesis to support the development of specific recommendations. Cochrane Rehabilitation provided the best available evidence from the REH-COVER rapid living systematic review results, a systematic scoping review on the models of care and a summary of "evidence relevant to" the rehabilitation for adults with PCC. Based on this evidence, expert groups developed the 16 recommendations for the rehabilitation of adults with PCC recently published in Chapter 24 of the WHO "Clinical management of COVID-19 living guideline." This paper aims to introduce the Special Section of EJPRM reporting the work performed by Cochrane Rehabilitation to produce a summary of the existing "evidence relevant to" the rehabilitation of adults with PCC. The paper reports the methodology (overview of systematic reviews with mapping) and introduces the concept of "evidence relevant to" rehabilitation.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | | | - Wouter DE Groote
- Rehabilitation Programme, Non-communicable Diseases Department, WHO, Geneva, Switzerland
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9
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Steensgaard R, Hundborg MO, Pallesen H, Aadal L. What is a meaningful life for persons with acquired neurological impairments? A scoping review protocol. PLoS One 2022; 17:e0269125. [PMID: 35709200 PMCID: PMC9202831 DOI: 10.1371/journal.pone.0269125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/13/2022] [Indexed: 12/04/2022] Open
Abstract
Objective This scoping review explores the constitution of a meaningful life as perceived by adults with acquired neurological impairment following an injury or a disease. Introduction A neurological injury or disease imposes extensive life changes on the affected person and his or her close relatives. Including the patients’ perception of a meaningful life is crucial to facilitate adjustment of any rehabilitation initiatives to the patients’ wishes, hopes, needs, and preferences. Even so, the descriptions and common traits of a meaningful life from the impaired person’s perspective are scarcely covered in the literature. Hence, a scoping review of existing knowledge is needed to facilitate quality rehabilitation and research initiatives. Inclusion criteria All studies, regardless of their design, are included provided they describe a meaningful life as considered or experienced by persons aged 18 years or more with neurological impairment. Methods A PICo framework defines the search algorithms used in the databases MEDLINE, Cinahl, PsycINFO and Embase. Using Covidence, the scoping review systematically organizes the identified articles to provide a broad description of the study phenomenon. Furthermore, titles, abstracts, and full-text articles are screened independently by two reviewers to determine if they meet the inclusion criteria. In case of disagreement, a third and fourth reviewer are consulted. The scoping will be reported according to the PRISMA- SCR checklist.
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Affiliation(s)
- Randi Steensgaard
- Knowledge Centre for Neurorehabilitation of Western Denmark, Roskilde, Denmark
- Spinal Cord Injury Centre of Western Denmark, Neurology, Central Regional Hospital, Viborg, Denmark
- * E-mail:
| | - Michele Offenbach Hundborg
- Knowledge Centre for Neurorehabilitation of Western Denmark, Roskilde, Denmark
- Specialised Center for Brain Injury, Central Denmark Region, Viborg, Denmark
| | - Hanne Pallesen
- Hammel Neurorehabilitation Centre and University Research Clinic, RM, University of Aarhus, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lena Aadal
- Hammel Neurorehabilitation Centre and University Research Clinic, RM, University of Aarhus, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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10
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Wang Y, Wang Z, Liu G, Wang Z, Wang Q, Yan Y, Wang J, Zhu Y, Gao W, Kan X, Zhang Z, Jia L, Pang X. Application of Serious Games in Health Care: Scoping Review and Bibliometric Analysis. Front Public Health 2022; 10:896974. [PMID: 35757619 PMCID: PMC9231462 DOI: 10.3389/fpubh.2022.896974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background Serious games (SGs) as one kind of intervention that can improve the level of knowledge and change behavior to affect health outcomes has been increasingly applied in health care. Objective Analyze hotspots and trends of the application of SGs in health care and provide reference and direction for further research in the future. Methods The Web of Science (WoS) Core Collection database was used for extracting the literature on SGs in health care for the period from the database established to 11 October, 2021. Scoping review and bibliometric analysis were used to deeply analyze and visualize countries, categories of studies, annual study output, cited authors, cited journals, cited articles, and keywords of healthcare field. Results A total of 1,322 articles were retrieved, then every articles' title and abstract were read one by one, and 795 articles were included after screening with an exponential increase in publication volume. The United States of America made the greatest contribution to global publications regarding SGs in health care. From the total, 20.8% of articles fall under the category of health care sciences services. The target groups were mainly concentrated in children (18.0%), youth (13.8%), the elderly (10.9%), adolescents (9.1%), and adults (3.4%). Baranowski T (n = 103 citations) is the most influential author, followed by Kato PM (n = 73 citations) and Desmet A (n = 58 citations). The top three cited journals were "Plos One" (n = 268 citations), "Games for Health Journal" (n = 209 citations), and "Journal of Medical Internet Research" (n = 197 citations), and the top three cited articles were "A meta-analysis of serious digital games for healthy lifestyle promotion," "A Systematic Review of Serious Games in Training Health Care Professionals," and "Video game training enhances cognitive control in older adults." More and more studies focus on specific age groups, such as children, adolescents, and the elderly. The research hotspots and trends included "rehabilitation," "medical education," and "design." Conclusions The application of SGs in health care remains important areas for future research. "Rehabilitation," "medical education," and "design" reflected the latest research hotpots and future trends.
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Affiliation(s)
- Yue Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhao Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guoqing Liu
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhangyi Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qinglong Wang
- Nursing Department, Tianjin Medical University Chu Hisen-I Memorial Hospital, Tianjin, China
| | - Yishan Yan
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Wang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yue Zhu
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Weijie Gao
- The School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiangling Kan
- Dean's Office, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhiguo Zhang
- The School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lixia Jia
- Dean's Office, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaoli Pang
- The School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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11
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Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T. Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation. Eur J Phys Rehabil Med 2022; 58:333-341. [PMID: 35306803 PMCID: PMC9980575 DOI: 10.23736/s1973-9087.22.07509-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: 1) support the conduct of primary studies and systematic reviews, and 2) identify relevant systematic reviews for knowledge translation purposes. We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement, refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks and 3 Cochrane Groups, and included invited experts, and representatives of low middle-income countries (LMICs) and consumers. We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range 5.5-50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework. We concluded that "In a health care context," rehabilitation is defined as a "multimodal, person-centered, collaborative process" (Intervention-general), including interventions targeting a person's "capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance" (Intervention-specific) with the goal of "optimizing" the "functioning" (Outcome) of "persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability" (Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a "rehabilitation intervention" as "any intervention provided within the rehabilitation process." We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale, " Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | | | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Luzern, Switzerland
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12
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Negrini S, Selb M, Kiekens C, Todhunter-Brown A, Arienti C, Stucki G, Meyer T. Rehabilitation Definition for Research Purposes. A Global Stakeholders' Initiative by Cochrane Rehabilitation. Neurorehabil Neural Repair 2022; 36:405-414. [PMID: 35574944 DOI: 10.1177/15459683221093587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: (1) support the conduct of primary studies and systematic reviews, and (2) identify relevant systematic reviews for knowledge translation purposes. We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings, and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement, refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks, and 3 Cochrane Groups, and included invited experts, and representatives of low middle-income countries and consumers. We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range 5.5-50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework. We concluded that "In a health care context," rehabilitation is defined as a "multimodal, person-centered, collaborative process" (Intervention-general), including interventions targeting a person's "capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance" (Intervention-specific) with the goal of "optimizing" the "functioning" (Outcome) of "persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability" (Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a "rehabilitation intervention" as "any intervention provided within the rehabilitation process." We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | | | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Luzern, Switzerland
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- Members are listed at the end of the paper
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13
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Momsen AMH, Fox JC, Nielsen CV, Thuesen J, Maribo T. Rehabilitation Research in Denmark Between 2001 and 2020: A Scoping Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:849216. [PMID: 36188956 PMCID: PMC9397721 DOI: 10.3389/fresc.2022.849216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
The demand for rehabilitation has increased, and evidence is rapidly growing; however, a rehabilitative health strategy receives less attention than treatment. Knowledge of what is being researched, who are the target groups and who contributes to rehabilitation research is deficient. We did not find any reviews mapping rehabilitation research regarding the research questions. The objective was to identify and synthesize existing scientific evidence on rehabilitation research published by Danish institutions between 2001 and 2021. The research questions to be explored were: Among which study groups has rehabilitation research been published?. Which types of studies on rehabilitation have been published?. Which institutions have been involved in rehabilitation research? Methods The process was guided according to the Joanna Briggs Institute's (JBI's) scoping review methodology. Four databases were searched. All types of peer-reviewed studies on any target group and rehabilitation setting, with any affiliation to a Danish institution, were eligible to be included. Studies referring to population and the type of design were categorized. Institutions were counted as Danish first authorship. Results The search revealed 3,100 studies, and following screening 1,779 were included. A total of 24 broad study groups were identified, mostly diagnosis-based health conditions. Musculoskeletal, cancer, and cardiac had 342, 228, and 174 studies, respectively. A total of 1,545 had a Danish first authorship, most of the Danish publications came from hospitals (56.6%) and universities (28.4%). The publication trend showed an almost linear development, with a 10-15% increase during the period. Conclusion Following screening 1,779 studies were included involving 24 broad study groups. Most categories were diagnosis-based; musculoskeletal, cancer, and cardiac health conditions encompassed most studies. All study designs were represented, and 1/10 were secondary studies. The majority (87%) of studies had a Danish first authorship. The majority of first affiliations were among hospitals followed by universities. A few municipalities were presented although they are yet to have research responsibility. Publication trends showed an increase primarily from 2013. Systematic Review Registration https://osf.io/, identifier [10.17605/OSF.IO/2AENX].
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Affiliation(s)
- Anne-Mette Hedeager Momsen
- DEFACTUM-Social and Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark
| | - Jasmine Charlotte Fox
- DEFACTUM-Social and Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- DEFACTUM-Social and Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Gødstrup Hospital, Herning, Denmark
| | - Jette Thuesen
- Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Odense University Hospital, Odense, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- Centre for Nutrition and Rehabilitation, Absalon University College, Sorø, Denmark
| | - Thomas Maribo
- DEFACTUM-Social and Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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14
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Timm H, Thuesen J, Clark D. Rehabilitation and palliative care: histories, dialectics and challenges. Wellcome Open Res 2022; 6:171. [PMID: 35118198 PMCID: PMC8790711 DOI: 10.12688/wellcomeopenres.16979.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 12/16/2022] Open
Abstract
Rehabilitation and palliative care are health care fields with separate histories but some recent convergences. Both have been identified as components within universal health coverage and each is the subject of a supportive World Health Assembly Resolution. We draw on the historiography of the two specialties, a recent systematic review of their engagement with each other as described in 62 studies, and critical policy perspectives to examine how rehabilitation and palliative care have been framed as potential partners in care. We examine the changing patient groups served by each field and the organizational forms that combined rehabilitation and palliative care (CRPC) may take. We explore the implications of such collaboration for the underlying goals and values of the two specialties, where each is the subject of changing definitions with differing responsibilities for regulating access to services as well as assuring and documenting quality. We conclude that to be effective CRPC must adapt to the highly segmented and specialized systems in which it is required to operate, recognizing that rehabilitation and palliative care are themselves co-constructors of such segmentation and specialization, but also potential agents for change.
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Affiliation(s)
- Helle Timm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, 1455, Denmark
| | - Jette Thuesen
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, 5800, Denmark
| | - David Clark
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, Scotland, DG2 OXY, UK
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15
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Negrini S, Levack WMM, Meyer T, Kiekens C. Why we need an internationally shared rehabilitation definition for clinical research purposes. Clin Rehabil 2021; 35:1657-1660. [PMID: 34461760 DOI: 10.1177/02692155211043215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Responding to a recent editorial arguing against defining rehabilitation, we discuss the reasons for developing a classification of rehabilitation for research purposes, its philosophical background and some of the possible risks. WHY DEFINE Science requires the definition and classification of phenomena to allow replication of experiments and studies, and to allow interpretation and use of the findings. As understanding increases, the definitions can be refined. Defining rehabilitation does run the risk of excluding some interventions or practices that are either considered rehabilitation (perhaps wrongly) or are rehabilitation interventions; when identified, these errors in definition can be remedied. Defining rehabilitation for research purposes should not inhibit but could (possibly) orient research. RISK OF NOT Without a definition, rehabilitation will remain in a permanent limbo. Experts will (apparently) know what it is, while others are left guessing or failing to comprehend or recognise it. This uncertainty may reassure some people, because all possible interventions are included; we argue that it downgrades the understanding of our field because interventions that are not rehabilitation are, nonetheless, called rehabilitation. In an era of international collaboration, and of undertaking systematic reviews with metanalysis, we need a shared definition. CONCLUSION Terminology is often controversial, but definition enables progress in understanding such that terms themselves can evolve over time.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University 'La Statale', Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Thorsten Meyer
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy
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16
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Abstract
The problem: Over 187 definitions of rehabilitation exist, none widely agreed or used. Why? The word: Words represent a core concept, with a penumbra of associated meanings. A word means what is agreed among those who use it. The precise meaning will vary between different groups. Words evolve, the meaning changing with use. Other words may capture some of the concepts or meanings. A definition: A definition is used to control the unstable, nebulous meaning of a word. It delineates, creating a boundary. A non-binary spectrum of meaning is transformed into binary categories: rehabilitation, or not rehabilitation. In clinical terms, it is a diagnostic test to identify rehabilitation. There are many different reasons for categorising something as rehabilitation. Each will need its own definition. Categorisation: The ability of a definition to distinguish cases accurately must be validated by comparison with ‘the truth’. If there were an external ‘true’ test to identify rehabilitation, a definition would not be needed. As with most concepts, the only truth is agreement by people familiar with the required distinction. Any definition will generate misclassification. People familiar with the required distinction will also need to resolve mis-categorisation. Description: An alternative is a ‘descriptive definition’, listing features over several domains which must be present. This fails logically. Rehabilitation is an emergent concept, more than the sum of its parts. Conclusion: A useful definition cannot be achieved because no definition will cover all needs, and a specific definition for a purpose will misclassify some cases.
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Affiliation(s)
- Derick T Wade
- Movement Science Group, Faculty of Health and Life Sciences, OxINMAHR, Oxford Brookes University, Oxford, UK
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17
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Trabacca A, Lucarelli E, Losito L. Moving towards precision neurological rehabilitation: a mandatory path to follow in the era of precision neurology. Neurol Sci 2021; 42:3889-3891. [PMID: 34046796 DOI: 10.1007/s10072-021-05349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Antonio Trabacca
- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Institute IRCCS "E. Medea", Ex Complesso Ospedaliero "A. Di Summa" - Piazza "A. Di Summa", 72100, Brindisi, Italy.
| | - Elisabetta Lucarelli
- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Institute IRCCS "E. Medea", Ex Complesso Ospedaliero "A. Di Summa" - Piazza "A. Di Summa", 72100, Brindisi, Italy
| | - Luciana Losito
- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Institute IRCCS "E. Medea", Ex Complesso Ospedaliero "A. Di Summa" - Piazza "A. Di Summa", 72100, Brindisi, Italy
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18
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Arienti C, Kiekens C, Bettinsoli R, Engkasan JP, Frischknecht R, Gimigliano F, Grubisic F, Howe T, Iannicelli V, Ilieva E, Lazzarini SG, Levack WM, Meyer T, Oral A, Patrini M, Pollini E, Rathore FA, Negrini S. Cochrane Rehabilitation: 2020 annual report. Eur J Phys Rehabil Med 2021; 57:303-308. [PMID: 33971699 DOI: 10.23736/s1973-9087.21.06877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During its fourth year of existence, Cochrane Rehabilitation went on to promote evidence-informed health decision-making in rehabilitation. In 2020, the outbreak of the COVID-19 pandemic has made it necessary to alter priorities. In these challenging times, Cochrane Rehabilitation has firstly changed its internal organisation and established a new relevant project in line with pandemic needs: the REH-COVER (Rehabilitation - COVID-19 evidence-based response) action. The aim was to focus on the timely collection, review and dissemination of summarised and synthesised evidence relating to COVID-19 and rehabilitation. Cochrane Rehabilitation REH-COVER action has included in 2020 five main initiatives: 1) rapid living systematic reviews on rehabilitation and COVID-19; 2) interactive living evidence map on rehabilitation and COVID-19; 3) definition of the research topics on "rehabilitation and COVID-19" in collaboration with the World Health Organization (WHO) rehabilitation programme; 4) Cochrane Library special collection on Coronavirus (COVID-19) rehabilitation; and 5) collaboration with COVID-END for the topics "rehabilitation" and "disability." Furthermore, we are still carrying on five different special projects: Be4rehab; RCTRACK; definition of rehabilitation for research purposes; ebook project; and a prioritization exercise for Cochrane Reviews production. The Review Working Area continued to identify and "tag" the rehabilitation-relevant reviews published in the Cochrane library; the Publication Working Area went on to publish Cochrane Corners, working more closely with the Cochrane Review Groups (CRGs) and Cochrane Networks, particularly with Cochrane Musculoskeletal, Oral, Skin and Sensory Network; the Education Working Area, the most damaged in 2020, tried to continue performing educational activities such as workshops in different online meetings; the Methodology Working Area organized the third and fourth Cochrane Rehabilitation Methodological (CRM) meetings respectively in Milan and Orlando; the Communication Working Area spread rehabilitation evidences through different channels and translated the contents in different languages.
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Affiliation(s)
| | - Carlotte Kiekens
- Montecatone Rehabilitation Institute SpA, Imola, Bologna, Italy.,University Hospitals Leuven - KU Leuven, Leuven, Belgium
| | | | - Julia P Engkasan
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rolf Frischknecht
- Honorary Consultant in Physical Medicine and Rehabilitation Center of Physical Medicine and Rehabilitation Lausanne University Hospital, Lausanne, Switzerland
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Frane Grubisic
- Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | | | | | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | | - Thorsten Meyer
- School of Public Health, University of Bielefeld, Bielefeld, Germany
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | - Farooq A Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi, Pakistan.,Bahria University Medical and Dental College, Karachi, Pakistan.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan "La Statale", Milan, Italy
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19
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Negrini S, Chan L, Ferriero G, Frontera WR, Heinemann AW. Current Evidence From the Randomized Controlled Trials Rehabilitation Checklist (RCTRACK) reporting guideline project. Arch Phys Med Rehabil 2021; 102:1665-1667. [PMID: 33991486 DOI: 10.1016/j.apmr.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Leighton Chan
- Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy; Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter R Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Allen W Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, and Shirley Ryan AbilityLab, Chicago, IL
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20
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Kiekens C, Meyer T, Selb M, Stucki G, Negrini S. Authors' reply to: Comment on the provisory definition of the term "Rehabilitation". Eur J Phys Rehabil Med 2021; 57:316-317. [PMID: 33619947 DOI: 10.23736/s1973-9087.21.06885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy
| | - Thorsten Meyer
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University La Statale, Milan, Italy - .,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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21
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Ebenbichler GR, Ammer K, Bochdansky T. Comment on a provisory definition of the term "Rehabilitation". Eur J Phys Rehabil Med 2021; 57:314-316. [PMID: 33565743 DOI: 10.23736/s1973-9087.21.06827-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gerold R Ebenbichler
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna Medical University, Vienna Austria -
| | - Kurt Ammer
- Faculty of Computing, Engineering and Science, University of South Wales, Pontypridd, UK
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22
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Negrini S, Chan L, Ferriero G, Frontera W, Heinemann A. Current evidence from the Randomized Controlled Trials Rehabilitation Checklist (RCTRACK) reporting guideline project. Eur J Phys Rehabil Med 2020; 56:787-789. [PMID: 33047946 PMCID: PMC8603787 DOI: 10.23736/s1973-9087.20.06635-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy -
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy -
| | - Leighton Chan
- Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
- Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, and Shirley Ryan AbilityLab, Chicago, IL, USA
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Miles A, Connor NP, Desai RV, Jadcherla S, Allen J, Brodsky M, Garand KL, Malandraki GA, McCulloch TM, Moss M, Murray J, Pulia M, Riquelme LF, Langmore SE. Dysphagia Care Across the Continuum: A Multidisciplinary Dysphagia Research Society Taskforce Report of Service-Delivery During the COVID-19 Global Pandemic. Dysphagia 2020; 36:170-182. [PMID: 32654059 PMCID: PMC7353832 DOI: 10.1007/s00455-020-10153-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
At the time of writing this paper, there are over 11 million reported cases of COVID-19 worldwide. Health professionals involved in dysphagia care are impacted by the COVID-19 pandemic in their day-to-day practices. Otolaryngologists, gastroenterologists, rehabilitation specialists, and speech-language pathologists are subject to virus exposure due to their proximity to the aerodigestive tract and reliance on aerosol-generating procedures in swallow assessments and interventions. Across the globe, professional societies and specialty associations are issuing recommendations about which procedures to use, when to use them, and how to reduce the risk of COVID-19 transmission during their use. Balancing safety for self, patients, and the public while maintaining adequate evidence-based dysphagia practices has become a significant challenge. This paper provides current evidence on COVID-19 transmission during commonly used dysphagia practices and provides recommendations for protection while conducting these procedures. The paper summarizes current understanding of dysphagia in patients with COVID-19 and draws on evidence for dysphagia interventions that can be provided without in-person consults and close proximity procedures including dysphagia screening and telehealth.
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Affiliation(s)
- Anna Miles
- The University of Auckland, Auckland, New Zealand. .,Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand.
| | - Nadine P Connor
- Communication Sciences & Disorders; Otolaryngology, Head and Neck Surgery, University of Wisconsin-Madison, Madison, USA
| | - Rinki Varindani Desai
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sudarshan Jadcherla
- Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jacqui Allen
- The University of Auckland, Auckland, New Zealand
| | - Martin Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Division of Pulmonary and Critical Care Medicine, Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Kendrea L Garand
- Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL, USA
| | - Georgia A Malandraki
- Speech, Language, and Hearing Sciences, and Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Timothy M McCulloch
- Otolaryngology, Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Marc Moss
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joseph Murray
- Audiology Speech Pathology Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Michael Pulia
- Emergency Care for Infectious Diseases (ECID) Research Program, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Luis F Riquelme
- New York Medical College, Valhalla, NY, USA.,Barrique Speech-Language Pathology, PC, Brooklyn, NY, USA
| | - Susan E Langmore
- Otolaryngology Head/Neck Surgery, Boston University School of Medicine, Boston, USA
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