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Alatawi SF. CLINICIANS' PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY. JOURNAL OF REHABILITATION MEDICINE. CLINICAL COMMUNICATIONS 2024; 7:23836. [PMID: 38645271 PMCID: PMC11031868 DOI: 10.2340/jrmcc.v7.23836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/11/2023] [Indexed: 04/23/2024]
Abstract
Objectives The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke. Design A qualitative focus group study. Methods Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed. Results Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, "The application of handling in stroke rehabilitation" includes clinical reasoning and real-world handling practices. The second theme, "Physical Effects on Therapists," examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, "Conflicts among health care professionals," investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists. Conclusion The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals' perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders.
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Affiliation(s)
- Salem F Alatawi
- From the Department of Health Rehabilitation Science, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk City, Kingdom of Saudi Arabia
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Kuciel M, Rutkowski S, Szary P, Kiper P, Rutkowska A. Effect of PNF and NDT Bobath Concepts on Ischemic Strokes Patients for Trunk Rehabilitation – A Randomized Pilot Study. REHABILITACJA MEDYCZNA 2021. [DOI: 10.5604/01.3001.0015.2537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Recently, various systematic reviews and evidence-based clinical practice guidelines have evaluated the efficacy of stroke rehabilitation interventions. Across them proprioceptive neuromuscular facilitation (PNF) and neuro-developmental treatment (NDT) Bobath resulted to be an effective and widely used therapeutic approaches.
Objective of the work: The aim of the study was to evaluate the therapeutic effectiveness of PNF and NDT Bobath concept for improvement of trunk motor control in patients after ischemic stroke.
Materials and methods: The study consisted of 30 patients up to 3 months after ischemic stroke. Participants were randomly assigned to two study groups. Both group consisted of 15 patients underwent rehabilitation according to the PNF or NDT Bobath concept. Comparison of the changes in the Trunk Impairment Scale was the primary outcome.
Results: The analysis of the values of total TIS scale showed a statistically significant improvement in both group. Within group analysis showed statistical significance among baseline and intermediate measurement, and among baseline and final measurement within both groups. The analysis of total TIS scale indicators between the PNF and Bobath groups showed no statistically significant differences.
Conclusions: Both the PNF and Bobath concepts have proven to be effective in the treatment of posture control and there have been significant improvements in patients from both groups.
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Affiliation(s)
- Michał Kuciel
- Department of Nurorehabilitation of the Public Hospital in Chrzanów, Poland
| | - Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Patryk Szary
- Student scientific circle Descartes' Error, Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Paweł Kiper
- Laboratory of Neurorehabilitation Technologies, Fondazione Ospedale San Camillo IRCCS, Venice, Italy
| | - Anna Rutkowska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
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Buccellato KH, Nordstrom M, Murphy JM, Burdea GC, Polistico K, House G, Kim N, Grampurohit N, Sorensen J, Isaacson BM, Pasquina PF. A Randomized Feasibility Trial of a Novel, Integrative, and Intensive Virtual Rehabilitation Program for Service Members Post-Acquired Brain Injury. Mil Med 2019; 185:e203-e211. [DOI: 10.1093/milmed/usz150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the “signature” injury of recent U.S. military conflicts in Iraq and Afghanistan – affecting approximately 380,000 service members from 2000 to 2017; whereas CVA has been estimated to effect 795,000 individuals each year in the United States. TBI and CVA often present with similar motor, cognitive, and emotional deficits; therefore the treatment interventions for both often overlap. The Defense Health Agency and Veterans Health Administration would benefit from enhanced rehabilitation solutions to treat deficits resulting from acquired brain injuries (ABI), including both TBI and CVA. The purpose of this study was to evaluate the feasibility of implementing a novel, integrative, and intensive virtual rehabilitation system for treating symptoms of ABI in an outpatient clinic. The secondary aim was to evaluate the system’s clinical effectiveness.
Materials and Methods
Military healthcare beneficiaries with ABI diagnoses completed a 6-week randomized feasibility study of the BrightBrainer Virtual Rehabilitation (BBVR) system in an outpatient military hospital clinic. Twenty-six candidates were screened, consented and randomized, 21 of whom completed the study. The BBVR system is an experimental adjunct ABI therapy program which utilizes virtual reality and repetitive bilateral upper extremity training. Four self-report questionnaires measured participant and provider acceptance of the system. Seven clinical outcomes included the Fugl-Meyer Assessment of Upper Extremity, Box and Blocks Test, Jebsen-Taylor Hand Function Test, Automated Neuropsychological Assessment Metrics, Neurobehavioral Symptom Inventory, Quick Inventory of Depressive Symptomatology-Self-Report, and Post Traumatic Stress Disorder Checklist- Civilian Version. The statistical analyses used bootstrapping, non-parametric statistics, and multilevel/hierarchical modeling as appropriate. This research was approved by the Walter Reed National Military Medical Center and Uniformed Services University of the Health Sciences Institutional Review Boards.
Results
All of the participants and providers reported moderate to high levels of utility, ease of use and satisfaction with the BBVR system (x̄ = 73–86%). Adjunct therapy with the BBVR system trended towards statistical significance for the measure of cognitive function (ANAM [x̄ = −1.07, 95% CI −2.27 to 0.13, p = 0.074]); however, none of the other effects approached significance.
Conclusion
This research provides evidence for the feasibility of implementing the BBVR system into an outpatient military setting for treatment of ABI symptoms. It is believed these data justify conducting a larger, randomized trial of the clinical effectiveness of the BBVR system.
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Affiliation(s)
- Kiara H Buccellato
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Michelle Nordstrom
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD
| | - Justin M Murphy
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Grigore C Burdea
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Kevin Polistico
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Gregory House
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Nam Kim
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | | | - Jeff Sorensen
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Brad M Isaacson
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- The Geneva Foundation, 917 Pacific Ave, Tacoma, WA
| | - Paul F Pasquina
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD
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