Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jan 2014
ReviewCommunity integration after traumatic brain injury: a systematic review of the clinical implications of measurement and service provision for older adults.
To explore the scope, reliability, and validity of community integration measures for older adults after traumatic brain injury (TBI). ⋯ Enhancing integration of older adults after TBI into their community of choice, with particular emphasis on social integration and quality of life, should be a primary rehabilitation goal. However, more research is needed to inform best practice guidelines to meet the needs of this growing TBI population. It is recommended that subjective tools, such as quality of life measures, are used in conjunction with well-established community integration measures, such as the CIQ, during the assessment process.
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Arch Phys Med Rehabil · Jan 2014
Review Meta AnalysisEconomic evaluation of adult rehabilitation: a systematic review and meta-analysis of randomized controlled trials in a variety of settings.
To report if there is a difference in costs from a societal perspective between adults receiving rehabilitation in an inpatient rehabilitation setting versus an alternative setting. If there are cost differences, to report whether opting for the least expensive program setting adversely affects patient outcomes. ⋯ Based on this systematic review and meta-analyses, a single rehabilitation service may not provide health economic benefits for all patient groups and situations. For some patients, inpatient rehabilitation may be the most cost-effective method of providing rehabilitation; yet, for other patients, rehabilitation in the home or community may be the most cost-effective model of care. To achieve cost-effective outcomes, the ideal combination of rehabilitation services and patient inclusion criteria, as well as further data for nonstroke populations, warrants further research.
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Arch Phys Med Rehabil · Jan 2014
Review Meta AnalysisPain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis.
To conduct a systematic review and meta-analysis to establish the association between pain and falls in community-dwelling older adults. ⋯ Community-dwelling older adults with pain were more likely to have fallen in the past 12 months and to fall again in the future. Foot and chronic pain were particularly strong risk factors for falls, and clinicians should routinely inquire about these when completing falls risk assessments.
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Arch Phys Med Rehabil · Jan 2014
Multicenter StudySymptom burden and comorbidities impact the consistency of responses on patient-reported functional outcomes.
To assess the influence of symptom intensity, mood, and comorbidities on patient-clinician agreement and the consistency of responses to functional patient-reported outcomes (PROs). ⋯ Pain intensity is associated with disagreement between patients and clinicians about the patient's level of functioning. Moreover, physical symptoms (pain, dyspnea, fatigue) as well as specific medical comorbidities (musculoskeletal disorders, coronary artery disease), but not mood, are associated with inconsistency in patients' assessment of their functional abilities.
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Arch Phys Med Rehabil · Jan 2014
Comparative StudyComparison of the Utrecht Scale for Evaluation of Rehabilitation-Participation with the ICF Measure of Participation and Activities Screener and the WHO Disability Assessment Schedule II in persons with spinal cord injury.
To validate the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in persons with spinal cord injury (SCI) using 2 International Classification of Functioning, Disability and Health (ICF)-based instruments: the ICF Measure of Participation and Activities-Screener (IMPACT-S) and the World Health Organization Disability Assessment Schedule II (WHODAS II). ⋯ The USER-Participation showed generally satisfactory psychometric properties in Dutch persons with long-term SCI living in the community. The IMPACT-S showed the best psychometric properties, and the WHODAS II showed less favorable results. Future research on the USER-Participation should focus on validation in other languages and different diagnostic groups.