Disability and rehabilitation
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After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity. ⋯ Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental context and resources and social influences were the mostly commonly report influences on stroke survivors' perceived barriers and facilitators to physical activity.
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Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. ⋯ Stroke patients think about goals very differently from health professionals. Individual patients have diverse ideas about goals within the context of the uncertainty of stroke, their life as a whole and recovery after formal rehabilitation is completed. To meet these diverse needs, health professionals need to communicate fully with patients to gain an understanding of their experiences of stroke and wider views on goals.
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To determine the predictive value of age, stroke severity and caregiver availability for discharge destination of individuals with severe stroke following inpatient rehabilitation. ⋯ Age, admission FIM® and caregiver availability were significant predictors of post-rehabilitation discharge destination. Results of this study suggest that for individuals with severe stroke, discharge home is unlikely in the absence of an available caregiver. Implications for Rehabilitation Age, stroke severity at admission and the availability of a caregiver play an important role in determining post rehabilitation discharge destination of individuals with severe stroke. These factors must be considered to assist with appropriate goal setting and discharge planning during inpatient rehabilitation.
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To explore the perceptions of people with low back pain (LBP) treated within the Spanish National Health Service, and their experience while undergoing a new evidence-based treatment ("neuroreflexotherapy"). ⋯ Southern European LBP patients have similar perceptions to those in other cultural settings. LBP jeopardizes patients' QoL and self-esteem. When pain improves significantly, patients are happy to acknowledge it and resume their normal life. Implications for Rehabilitation People with low back pain (LBP) want to be treated with respect and empathy by clinicians who inspire confidence and refrain from judging them. When faced with a new evidence based treatment, people with subacute and chronic LBP are hopeful, but apprehensive. Most of those who experience a clinically meaningful improvement after treatment are happy to acknowledge it and resume an active and fulfilling life. People who report no improvements after being treated, should be believed.
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Patients with a neuromuscular disease (NMD) can present with dysarthria and/or dysphagia. Literature regarding prevalence rates of dysarthria and dysphagia is scarce. The purpose of this study was to determine prevalence rates, severity and co-presence of dysarthria and dysphagia in adult patients with NMD. ⋯ The prevalence rates of dysarthria and dysphagia among patients with various types of NMD are high. Physicians should therefore be aware of this prevalence and consider referring NMD patients to a speech-language pathologist. IMPLICATONS OF REHABILITATION: Both dysarthria and dysphagia are highly prevalent among patients with neuromuscular diseases; moreover, although often mild, these disorders can occur relatively early in the course of the disease. Clinicians should routinely check for signs and symptoms related to dysarthria and/or dysphagia in patients who present with a neuromuscular disease, preferably using standardised instruments.