Developing a minimum data set for stroke patients assessment: the " Protocollo di Minima per l'Ictus (PMIC) as a starting point towards an Italian stroke registry.
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AIM: The complex nature of stroke sequelae requires several assessment instruments to quantify correctly every residual symptom. As there was no general consensus on stroke evaluation among Italian Physiatrists, in 2004 the Italian Society of Physical Medicine and Rehabilitation and S. Lucia Foundation (a Scientific Institute for hospitalization and treatment) established a Project Group to propose a standardized assessment tool (''Protocollo di Minima per l'Ictus PMIC'') for acute, post-acute and community-living stroke patients. This tool aimed to be easy to use and comprehensive of all the elements necessary for accurately address the great range of different rehabilitation needs. The objective was to provide physiatrists with a standard assessment battery and to make prognostic factors available on large community samples. METHODS: From end 2004 to early 2006, the Project Group examined literature data on stroke assessment, prognostic factors and outcome and selected the specific data elements to be included in a data collection tool. RESULTS: A consensus was reached on a ''minimum'' core set of data. This protocol was peer submitted in early 2006, to test the burden of data collection, and to allow modifications and adjustments. Specific forms (file to download) for data collection and database to be shared (a dedicated ''Client'' software) are now freely offered by the Project Group for data collection. CONCLUSION: PMIC is an evaluation procedure manageable in every-day practice and in every setting, a quick screening instrument that, given its large diffusion, can be expanded from a National Database into a National Rehabilitation Stroke Registry. (+info)
Developing research capacity in human functioning and rehabilitation research from the comprehensive perspective based on the ICF-model.
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With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here the authors will summarize approaches to address these challenges with respect to three areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programs and the building of university centres and collaboration networks. (+info)
Effect of treatment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation) on breast tissue and pain in patients with secondary breast lymphoedema.
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Best research evidence for physical medicine and rehabilitation.
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Evidence-based medicine is a strong movement in this century, and randomized clinical trials continue to be the best level of evidence for establishing cause-effect relationships between treatment interventions and outcomes. The field of physical medicine and rehabilitation has many excellent research questions on the effects of treatment but seems to rely mostly on weak observational methods (eg, chart review, case series, and single-group designs) for answers. This paper highlights 3 basic and relatively simple principles of good experimental design: control, randomization, and replication that were developed by R. A. Fisher for large, complex, agricultural field trials. The principles diffused readily into many scientific arenas, and Fisher even applied the principles in his backyard studies into Mendelian genetics. The thoughts of R. A. Fisher, arguably the most influential statistician of the 20th century, on the promise and challenges of randomized clinical trials in medicine should motivate rehabilitation clinicians to do their own small-scale controlled trials, with Institutional Review Board approval, when faced with equally realistic and plausible treatment options for their patients. (+info)
Les Annales de Readaptation et de Medecine Physique publication in 2008.
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In 2008 the European Society of Physical and Rehabilitation Medicine (ESPRM) established a network of European journal and promoted collaboration among the European Physical and Rehabilitation Medicine (PRM) journals. In this connection, the authors present here the articles published in the Annales de Readaptation et Medecine Physique in 2008. In the same time, the European Journal presents in the Annales de Readaptation et Medecine Physique its main articles of year 2008. The papers published in the Annales de Readaptation et Medecine Physique in 2008 were reviewed, classified by topics and discussed. Sixty-four papers are described, with a coverage of all the fields of PRM, from childhood to elderly, from basic science to clinical research, from case studies to epidemiological works. The aim of this paper was to provide physiatrists with some articles of the Annales de Readaptation et Medecine Physique related to their working condition. Next year, the name of our journal will become Annals of Physical and Rehabilitation Medicine, as most of the articles will be published in French and in English, with the hope that more and more European authors and readers will find it more convenient. (+info)
EJPRM systematic continuous update on Cochrane reviews in rehabilitation: news from the 4th Issue 2008.
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AIM: In 2007 a systematic review about the rehabilitation contents of the Cochrane Collaboration was published. That review was then continuously updated by systematically searching the new papers published in every Cochrane Issue. The aim of the present paper was to systematically review all the rehabilitation papers published in the 4th Issue of 2008 from the Cochrane Library. METHODS: The author systematically searched all the paper of rehabilitative interest from the 4th Issue 2008 of the Cochrane Library. The papers have been divided in 3 groups: new reviews, updated reviews and protocols. Each group have been then divided in subgroups on the base of the topic. RESULTS: The number of included papers was 27, including 7 new reviews, 11 updated reviews and 9 protocols. About updated reviews, 4 reviews changed conclusions on the base of the most recent RCTs. CONCLUSIONS: The Cochrane Collaboration and its product, the Cochrane Library are really relevant instruments to improve evidence-based medicine (EBM) in medical practice and thus also in the rehabilitation field. The present paper can help REHABILITATION SPECIALISTS to easily retrieve the conclusions of the most relevant and updated reviews in order to change their clinical practice in a more rapid and effective way. (+info)
The practice of physical medicine and rehabilitation in subSaharan Africa and Antarctica: a white paper or a black mark?
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AIM: The medical specialty of physical medicine and rehabilitation (PM&R) has had a proven impact on persons with disability and on healthcare systems. Documents such as The White Book on Physical and Rehabilitation Medicine in Europe have been important in defining the scope of practice within various regions. However on some continents the practice has not been well defined. The aim of this paper was to explore the practice of PM&R in subSaharan Africa and Antarctica. METHODS: Medline searches, membership data searches, fax survey of medical schools, Internet searches, and interviews with experts. RESULTS: The continents are dissimilar in terms of climate and government; However, both Antarctica and subSaharan Africa have no PM&R training programs, no professional organizations, no specialty board requirements, and no practicing physicians in the field. Since there are no known disabled children on Antarctica and adults are airlifted to world-class health care, the consequences of this deficit are minimal there. However the 788,000,000 permanent residents of subSaharan Africa including approximately 78 million persons with disability are left unserved. CONCLUSIONS: Antarctica is doing fine. Africa is in a crisis. Local medical schools, hospitals doctors, and persons with disability; along with foreign volunteers, aid groups, and policymakers can impact the crisis. However government specifically national ministries of health is ultimately responsible for the health and wellbeing of citizens. (+info)
Adopting new technologies in stroke rehabilitation: the influence of the US health care system.
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Stroke rehabilitation is entering a new era of technological innovation, including the development of robotic aids for therapy, peripheral electrical stimulation devices, and brain stimulation systems. These technologies have the potential to significantly improve the efficiency and efficacy of stroke rehabilitation. The United States health care system creates both opportunities for new technologies to be created and adopted, as well as important barriers. Inadequate support of clinical trials of the efficacy of new non-invasive devices is a particular concern for practitioners seeking to determine if new devices are clinically useful. Government support of clinical trials of efficacy, coupled with reform of FDA approval processes for novel therapies, is needed to create an evidence-based approach to improving stroke rehabilitation. (+info)