Journal of Rehabilitation Research and Development最新文献

{"title":"Bodies in Motion","authors":"","doi":"10.2307/j.ctv13qfw9f.7","DOIUrl":"https://doi.org/10.2307/j.ctv13qfw9f.7","url":null,"abstract":"","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68775612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between symptoms and family relationships in Veterans with serious mental illness","authors":"Morgan Haselden, Sarah Piscitelli, Amy L. Drapalski, D. Medoff, S. Glynn, Amy N. Cohen, L. Dixon","doi":"10.1682/JRRD.2015.08.0158","DOIUrl":"https://doi.org/10.1682/JRRD.2015.08.0158","url":null,"abstract":"Little is known about how the symptoms experienced by individuals with serious mental illness (SMI) affect family relationships. This study assessed the association between symptoms and patient perceptions of family relationships. The sample of 226 outpatient Veterans diagnosed with SMI, whose relatives had low contact rates with treatment staff, was enrolled in a study that used shared decision making to consider family involvement in care. We analyzed baseline data using multiple regressions to understand the unique effect that positive, negative, and depressive symptoms have on perceptions of family relationships, including general functioning, problem solving, communication, support, satisfaction, conflict, and distress. Greater depressive and disorganized symptoms were significant, unique predictors of perceptions of poorer communication and problem solving, while higher levels of expressive negative symptoms—blunted affect, lack of spontaneity, and motor retardation—were unique predictors of better communication and problem solving. More depressive symptoms also significantly predicted perceptions of greater family conflict and distress. While we cannot assume causation, these associations underscore the important role of depression and expressive negative symptoms in adopting a family-centered approach in the care of persons with SMI. Clinical Trial Registration: ClinicalTrials.gov: “The effectiveness of FMPO in improving the quality of care for persons with severe mental illness”; NCT00466323; https://clinicaltrials.gov/ct2/show/NCT00466323","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.08.0158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67552000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Effects of Exposure to High-Intensity Blasts: Results of Tests of Central Auditory Processing","authors":"F. Gallun, M. Lewis, R. Folmer, Michele Hutter, Melissa A Papesh, H. Belding, M. Leek","doi":"10.1682/JRRD.2014.12.0313","DOIUrl":"https://doi.org/10.1682/JRRD.2014.12.0313","url":null,"abstract":"Clinical Trial Registration: ClinicalTrials.gov: \"Central auditory processing deficits associated with blast exposure\"; NCT01567020; https://clinicaltrials.gov/ct2/show/NCT01567020 INTRODUCTION For well over a decade, the U.S. military has been engaged in conflicts that have changed the nature of injury and survival among Veterans because of changes in weaponry, battle armor, and medical technology that have taken place over the course of the past 20 yr [1]. According to the Institute of Medicine (IOM), these changes have resulted in a ratio of wounded to dead soldiers of 9.7 to 1 for the Global War on Terror, in contrast to rates of 4.3 to 1 or lower for all wars preceding it in the history of the United States [1]. Both the increased reliance upon explosives and the higher survival rate have created a landscape of new questions that must be answered in order to provide the best medical care for Veterans. This is true for hearing healthcare as much as for any other area of medicine. In 2014, the IOM issued a report on the chronic effects of exposure to high-intensity blasts [1]. In a systematic review of the literature, the IOM report found that symptoms of hearing loss are often present following blast exposure [2-3]. The report went on to state that while peripheral auditory dysfunction is likely to persist even after other effects have diminished, there was \"inadequate\" evidence in the literature to answer the question of whether or not central auditory effects persist beyond a period of 6 mo after blast exposure. The current report was motivated by ongoing research in our laboratory that has revealed evidence of an association between remote high-intensity blast exposure and the ability to process auditory information. Previous reports have described the ways in which blast exposure could [4] and does [3] cause changes in the ability of listeners to perform on tests of central auditory processing measured within a year of blast exposure. Tasks upon which blast-exposed participants were most likely to perform poorly included those relying upon temporal pattern perception, auditory temporal resolution, binaural processing, and dichotic listening. In addition, it has been demonstrated [3] that these problems occur even when traditional audiometric test results and electrophysiological measures primarily assessing the auditory brainstem remain largely in the normal range. Furthermore, electrophysiological measures evaluating cortical function indicate that some of these same listeners show delayed and reduced peak amplitudes relative to the responses expected from young listeners with normal peripheral auditory function. This pattern is consistent with the hypothesis that blast exposure can cause damage to cortical areas responsible for auditory processing, as well as potentially damaging the connections among central auditory processing areas. Clinically, these patterns of dysfunction are unusual in younger listeners but have similarities with ","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67551908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based hand rehabilitation after chronic stroke: Randomized, controlled single-blind trial comparing the MusicGlove with a conventional exercise program.","authors":"Daniel K Zondervan,&nbsp;Nizan Friedman,&nbsp;Enoch Chang,&nbsp;Xing Zhao,&nbsp;Renee Augsburger,&nbsp;David J Reinkensmeyer,&nbsp;Steven C Cramer","doi":"10.1682/JRRD.2015.04.0057","DOIUrl":"https://doi.org/10.1682/JRRD.2015.04.0057","url":null,"abstract":"<p><strong>Unlabelled: </strong>Individuals with chronic stroke have limited options for hand rehabilitation at home. Here, we sought to determine the feasibility and efficacy of home-based MusicGlove therapy. Seventeen participants with moderate hand impairment in the chronic phase of stroke were randomized to 3 wk of home-based exercise with either the MusicGlove or conventional tabletop exercises. The primary outcome measure was the change in the Box and Blocks test score from baseline to 1 mo posttreatment. Both groups significantly improved their Box and Blocks test score, but no significant difference was found between groups. The MusicGlove group did exhibit significantly greater improvements than the conventional exercise group in motor activity log quality of movement and amount of use scores 1 mo posttherapy (p = 0.007 and p = 0.04, respectively). Participants significantly increased their use of MusicGlove over time, completing 466 gripping movements per day on average at study end. MusicGlove therapy was not superior to conventional tabletop exercises for the primary end point but was nevertheless feasible and led to a significantly greater increase in self-reported functional use and quality of movement of the impaired hand than conventional home exercises.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov; \"Influence of Timing on Motor Learning\"; NCT01769326; https://clinicaltrials.gov/ct2/show/NCT01769326.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.04.0057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34313942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation.","authors":"Hongen Qu,&nbsp;Yongji Xie,&nbsp;Xiaoxuan Liu,&nbsp;Xin He,&nbsp;Manzhao Hao,&nbsp;Yong Bao,&nbsp;Qing Xie,&nbsp;Ning Lan","doi":"10.1682/JRRD.2014.10.0227","DOIUrl":"https://doi.org/10.1682/JRRD.2014.10.0227","url":null,"abstract":"<p><p>Neuromuscular electrical stimulation (NMES) is a promising assistive technology for stroke rehabilitation. Here we present the design and development of a multimuscle stimulation system as an emerging therapy for people with paretic stroke. A network-based multichannel NMES system was integrated based on dual bus architecture of communication and an H-bridge current regulator with a power booster. The structure of the system was a body area network embedded with multiple stimulators and a communication protocol of controlled area network to transmit muscle stimulation parameter information to individual stimulators. A graphical user interface was designed to allow clinicians to specify temporal patterns and muscle stimulation parameters. We completed and tested a prototype of the hardware and communication software modules of the multichannel NMES system. The prototype system was first verified in nondisabled subjects for safety, and then tested in subjects with stroke for feasibility with assisting multijoint movements. Results showed that synergistic stimulation of multiple muscles in subjects with stroke improved performance of multijoint movements with more natural velocity profiles at elbow and shoulder and reduced acromion excursion due to compensatory trunk rotation. The network-based NMES system may provide an innovative solution that allows more physiological activation of multiple muscles in multijoint task training for patients with stroke.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2014.10.0227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34363060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociotechnical probabilistic risk modeling to predict injurious falls in community living centers.","authors":"Gail Powell-Cope,&nbsp;Robert Campbell,&nbsp;Bridget Hahm,&nbsp;Tatjana Bulat,&nbsp;John Westphal","doi":"10.1682/JRRD.2015.08.0165","DOIUrl":"https://doi.org/10.1682/JRRD.2015.08.0165","url":null,"abstract":"<p><p>The goal of this study was to apply sociotechnical probabilistic risk assessment to prioritize risks and prevention strategies for serious injurious falls of residents in nursing homes. Risk modeling teams consisted of 26 clinical and nonclinical staff from three Department of Veterans Affairs community living centers and one state Veteran's nursing home. Participants met in groups several times to identify and assign probabilities to provider and resident at-risk behaviors and equipment failures. They identified prevention strategies for the failures that accounted for the highest levels of risk. Six scenarios were modeled: (1) transferring from bed to wheelchair, (2) propelling from bedside to bathroom, (3) transferring from wheelchair to toilet, (4) transferring from toilet to wheelchair, (5) propelling from bathroom to bedside, and (6) transferring from wheelchair to bed. The greatest paths of risk were for residents with impaired mobility and high fragility. A 26% reduction in injurious falls could be achieved by (1) reducing the number of unassisted transfers through a modest improvement in response time to alarms, (2) installing automatic brake locks on 90% of wheelchairs, (3) making the wheelchair maintenance process highly reliable, and (4) decreasing improper transfer techniques by 10%.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.08.0165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34794545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of physical and mental health symptoms on Veterans' functional health status.","authors":"Tong Sheng,&nbsp;J Kaci Fairchild,&nbsp;Jennifer Y Kong,&nbsp;Lisa M Kinoshita,&nbsp;Jauhtai J Cheng,&nbsp;Jerome A Yesavage,&nbsp;Drew A Helmer,&nbsp;Matthew J Reinhard,&nbsp;J Wesson Ashford,&nbsp;Maheen M Adamson","doi":"10.1682/JRRD.2015.07.0146","DOIUrl":"https://doi.org/10.1682/JRRD.2015.07.0146","url":null,"abstract":"<p><p>Veterans who have been deployed to combat often have complex medical histories including some combination of traumatic brain injury (TBI); mental health problems; and other chronic, medically unexplained symptoms (i.e., chronic multisymptom illness [CMI] clusters). How these multiple pathologies relate to functional health is unclear. In the current study, 120 Veterans (across multiple combat cohorts) underwent comprehensive clinical evaluations and completed self-report assessments of mental health symptoms (Patient Health Questionnaire-2 [PHQ-2], PTSD Checklist-Civilian Version [PCL-C]) and functional health (Veterans Rand 36-Item Health Survey). Canonical correlation and regression modeling using split-sample permutation tests revealed that the PHQ-2/PCL-C composite variable (among TBI severity and number of problematic CMI clusters) was the primary predictor of multiple functional health domains. Two subscales, Bodily Pain and General Health, were associated with multiple predictors (TBI, PHQ-2/PCL-C, and CMI; and PHQ-2/PCL-C and CMI, respectively), demonstrating the multifaceted nature of how distinct medical problems might uniquely and collectively impair aspects of functional health. Apart from these findings, however, TBI and CMI were not predictors of any other aspects of functional health. Taken together, our findings suggest that mental health problems might exert ubiquitous influence over multiple domains of functional health. Thus, screening of mental health problems and education and promotion of mental health resources can be important to the treatment and care of Veterans.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.07.0146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34794547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a prediabetes identification algorithm for overweight and obese Veterans.","authors":"Tannaz Moin,&nbsp;Laura J Damschroder,&nbsp;Bradley Youles,&nbsp;Fatima Makki,&nbsp;Charles Billington,&nbsp;William Yancy,&nbsp;Matthew L Maciejewski,&nbsp;Linda S Kinsinger,&nbsp;Jane E Weinreb,&nbsp;Nanette Steinle,&nbsp;Caroline Richardson","doi":"10.1682/JRRD.2015.06.0104","DOIUrl":"https://doi.org/10.1682/JRRD.2015.06.0104","url":null,"abstract":"<p><p>Type 2 diabetes prevention is an important national goal for the Veteran Health Administration (VHA): one in four Veterans has diabetes. We implemented a prediabetes identification algorithm to estimate prediabetes prevalence among overweight and obese Veterans at Department of Veterans Affairs (VA) medical centers (VAMCs) in preparation for the launch of a pragmatic study of Diabetes Prevention Program (DPP) delivery to Veterans with prediabetes. This project was embedded within the VA DPP Clinical Demonstration Project conducted in 2012 to 2015. Veterans who attended orientation sessions for an established VHA weight-loss program (MOVE!) were recruited from VAMCs with geographically and racially diverse populations using existing referral processes. Each site implemented and adapted the prediabetes identification algorithm to best fit their local clinical context. Sites relied on an existing referral process in which a prediabetes identification algorithm was implemented in parallel with existing clinical flow; this approach limited the number of overweight and obese Veterans who were assessed and screened. We evaluated 1,830 patients through chart reviews, interviews, and/or laboratory tests. In this cohort, our estimated prevalence rates for normal glycemic status, prediabetes, and diabetes were 29% (n = 530), 28% (n = 504), and 43% (n = 796), respectively. Implementation of targeted prediabetes identification programs requires careful consideration of how prediabetes assessment and screening will occur.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.06.0104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34794549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial effects of competitive Boccia program in persons with severe chronic disability.","authors":"Sharon Barak,&nbsp;Nuria Mendoza-Laiz,&nbsp;Maria Teresa Gutierrez Fuentes,&nbsp;Maria Rubiera,&nbsp;Yeshayahu Huyzler","doi":"10.1682/JRRD.2015.08.0156","DOIUrl":"https://doi.org/10.1682/JRRD.2015.08.0156","url":null,"abstract":"<p><p>People with severe physical disabilities may experience psychosocial problems. Boccia is one sport that athletes with severe disability can engage in, but no information on the effects of Boccia on psychosocial outcomes for participants with severe disability is available. Therefore, we analyzed the effects of Boccia on psychosocial outcomes in persons with severe disabilities. The study included two competitive Boccia groups: independent competitive (IC) (n = 9) and nonindependent competitive (NIC) (n = 7), as well as a recreational Boccia group (n = 14) and control subjects (n = 13) (mean age = 46.46 +/- 10.75). All participants underwent a rehabilitation program. Between-group differences in change scores were assessed using analysis of variance/multivariate analysis of variance. Within-group differences were compared using t-tests and effect sizes (ESs). Change in psychosocial parameters was not significantly influenced by study group (p > 0.05). All groups presented moderate-to-large ESs in physical and psychological quality of life (ES > 0.51). In comparison to the control group, who presented small-to-trivial ESs in General Health Questionnaire-28 (GHQ-28), State-Trait Anxiety Inventory, and Profile of Mood States-Tension, the IC and recreational group presented moderate ESs in GHQ-28, whereas the NIC group presented moderate ESs in anxiety and tension. In conclusion, the rehabilitation program had a general positive effect on the psychosocial status of individuals with severe physical disabilities. However, the competitive Boccia groups demonstrated a greater number of favorable changes, suggesting an added value of participation in Boccia.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.08.0156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34969969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.","authors":"Cameron Rink,&nbsp;Matthew M Wernke,&nbsp;Heather M Powell,&nbsp;Surya Gynawali,&nbsp;Ryan M Schroeder,&nbsp;Jayne Y Kim,&nbsp;Jeffrey A Denune,&nbsp;Gayle M Gordillo,&nbsp;James M Colvin,&nbsp;Chandan K Sen","doi":"10.1682/JRRD.2015.07.0145","DOIUrl":"https://doi.org/10.1682/JRRD.2015.07.0145","url":null,"abstract":"<p><p>A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov; \"Evaluation of limb health associated with a prosthetic vacuum socket system\": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.07.0145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34866442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}