Journal of rehabilitation medicine. Clinical communications最新文献

{"title":"E-Survey of Current International Physiotherapy Practice for Children with Ataxia Following Surgical Resection of Posterior Fossa Tumour.","authors":"Helen Hartley, Bernie Carter, Lisa Bunn, Barry Pizer, Steven Lane, Ram Kumar, Elizabeth Cassidy","doi":"10.2340/20030711-1000020","DOIUrl":"https://doi.org/10.2340/20030711-1000020","url":null,"abstract":"Objective To determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour. Design: An e-survey covering the following domains: participant demographics, treatment/ intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management. Participants Physiotherapists involved in the management of children with ataxia following surgical resection of posterior fossa tumour. Participants were contacted via 6 key groups; Paediatric Oncology Physiotherapy Network (POPs), Association of Paediatric Chartered Physiotherapists (APCP), European Paediatric Neurology Society (EPNS), International Society of Paediatric Oncology (SIOP)-Europe Brain Tumour Group, Posterior Fossa Society (PFS), and Pediatric Oncology Special Interest Group (SIG) (American Physical Therapy Association). Results A total of 96 physiotherapists participated: UK (n =53), rest of Europe (n = 23), USA/ Canada (n = 10), and Australia/NZ (n = 10). The most common physiotherapy interventions used were balance exercises, gait re-education and proximal control activities. The most frequently used adjuncts to treatment were mobility aids and orthotics. Challenges reported regarding physiotherapy treatment were: reduced availability of physiotherapy input following discharge from the acute setting, lack of evidence, impact of adjuvant oncology treatment, and psychosocial impact. Conclusion This e-survey provides an initial scoping review of international physiotherapy practice in this area. It establishes a foundation for future research on improving rehabilitation of ataxia in this population. LAY ABSTRACT The aim of this study was to determine how physiotherapists in different countries currently treat children with balance/coordination problems following surgery for a brain tumour. An e-survey, with questions on type of physiotherapy treatment, intensity and timing of treatment, and aims and outcomes of physiotherapy management, was sent to special interest groups, which included physiotherapists with expertise in this area. A total of 96 physiotherapists participated in the survey. The most common physiotherapy treatments used were balance exercises and gait re-education. Mobility aids and orthotics (e.g. splints) were also commonly used. Physiotherapists reported challenges to treatment, including lack of availability of physiotherapy following discharge from hospital, lack of evidence to guide treatment, and impact of oncology treatment (e.g. chemotherapy/radiotherapy) on the child’s rehabilitation. In conclusion, there is little evidence in this area. The results of this survey provide an initial basis to understand the challenges of treatment and to plan future research.","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/10/d8/JRMCC-2-1000020.PMC8008714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Analysis of Functional and Tracheostomy (Decannulation) Outcomes in Patients with Brain Injury in a Hyperacute Rehabilitation Unit.","authors":"Lin Cheng,&nbsp;Kay Mitton,&nbsp;Krystyna Walton,&nbsp;Manoj Sivan","doi":"10.2340/20030711-1000024","DOIUrl":"https://doi.org/10.2340/20030711-1000024","url":null,"abstract":"<p><strong>Objectives: </strong>Hyper-Acute Rehabilitation Units (HA-RUs) provide multidisciplinary rehabilitation to patients with acute neurological injuries. This includes managing patients with tracheostomies. This is the first study of its kind to examine clinical outcomes in patients with brain injury and tracheostomy managed in a HARU.</p><p><strong>Methods: </strong>Retrospective analysis of clinical outcomes in tracheostomy patients admitted to a HARU over a 2-year period.</p><p><strong>Results: </strong>A total of 208 patients were admitted to the HARU, of whom 99 (60 males and 39 females) had a tracheostomy either at admission or during their stay in the HARU. Mean Glasgow Coma Scale score at admission was 11 (range 5-15) and at discharge was 13 (range 8-15). Mean Functional Independence Measure and Functional Assessment Measure (FIM+FAM) score improved from 52 at admission to 95 at discharge. Mean FIM+FAM cognitive admission cognitive sub-score improved from 23 to 42, and mean motor sub-score from 29 to 42. Changes in scores were deemed to be clinically significant as per thresholds reported in the literature. Of the total patients in this study, 79% were successfully decannulated and 21% needed long-term tracheostomy.</p><p><strong>Conclusion: </strong>Patients with tracheostomy following brain injury can be appropriately managed in a HARU and show clinically significant improvement in functional outcomes.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/44/JRMCC-2-1000024.PMC8206517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39242835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthesis to Enable a Patient with Above-Elbow Amputation to Resume Hunting.","authors":"Laurent ThÉfenne,&nbsp;Bénédicte GuÉrin,&nbsp;Arnaud Jouvion,&nbsp;Héléne Bisseriex,&nbsp;Bertrand TourÉ,&nbsp;Janyce Cantu,&nbsp;Thomas Trappier,&nbsp;Maxime Obrecht,&nbsp;Gratiane De Brier","doi":"10.2340/20030711-1000025","DOIUrl":"https://doi.org/10.2340/20030711-1000025","url":null,"abstract":"<p><strong>Background: </strong>Creating a custom prosthetic device is challenging. The requirements of the patient's life must be taken into consideration when manufacturing the device. After having met the requirements for an autonomous daily life, adjustments can be made for recreational activities.</p><p><strong>Subject and methods: </strong>A 67-year-old patient with an above-elbow amputation following a hunting accident wanted to use a rifle to hunt again. We considered her desires, the short stump, and the constraints of the type of hunting and environment, bearing in mind the safety of the patient and other hunters.</p><p><strong>Results and conclusion: </strong>An orthopaedic prosthetic system was developed to allow her to pick up the rifle, aim (sight), and shoot with recoil. The 2 rifle supports are fixed onto a bolero vest. The supports are made of carbon fibre, which is lightweight, and the gun can be aimed between them. Appropriate safety was achieved. The efficiency depends on the patient. There are few publications regarding amputation cases of this type, in which the specification goals were precision and the ability to walk with the prosthesis. Multi-disciplinary collaboration enabled us to create a device that met the requirements of this case.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/0b/JRMCC-2-1000025.PMC8206516.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39242792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Stiff Person Syndrome with Intrathecal Baclofen.","authors":"Saul Geffen,&nbsp;Nick Chiang","doi":"10.2340/20030711-1000016","DOIUrl":"https://doi.org/10.2340/20030711-1000016","url":null,"abstract":"Intrathecal baclofen therapy is a recognized treatment for severe spasticity. We report here a case of stiff person syndrome in Australia, treated with intrathecal baclofen followed by a rehabilitation programme with substantial clinical and functional improvements. A 59-year-old woman diagnosed with stiff person syndrome had become hoist-dependent and required full care due to severe spasticity over the past 12 years. Treatment with oral benzodiazepines and botulinum toxin injections to the affected muscles had no therapeutic response. After a test dose of 100 pg intrathecal baclofen resulted in a substantial improvement in her physical function, a decision was made to insert an intrathecal baclofen delivery device. This case report supports the use of intrathecal baclofen therapy and a formal inpatient rehabilitation programme for spasticity related to stiff person syndrome. LAY ABSTRACT Stiff person syndrome, a rare autoimmune and neurological disease that leads to significant disability, can be treated by the use of a device delivering baclofen into the spine combined with physical rehabilitation. A 59-year-old woman was diagnosed with stiff person syndrome and had become dependent, with full-time care, due to severe spasms. Conventional treatment with oral muscle relaxants and botulinum toxin injections to her muscles did not have an adequate effect. A trial dose of baclofen was administered into her spine, followed by implantation of a drug delivery device. This resulted in a substantial improvement in function.","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/53/JRMCC-2-1000016.PMC8008728.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysarthria Consequent to Cervical Spinal Cord Injury and Recurrent Laryngeal Nerve Damage: A Case Report.","authors":"Bijoyaa Mohapatra,&nbsp;Nachiketa Rout","doi":"10.2340/20030711-1000022","DOIUrl":"https://doi.org/10.2340/20030711-1000022","url":null,"abstract":"<p><strong>Objective: </strong>To assess and describe the involvement of all speech subsystems, including respiration, phonation, articulation, resonance, and prosody, in an individual with cervical spinal cord injury.</p><p><strong>Methods: </strong>Detailed speech and voice assessment was performed that included Frenchay Dysarthria Assessment, cranial nerve examination, voice (per-ceptual and instrumental) and nasometric evalua-tion, and intelligibility and communicative effecti-veness.</p><p><strong>Results: </strong>Impaired respiratory and phonatory con-trol correlated with the physical impairment of C4 and C5 prolapsed intervertebral disc. Cranial nerve examination indicated nerve IX and XI pathology. Phonatory deficits such as imprecise consonants and mild sibilant distortions were apparent. Voice analysis revealed a hoarse, breathy voice with re-duced loudness and no problems with resonance. Reading and speaking rate was reduced, and over-all a mild reduction in communicative effectiveness was perceived.</p><p><strong>Conclusion: </strong>Assessment of the speech subsystems produced a comprehensive picture of the patient's condition and impairments in one or more areas was identified. Treatment options to improve speech outcomes were provided.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/d9/JRMCC-2-1000022.PMC8008712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Whole Body Vibration Therapy in Individuals with Dystonic or Spastic Dystonic Cerebral Palsy: A Pilot Study.","authors":"Tamis W Pin,&nbsp;Penelope B Butler,&nbsp;Sheila Purves,&nbsp;Nathan C-K Poon","doi":"10.2340/20030711-1000021","DOIUrl":"https://doi.org/10.2340/20030711-1000021","url":null,"abstract":"<p><strong>Objective: </strong>To examine the feasibility and practicality of whole body vibration therapy for individuals with dystonic or spastic dystonic cerebral palsy.</p><p><strong>Design: </strong>Pilot study.</p><p><strong>Subjects: </strong>Children and adults with dystonic or spastic dystonic cerebral palsy.</p><p><strong>Methods: </strong>Study participants received total body vibration therapy when standing still on a vibration platform for 3 bouts, duration 3-min, of vibration (20 Hz, 2 mm amplitude), 4 days per week for 4 weeks in addition to their usual therapy. All participants were assessed at baseline and completion of the study using the Gross Motor Function Measure Item Set, Timed Up and Go test, Barry-Albright Dystonia Scale, Edinburgh Visual Gait Score, and Pediatric Evaluation of Disability Inventory.</p><p><strong>Results: </strong>Ten participants (mean age 18.60 years (standard deviation (SD) 14.68); 9 males, Gross Motor Function Classification System level II-IV) completed the study with more than 90% attendance rate. All participants tolerated the protocol with no adverse events.</p><p><strong>Conclusion: </strong>The vibration treatment protocol was feasible and safe for all participants. With no significant differences found in all the outcome measures, future studies with more rigorous study designs are required before this intervention is recommended for this population group.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/18/JRMCC-2-1000021.PMC8008730.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Sub-Acute Rehabilitation Needs Among Individuals After Transient Ischaemic Attack Using Rehab-Compass as a Simple Screening Tool in the Outpatient Clinic.","authors":"Gustaf Magaard,&nbsp;Britt-Marie StÅLnacke,&nbsp;Ann SÖrlin,&nbsp;Fredrik Öhberg,&nbsp;Stina Berggren,&nbsp;Emma Grollmuss,&nbsp;Xiaolei Hu","doi":"10.2340/20030711-1000018","DOIUrl":"https://doi.org/10.2340/20030711-1000018","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate comprehensive unmet rehabilitation needs by using a novel graphic screening tool, Rehab-Compass, among individuals in the sub-acute stage after first-ever transient ischaemic attack.</p><p><strong>Methods: </strong>A pilot prospective cohort study investigated 47 individuals with first-ever transient ischaemic attack in an outpatient clinic setting. By using Rehab-Compass, based on well-validated patient-reported outcome measure questionnaires, this study examined comprehensive unmet rehabilitation needs among individuals at 4-month follow-up after the onset of transient ischaemic attack.</p><p><strong>Results: </strong>Rehab-Compass identified that most participants were independent in their daily lives (modified Rankin Scale; mRS 0-1) with a relatively good quality of life (median EuroQol 5 dimensions (EQ-5D) 0.85), but certain limitations in participation in their daily lives. Rehab-Compass showed that, at 4 months after transient ischaemic attack, the most common condition affected was mood (reported by 89% of participants), followed by bladder function (70%), sexual life (52%), strength (51%) and fatigue (26%). Symptoms of depression and anxiety were reported by 6% and 17% of participants, respectively.</p><p><strong>Conclusion: </strong>This pilot study indicates that RehabCompass might be a suitable simple screening tool for use in the outpatient clinic setting to identify the multidimensional rehabilitation needs of individuals after transient ischaemic attack.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/b5/JRMCC-2-1000018.PMC8008729.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral Insufficiency Fractures in Patients with Spinal Cord Injury: A Report of Two Unusual Cases and Review of Literature.","authors":"Kappaganthu Venkatesh Prasanna,&nbsp;Nijanth M Raj,&nbsp;Siddeshwar Patil","doi":"10.2340/20030711-1000019","DOIUrl":"https://doi.org/10.2340/20030711-1000019","url":null,"abstract":"<p><strong>Objective: </strong>Sacral insufficiency fractures should be considered in differential diagnosis as a cause of autonomic dysreflexia and other vague symptoms in patients with spinal cord injury.</p><p><strong>Setting: </strong>The Supra Regional Tertiary Centre, Midlands Centre for Spinal Injuries, Oswestry, UK.</p><p><strong>Method: </strong>Outpatient clinic review of 2 patients with long-standing spinal cord injury presenting with vague symptoms of abdominal discomfort, and increased spasms including autonomic dysreflexia in which no evidence of causation was found on clinical examination.</p><p><strong>Result: </strong>Radiological investigation with computed tomography of the abdomen and pelvis demonstrated sacral insufficiency fractures in both cases. These were managed conservatively and, following a diagnosis of osteoporosis, treatment with bisphosphonates was commenced. There was an improvement in symptomatology at the 12-week follow-up.</p><p><strong>Conclusion: </strong>Longevity in spinal cord injury continues to improve with increased awareness and improved management. However, along with improved longevity, secondary complications may occur, including sacral insufficiency fracture, which is difficult to diagnose and can affect quality of life. An awareness of sacral insufficiency fracture and its possible occurrence as a differential diagnosis in patients with chronic spinal cord injury presenting with vague symptoms can result in early diagnosis. Conservative management with bed rest is a viable option.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/83/JRMCC-2-1000019.PMC8008716.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsychosocial Rehabilitation Treatment \"Exposure <i>In Vivo</i>\" for Patients with Painful Diabetic Neuropathy: Development of a Treatment Protocol.","authors":"Charlotte C M Van Laake-Geelen,&nbsp;Rob J E M Smeets,&nbsp;Thijs Van Meulenbroek,&nbsp;Marlies Den Hollander,&nbsp;Marielle E J B Goossens,&nbsp;Jeanine A Verbunt","doi":"10.2340/20030711-1000015","DOIUrl":"https://doi.org/10.2340/20030711-1000015","url":null,"abstract":"<p><strong>Objective: </strong>Painful diabetic neuropathy is associated with low quality of life, depression and anxiety. Patients are limited in their performance of activities of daily living due to fears related to their condition. Treatment modalities are needed to help patients cope with their pain and pain-related disability. Exposure <i>in vivo</i> is an effective treatment in other chronic pain syndromes, increasing patients' functional ability and quality of life. This paper presents an Exposure <i>in vivo</i> treatment protocol for patients with painful diabetic neuropathy.</p><p><strong>Protocol: </strong>An 8-week Exposure <i>in vivo</i> treatment protocol was specifically adapted to the needs and risks of patients with painful diabetic neuropathy. New screening tools were developed for patients with PDN; the Painful Diabetic Neuropathy Anxiety Rasch-Transformed Questionnaire (PART-Q30) identifies specific fears related to painful diabetic neuropathy (e.g. fear of hypoglycaemia); and a customized version of the Photograph-series Of Daily Activities (PHODA-PDN) detects fear-eliciting activities related to the condition in individual patients. During Exposure <i>in vivo</i>, catastrophic interpretations regarding painful stimuli are challenged and corrected, thereby diminishing pain-related fear and enabling the patient to re-engage in activities of daily living. An interdisciplinary team provides Exposure <i>in vivo</i> in 1-h sessions twice a week.</p><p><strong>Discussion: </strong>To the best of our knowledge, this treatment protocol is the first intervention using Exposure <i>in vivo</i> specifically adapted to the needs and risks of patients with painful diabetic neuropathy.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2340/20030711-1000015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Physical Therapy Results in Shorter Length of Stay and Discharge Disposition Following Total Knee Arthroplasty: A Retrospective Study.","authors":"Sheldon R Garrison,&nbsp;Kelly E Schneider,&nbsp;Maharaj Singh,&nbsp;Jennifer Pogodzinski","doi":"10.2340/20030711-1000017","DOIUrl":"https://doi.org/10.2340/20030711-1000017","url":null,"abstract":"<p><strong>Objective: </strong>Total knee arthroplasty is an effective surgical approach used to treat arthritis and knee trauma. Its utilization has grown, as has the accompanying financial impact, resulting in an equal need to advance physical therapy practice. One emerging approach improving patient outcomes and reducing cost is the inclusion of a preoperative physical therapy visit. The aim of this study was to quantify the economic impact of a standardized preoperative physical therapy visit in the healthcare setting.</p><p><strong>Design: </strong>This study is a retrospective review of 1,043 adult patients who underwent total knee arthroplasty.</p><p><strong>Methods: </strong>Patients who underwent total knee arthroplasty were divided into those who received a prehab compared with those who did not.</p><p><strong>Results: </strong>Preoperative physical therapy resulted in a marked decrease in length of stay, with 37.1% of preoperative physical therapy patients leaving inpatient care on post-operative day 1 compared to 27.0% of the no preoperative physical therapy controls (<i>p</i> < 0.001). Preoperative physical therapy also improved discharge disposition, with 41.6% of preoperative physical therapy patients returning home and utilizing outpatient services compared to 23.2% of controls (<i>p</i> < 0.001). No effect on duration of care was observed.</p><p><strong>Conclusion: </strong>These data suggest that a single pre-operative physical therapy visit improves key outcomes, both clinically and financially, following total knee arthroplasty.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/89/JRMCC-2-1000017.PMC8008722.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}