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- Filipe, A., et al.
(author)
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White Book on Physical and Rehabilitation Medicine in Europe Introductions, Executive Summary, and Methodology
- 2018
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In: European Journal of Physical and Rehabilitation Medicine. - : Edizioni Minerva Medica. - 1973-9087 .- 1973-9095. ; 54:2, s. 125-155
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Journal article (peer-reviewed)abstract
- The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies (European Academy of Rehabilitation Medicine - EARM, European Society of PRM - ESPRM, European Union of Medical Specialists - PRM Section, European College of PRM-ECPRM served by the European Union of Medical Specialists-PRM Board) and constitutes the reference book for PRM physicians in Europe. It has now reached its third edition; the first was published in 1989 and the second in 2006/2007. The WB has multiple purposes, including providing a unifying framework for European countries, to inform decision-makers on European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public. The WB states the importance of PRM, a primary medical specialty that is present all over Europe, with a specific corpus disciplinae, a common background and history throughout Europe. PRM is internationally recognized and a partner of major international bodies, including the World Health Organization (WHO). PRM activities are strongly based on the documents of the United Nations (UN) and WHO, such as the Convention of the Rights of Persons with Disabilities (2006), the World Report on Disability (2011), the WHO Global Disability Action Plan 2014-2021 (2014) and the WHO initiative "Rehabilitation 2030: a call for action" (2017). The WB is organized in 4 sections, 11 chapters and some appendices. The WB starts with basic definitions and concepts of PRM and continues with why rehabilitation is needed by individuals and society. Rehabilitation focuses not only on health conditions but also on functioning. Accordingly. PRM is the medical specialty that strives to improve functioning of people with a health condition or experiencing disability. The fundamentals of PRM, the history of the PRM specialty, and the structure and activities of PRM organizations in Europe are presented, followed by a thorough presentation of the practice of PRM, i.e. knowledge and skills of PRM physicians, the clinical field of competence of PRM, the place of the PRM specialty in the healthcare system and society, education and continuous professional development of PRM physicians, specificities and challenges of science and research in PRM. The WB concludes with the way forward for the specialty: challenges and perspectives for the future of PRM.
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| 2. |
- Grimby, Agneta, et al.
(author)
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Walking habits in elderly widows.
- 2008
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In: The American journal of hospice & palliative care. - : SAGE Publications. - 1049-9091 .- 1938-2715. ; 25:2, s. 81-7
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Journal article (peer-reviewed)abstract
- Walking habits were studied in 3 groups of elderly widows. The average walking time per week was calculated from interviews or questionnaires. There was in a small studied group a tendency for walking time to be lower at 3 and 12 months after loss than at 4 or 5 years. An increased odds ratio was demonstrated in larger groups of widows for walking less than 120 minutes per week in those who "did not feel healthy," or who had "musculoskeletal health problems," or "cardiovascular health problems." Widows from a population-based study also showed increased odds ratio for not walking as long with "lack of friends" and "not being active in associations." This was not found in married women from the population study. Our results indicate that newly bereaved women may reduce their physical activity, and that the change in exercise habits may be associated with reduced perception of being healthy and a decreased social network.
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| 4. |
- Andrén, Eva, 1939, et al.
(author)
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Activity limitations in personal, domestic and vocational tasks: a study of adults with inborn and early acquired mobility disorders.
- 2004
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In: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 26:5, s. 262-71
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Journal article (peer-reviewed)abstract
- PURPOSE: To compare activity limitations at the workplace with those in the home situation. SUBJECTS AND METHODS: Sixty-nine subjects, 22-49 years of age, with inborn or early acquired mobility disorders and with experience of vocational employment were studied. They were interviewed to assess their level of dependence according to the Functional Independence Measure (FIM) and Instrumental Activity Measure (IAM) and in 22 vocation-related items. Rasch analysis was perfomed in order to assess the relative difficulty of the items. In the vocational items the subjects rated perceived difficulty on a 4-level scale. Satisfaction in one general and six domain-specific areas was rated on a 6-level scale. RESULTS: Forty-six per cent of the subjects were dependent in one or several FIM items, 90% in IAM items and 38% in the vocation-related items. In 15 of these items great difficulty was reported by few subjects. Collapsing the 7-category scale for dependence to four categories gave the best Rasch model. Most of the IAM items were the hardest to manage without assistance. FIM social-cognitive and cognitive vocation-related items were the easiest items. Most subjects were satisfied in the general and domain-specific areas. CONCLUSIONS: Activities related to household tasks and transportation demonstrated the highest level of dependence, whereas it was easier to acquire independence in most vocation-related tasks.
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| 5. |
- Andrén, Eva, 1939, et al.
(author)
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Dependence in daily activities and life satisfaction in adult subjects with cerebral palsy or spina bifida: a follow-up study.
- 2004
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In: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 26:9, s. 528-36
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Journal article (peer-reviewed)abstract
- PURPOSE: To study dependence in daily activities in adults with congenital disorders living in the community by interviewing them with an interval of 5 years. SUBJECTS AND METHODS: Thirty-one subjects (20 men, 11 women) aged 24-43 years at the second assessment. Twenty-two subjects had cerebral palsy, and nine had spina bifida. Interviews in the subjects' homes were conducted using Functional Independence Measure (FIM), Instrumental Activity Measure (IAM), and a questionnaire concerning life satisfaction. Rasch analysis was used for joint calibration of physical FIM- and IAM-items to obtain measure values (logits) for items and persons. RESULTS: Most subjects were independent in FIM items, but usually dependent in IAM items, except Mobility outdoors and Simple meal. The level of dependence increased significantly between the two assessments for four self-care items in FIM, Stairs and all IAM items except Mobility outdoors and Cleaning. For 13 subjects the overall level of dependence increased significantly for self-care between the two assessments. Most subjects were satisfied in life in general, but satisfaction in self-care ADL decreased between the two assessments. CONCLUSIONS: The increased dependence in daily activities demonstrated may reflect reduced capacity but also changes in preferences and interests as well as the social situation.
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| 6. |
- Beck, J., et al.
(author)
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Diaphragmatic function in advanced Duchenne muscular dystrophy
- 2006
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In: Neuromuscul Disord.. ; 16:3
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Journal article (peer-reviewed)abstract
- The aim of this study was to assess diaphragm electrical activation and diaphragm strength in patients with advanced Duchenne muscular dystrophy during resting conditions. Eight patients with advanced Duchenne muscular dystrophy (age of 25+/-2 years) were studied during tidal breathing, maximal inspiratory capacity, maximal sniff inhalations, and magnetic stimulation of the phrenic nerves. Six patients were prescribed home mechanical ventilation (five non-invasive and one tracheotomy). Transdiaphragmatic pressure and diaphragm electrical activation were measured using an esophageal catheter. During tidal breathing (tidal volume 198+/-83ml, breathing frequency 25+/-7), inspiratory diaphragm electrical activation was clearly detectable in seven out of eight patients and was 12+/-7 times above the noise level, and represented 45+/-19% of the maximum diaphragm electrical activation. Mean inspiratory transdiaphragmatic pressure during tidal breathing was 1.5+/-1.2cmH(2)O, and during maximal sniff was 7.6+/-3.6cmH(2)O. Twitch transdiaphragmatic pressure deflections could not be detected. This study shows that despite near complete loss of diaphragm strength in advanced Duchenne muscular dystrophy, diaphragm electrical activation measured with an esophageal electrode array remains clearly detectable in all but one patient.
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| 10. |
- Björkdahl, Ann, 1959-, et al.
(author)
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Does a short period of rehabilitation in the home setting facilitate functioning after stroke? : A randomized controlled trial
- 2006
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In: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 20:12, s. 1038-1049
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess the effect of three weeks of rehabilitation in the home setting for younger patients with stroke with the aim of improving activity level.DESIGN: A randomized controlled study with blinded evaluations at discharge, three weeks, three months and one year after discharge.SETTING: Home of the patient or the ordinary day rehabilitation clinic at the university hospital.SUBJECTS: Fifty-eight patients (median age 53 years) consecutively discharged from inpatient rehabilitation with a first occurrence of stroke participated in training directly after discharge. Intervention: Rehabilitation was given for 9 hours/week over three weeks. The home group received individually tailored training, based on the patient's needs and desires, with a focus on activities in their natural context. Support and information were also given. The intervention in the day clinic group was aimed mainly at improved functions.MAIN MEASURES: The main outcome was activity, assessed with the Assessment of Motor and Process Skill (AMPS). The impairment level was also evaluated. Costs were estimated.RESULT: There were no significant differences between the groups on any of the four assessments. However, there seemed to be an earlier improvement on some measures (including AMPS) for the home group. For both groups there was a greater improvement on the activity level than on the impairment level. the costs of the home group were less than half of the costs of the day clinic group.CONCLUSION: With the present results, both rehabilitation programmes could be recommended, however, further studies are needed to define patients who may specifically benefit from the home rehabilitation programme. Costs should be taken into consideration.
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