Rehab Centers: New Clinical Pathways for Keratoconus.
New clinical pathways for keratoconus.
Filed under: Rehab Centers
Eye (Lond). 2012 Dec 21;
Gore DM, Shortt AJ, Allan BD
Pre-2000, the clinical management of keratoconus centred on rigid contact lens fitting when spectacle corrected acuity was no longer adequate, and transplantation where contact lens wear failed. Over the last decade, outcome data have accumulated for new interventions including corneal collagen crosslinking, intracorneal ring implantation, topographic phototherapeutic keratectomy, and phakic intraocular lens implantation. We review the current evidence base for these interventions and their place in new management pathways for keratoconus under two key headings: corneal shape stabilisation and visual rehabilitation.Eye advance online publication, 21 December 2012; doi:10.1038/eye.2012.257.
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Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial.
Filed under: Rehab Centers
Gerontology. 2012 Dec 20;
Grönstedt H, Frändin K, Bergland A, Helbostad JL, Granbo R, Puggaard L, Andresen M, Hellström K
Background: Nursing home residents are extremely inactive and deterioration in health and an increasing dependence in activities of daily living (ADL) are common. Physical activity and exercise play a major role in the preservation of physical function and quality of life late in life. However, evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive. Objective: To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength. Methods: In this single-blind randomized clinical trial with parallel groups, nursing home residents >64 years of age from three Nordic countries were included. The intervention group (IG) was assigned to individually tailored physical and daily activities, while the control group (CG) received ordinary care. Primary outcomes were ADL and balance, and secondary outcomes physical activity level, mobility and muscle strength. Results: At baseline, 322 nursing home residents were included, of whom 266 were assessed after 3 months of intervention. Following the intervention, a significant difference was found between participants in the IG and CG on measures of balance, physical activity and transfers. The CG significantly improved walking/wheelchair speed and functional leg muscle strength. The CG had significantly deteriorated in ADL, balance and transfers. Persons who had taken part in the intervention for more than 150 min/week significantly improved their balance and physical activity level. Participation in more than 10 weeks of intervention significantly improved physical activity and walking/wheelchair speed, while a deterioration was seen in those who had participated less. Conclusion: Individually tailored intervention in nursing home residents focusing on physical and daily activities is effective in improving transfers, balance and physical activity level compared to usual care. The effect of the intervention is dependent on the total activity time.
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Description and Validation of a Test to Evaluate Sustained Silent Reading.
Filed under: Rehab Centers
Invest Ophthalmol Vis Sci. 2012 Dec 20;
Ramulu PY, Swenor BK, Jefferys JL, Rubin GS
PURPOSE: To construct and validate a test of sustained silent reading. METHODS: Standardized 7,300 and 7,600 word passages were written to evaluate sustained silent reading. 240 subjects validated whether comprehension questions could discriminate subjects who did and did not read the passage. To evaluate test-retest properties, 49 subjects silently read the standardized passages on separate days. Sixty glaucoma suspect controls and 64 glaucoma subjects had their out-loud reading evaluated with the MNRead card and an IReST passage, and their silent reading measured using the 7,300 word passage. Sustained silent reading parameters included reading speed and reading speed slope over time. RESULTS: Comprehension questions distinguished individuals who had and had not read passage materials. Bland-Altman analyses of intersession sustained reading speed and reading speed slope demonstrated 95% coefficients of repeatability of 57 words per minute (wpm) and 2.76 wpm/minute. Sustained silent reading speed was less correlated with MNRead (r=0.59) or IReST passage (r=0.68) reading speeds than the correlation of these 2 measures of out-loud reading speed with each other (r=0.72). Sustained silent reading speed was more likely to differ from IReST reading speed by more than 50% in rapid silent readers (OR=29, 95% CI=10 to 87), and comparisons of sustained and out-loud reading speeds demonstrated proportional error in Bland-Altman analyses. CONCLUSIONS: Tests of out-loud reading do not accurately reflect silent reading speed in individuals with normal vision or glaucoma. The described test offers a standardized way to evaluate the impact of eye disease and/or visual rehabilitation on sustained silent reading.
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Walking speed in patients with first acute myocardial infarction who participated in a supervised cardiac rehabilitation program after coronary intervention.
Filed under: Rehab Centers
Int Heart J. 2012; 53(6): 347-52
Yamamoto S, Matsunaga A, Kamiya K, Miida K, Ebina Y, Hotta K, Shimizu R, Matsuzawa R, Abe Y, Kimura M, Shimizu S, Watanabe H, Noda C, Yamaoka-Tojo M, Masuda T, Izumi T
This study aimed to evaluate the degree of reduction in walking speed in patients with acute myocardial infarction (AMI) compared to age-matched community-dwelling people and identify factors associated with walking speed. The subjects were 210 middle-aged and 188 elderly patients with a first AMI (AMI group) and 198 age-matched community-dwelling people with no medical events (non-AMI group). We measured maximum walking speed in all subjects and collected clinical data, including that related to motor function, at the end of a supervised cardiac rehabilitation program in the AMI group. Data were analyzed based on age and sex. Walking speed in men and women in the middle-aged AMI subgroup decreased to 77.9% and 75.7% relative to that of the non-AMI subgroup matched by sex, respectively; walking speed in men and women in the elderly AMI subgroup decreased to 78.7% and 74.2% relative to that of the non-AMI subgroup matched by sex, respectively. Moreover, 6.4% of men and 23.8% of women in the middle-aged AMI subgroup, and 28.8% of men and 43.5% of women in the elderly AMI subgroup, had a slower walking speed compared to their respective non-AMI groups, which may contribute to an increased risk for cardiovascular mortality. Stepwise multiple regression analysis for motor function revealed that only leg strength in the middle-aged AMI subgroup, and both leg strength and standing balance in the elderly AMI subgroup, were associated with walking speed, regardless of sex after adjusting for clinical characteristics. These results suggest that evaluation and management of walking speed are necessary in implementing effective disease management for patients with first AMI.
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