Changes in Pyriform Sinus Morphology in the Head Rotated Position as Assessed by 320-Row Area Detector CT.
Changes in Pyriform Sinus Morphology in the Head Rotated Position as Assessed by 320-Row Area Detector CT.
Filed under: Rehab Centers
Dysphagia. 2012 Nov 3;
Nakayama E, Kagaya H, Saitoh E, Inamoto Y, Hashimoto S, Fujii N, Katada K, Kanamori D, Tohara H, Ueda K
In patients with unilateral pharyngeal paresis and dysphagia, the head is rotated to the paretic side to prevent food flow to the rotated side during swallowing. Only a few studies to date have reported on pyriform sinus morphology upon head rotation. The purpose of this study was to measure the volume, depth, and cross-sectional area of the pyriform sinus during head rotation using 320-row area detector computed tomography. We imaged the neck during head rotation at 0° and at 30°, 45°, and 60° to the left or right in nine healthy young adults and determined the volume, depth, and cross-sectional area of the pyriform sinus in each position. On the rotated side, volume and cross-sectional area were significantly decreased at 60°. In contrast, volume, cross-sectional area, and depth were all significantly increased on the opposite side at 60°. These results suggest that head rotation at 60° significantly increases the volume, cross-sectional area, and depth of the opposite side, and significantly decreases the volume and depth of the rotated side of the pyriform sinus.
HubMed – rehab
Does Post-Acute Care Site Matter? A longitudinal study assessing functional recovery after a stroke.
Filed under: Rehab Centers
Arch Phys Med Rehabil. 2012 Nov 1;
Chan L, Sandel ME, Jette AM, Appelman J, Brandt DE, Cheng P, Teselle M, Delmonico R, Terdiman JF, Rasch EK
OBJECTIVE: To determine the impact of post acute care site on stroke outcomes. Following a stroke, patients may receive post acute care in a number of different sites: inpatient rehabilitation (IRF), skilled nursing facility (SNF), and home health care/outpatient (HH/OP). We hypothesized that patients who received IRF would have better six-month functional outcomes than those who received care in other settings after controlling for patient characteristics. DESIGN: Prospective Cohort Study. SETTING: Four Northern California hospitals which are part of a single health maintenance organization. PARTICIPANTS: 222 patients with stroke enrolled between February 2008 and July 2010. INTERVENTION: Not Applicable. MAIN OUTCOME MEASURE: Baseline and 6 month assessments were performed using the Activity Measure for Post Acute Care (AM-PAC™), a test of self-reported function in three domains: Basic Mobility, Daily Activities, and Applied Cognition. RESULTS: Of the 222 patients analyzed, 36% went home with no treatment, 22% received HH/OP care, 30% included IRF in their care trajectory, and 13% included SNF (but not IRF) in their care trajectory. At six months, after controlling for important variables such as age, functional status at acute care discharge, and total hours of rehabilitation, patients who went to an IRF had functional scores that were at least 8 points higher (twice the minimally detectable change for the AM-PAC) than those who went to a SNF in all 3 domains and in two out of three functional domains compared to those who received HH/OP care. CONCLUSIONS: Patients with stroke may make more functional gains if their post-acute care includes an IRF. This finding may have important implications as post-acute care delivery is reshaped through health care reform.
HubMed – rehab
When is virtual reality ‘therapy’?
Filed under: Rehab Centers
Arch Phys Med Rehabil. 2012 Nov 1;
Levac DE, Galvin J
The use of virtual reality (VR) systems within physical rehabilitation clinical practice and research is rapidly developing, highlighting the need for consensus as to the meaning and relevance of the label “VR therapy”. The purpose of this communication is to argue that explicit examination of the inferences underlying this label and discussion regarding the role of clinicians in VR implementation is required. In this vein, we propose what we consider to be a more relevant label and discuss the need for evidence to support knowledge translation initiatives for therapists interested in integrating VR systems within clinical practice.
HubMed – rehab
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