Cognitive Adaptation Training Provided to Chronically Hospitalized Patients With Schizophrenia in the Netherlands: Two Case Reports.
Cognitive adaptation training provided to chronically hospitalized patients with schizophrenia in the Netherlands: two case reports.
Filed under: Rehab Centers
Case Rep Psychiatry. 2012; 2012: 596162
Quee PJ, Schneider H, van Slogteren S, Wiersma D, Bruggeman R, Velligan DI
Cognitive adaptation training (CAT) improves functional outcome in outpatients with schizophrenia living in the United States of America. The efficacy of CAT has never been demonstrated for patients living in a residential facility. We describe how CAT was delivered to two chronically hospitalized patients with schizophrenia living in The Netherlands. CAT was delivered for 8 months, and consisted of weekly home visits by a psychiatric nurse. Both patients improved on measures of functional outcome used in the US studies. These results indicate that CAT may improve outcomes, even in patients that have been hospitalized for several years.
HubMed – rehab
Rethinking Clinical Trials of Transcranial Direct Current Stimulation: Participant and Assessor Blinding Is Inadequate at Intensities of 2mA.
Filed under: Rehab Centers
PLoS One. 2012; 7(10): e47514
O’Connell NE, Cossar J, Marston L, Wand BM, Bunce D, Moseley GL, De Souza LH
Many double-blind clinical trials of transcranial direct current stimulation (tDCS) use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding.A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised) at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation.tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (?) 0.28, 95% confidence interval (CI) 0.09 to 0.47 p?=?0.005) and the second session (??=?0.77, 95%CI 0.64 to 0.90), p?=?<0.001) indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, ??=?0.512, 95%CI 0.363 to 0.66, p<0.001; session two, ??=?0.677, 95%CI 0.534 to 0.82) indicating inadequate assessor blinding.Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution. HubMed – rehab
Students who are deaf and hard of hearing and use sign language: considerations and strategies for developing spoken language and literacy skills.
Filed under: Rehab Centers
Semin Speech Lang. 2012 Nov; 33(4): 310-21
Nussbaum D, Waddy-Smith B, Doyle J
There is a core body of knowledge, experience, and skills integral to facilitating auditory, speech, and spoken language development when working with the general population of students who are deaf and hard of hearing. There are additional issues, strategies, and challenges inherent in speech habilitation/rehabilitation practices essential to the population of deaf and hard of hearing students who also use sign language. This article will highlight philosophical and practical considerations related to practices used to facilitate spoken language development and associated literacy skills for children and adolescents who sign. It will discuss considerations for planning and implementing practices that acknowledge and utilize a student’s abilities in sign language, and address how to link these skills to developing and using spoken language. Included will be considerations for children from early childhood through high school with a broad range of auditory access, language, and communication characteristics.
HubMed – rehab
Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.
Filed under: Rehab Centers
Knee Surg Sports Traumatol Arthrosc. 2012 Oct 19;
Janssen RP, du Mée AW, van Valkenburg J, Sala HA, Tseng CM
PURPOSE: Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. METHODS: A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS: Clinical outcome A significant improvement (p < 0.001) between preoperative and postoperative measurements could be demonstrated for the Lysholm and Tegner scores, IKDC patient subjective assessment, KT-1000 measurements, pivot shift test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50 %) patients and correlated with lower levels of activity (p < 0.022). Radiological outcome: At follow-up, 46 (53.5 %) patients had signs of osteoarthritis (OA). In this group, 33 patients (72 %) had chondral lesions (?grade 2) at the time of ACL reconstruction. A history of medial meniscectomy before or at the time of ACL reconstruction increased the risk of knee OA 4 times (95 % CI 1.41-11.5). An ICRS grade 3 at the time of ACL reconstruction increased the risk of knee OA by 5.2 times (95 % CI 1.09-24.8). There was no correlation between OA and activity level (Tegner score ?6) nor between OA and a positive pivot shift test. CONCLUSION: Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. LEVEL OF EVIDENCE: II. HubMed – rehab
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