Improved Strain and Psychosocial Outcomes for Caregivers of Individuals With Dementia: Findings From Project ANSWERS.
Improved Strain and Psychosocial Outcomes for Caregivers of Individuals with Dementia: Findings from Project ANSWERS.
Filed under: Rehab Centers
Gerontologist. 2012 Aug 16;
Judge KS, Yarry SJ, Looman WJ, Bass DM
PURPOSE: This study examined the efficacy of a newly developed intervention, Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS), for family caregivers of individuals with dementia. ANSWERS was designed for dyads comprised of an individual with dementia and his/her family caregiver. Using a strength-based approach, ANSWERS combined educational skills (traditionally used with caregivers) and cognitive rehabilitation skills training (traditionally used with individuals with dementia) into a single protocol for addressing the dyad’s care issues and needs. Key domains addressed by the intervention included: education about dementia and memory loss; effective communication; managing memory; staying active; and recognizing emotions and behaviors. This analysis focused on outcomes for caregivers. Design & Methods: The Stress Process Model guided the study’s hypotheses and design. Caregiving dyads were randomly assigned to the control or intervention conditions. Intervention dyads received 6-curriculum guided sessions with an intervention specialist. Data came from in-person baseline interviews with caregivers conducted prior to randomization and follow-up interviews conducted approximately 14.56 weekspost-baseline. RESULTS: Intervention caregivers, compared to controls, had decreased care-related strain as indicated by lower emotional health strain, dyadic relationship strain, role captivity, and higher caregiving mastery. Additionally, intervention caregivers had improved well-being as indicated by fewer symptoms of depression and anxiety. Implications : ANSWERS was efficacious in improving key strain and psychosocial outcomes for caregivers. Features essential to the success of ANSWERS included a strength-based approach for selecting, developing, and implementing care goals, as well as teaching caregivers educational and cognitive rehabilitation skills for addressing care needs.
HubMed – rehab
Is symptomatic knee osteoarthritis a risk factor for a fast decline in gait speed? Results from the osteoarthritis initiative.
Filed under: Rehab Centers
Arthritis Care Res (Hoboken). 2012 Aug 16;
White DK, Niu J, Zhang Y
OBJECTIVES: Gait speed is an important marker of health in adults and slows with aging. While knee osteoarthritis (OA) can result in difficulty walking, it is not known if radiographic knee OA (ROA) and/or knee pain are associated with a fast decline trajectory of gait speed over time. METHODS: Gait speed trajectories were constructed using a multinomial modeling strategy from repeated 20-meter walk tests measured annually over four years among participants from the Osteoarthritis Initiative (OAI), a prospective cohort study of adults with or at high risk of knee OA aged 45 to 79 at baseline. We grouped participants into four knee OA categories (having neither ROA nor knee pain, ROA only, knee pain only, or symptomatic knee OA (ROA and pain)) and examined their association with trajectories of gait speed using a multivariable polytomous regression model adjusting for age and other potential confounders. RESULTS: Of the 4179 participants (mean age (sd) = 61.1 (9.1), women =57.6%, mean BMI =28.5 (4.8) kg/m(2) ), 5% (n=205) were in a fast decline trajectory slowing 2.75%/year. People with symptomatic knee OA had almost a 9-fold risk (OR = 8.9, 95% CI [3.1, 25.5]) of being in a fast decline trajectory compared with those with neither pain nor ROA. Participants with knee pain had 4.5 times the odds of fast decline (95% CI [1.4, 14.6]) and those with ROA only had a slight but non-statistically significant increased risk. CONCLUSIONS: People with symptomatic knee OA have the highest risk of fast decline trajectory of gait speed compared with people with ROA or pain alone.
HubMed – rehab
Changes in spinal but not cortical excitability following combined electrical stimulation of the tibial nerve and voluntary plantar-flexion.
Filed under: Rehab Centers
Exp Brain Res. 2012 Aug 17;
Lagerquist O, Mang CS, Collins DF
Unilateral training involving voluntary contractions, neuromuscular electrical stimulation (NMES), or a combination of the two can increase the excitability of neural circuits bilaterally within the CNS. Many rehabilitation programs are designed to promote such “neuroplasticity” to improve voluntary movement following CNS damage. While much is known about this type of activity-dependent plasticity for the muscles that dorsi-flex the ankle, similar information is not available for the plantar-flexors. Presently, we assessed the excitability of corticospinal (CS) and spinal circuits for both soleus (SOL) muscles before and after voluntary contractions of the right plantar-flexors (VOL; 5 s on-5 s off, 40 min), NMES of the right tibial nerve (tnNMES; 5 s on-5 s off, 40 min), or both together (V + tnNMES). CS excitability for the right (rSOL) and left SOL (lSOL) muscles was assessed by quantifying motor evoked potentials elicited by transcranial magnetic stimulation. Spinal excitability was assessed using measures from the ascending limb of the M-wave versus H-reflex recruitment curve. CS excitability did not change for rSOL (the activated muscle) or lSOL following any condition. In contrast, there was a marked increase in spinal excitability for rSOL, but only following V + tnNMES; the slope of the M-wave versus H-reflex recruitment curve increased approximately twofold (pre = 7.9; post = 16.2) and H-reflexes collected when the M-wave was ~5 % of the maximal M-wave (M(max)) increased by ~1.5× (pre = 19 % M(max), post = 29 % M(max)). Spinal excitability for lSOL did not change following any condition. Thus, only voluntary contractions that were coupled with NMES increased CNS excitability, and this occurred only in the ipsilateral spinal circuitry. These results are in marked contrast to previous studies showing NMES-induced changes in CS excitability for every other muscle studied and suggest that the mechanisms that regulate activity-dependent neuroplasticity are different for SOL than other muscles. Further, while rehabilitation strategies involving voluntary training and/or NMES of the plantar-flexors may be beneficial for producing movement and reducing atrophy, a single session of low-intensity NMES and voluntary training may not be effective for strengthening CS pathways to the SOL muscle.
HubMed – rehab
The Houston Spine & Rehab Centers Present Magnum Rolle – NBA Player – Behind the scenes photo shoot for The Houston Spine and Rehab Centers featuring Magnum Rolle. For more information please visit us at www.spineandrehab.com
Volunteers needed for drug rehab transportation
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The Streator Options Counseling Services organizer said some people voluntarily come to their center looking for help and need inpatient treatment. Since the closest centers are in Peoria, Bloomington, Champaign and Rockford, a handful of those in need …
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Attacks against Muslims in US spike during Ramadan
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Ali, who is the president of the Joplin mosque said the congregation rented a convention center so people would have a place to pray and celebrate Eid al-Fitr, the feast that marks the end of fasting for Ramadan. Authorities are still investigating the …
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