Rehab Centers: Improvements in Children With Cerebral Palsy Following Intrathecal Baclofen: Use of the Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire (RIC CareQ).

Improvements in Children With Cerebral Palsy Following Intrathecal Baclofen: Use of the Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire (RIC CareQ).

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J Child Neurol. 2013 Feb 17;
Baker KW, Tann B, Mutlu A, Gaebler-Spira D

Implantation of an intrathecal baclofen pump is recommended for children with cerebral palsy as a means to improve care and comfort when other options fail to control severe hypertonia. Making an assessment of a child’s spasticity-related limitations in both routine care and activity is a necessary component of selection of intrathecal baclofen candidates. The Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire (RIC CareQ) is a validated, easy-to-use questionnaire that elicits information about the ease of daily activity and caregiving in patients with severe spasticity. Questionnaires completed by caregivers and patients at a pediatric physiatry spasticity clinic over an 11-year period were reviewed to evaluate whether the Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire captured improved caregiving and comfort of children with cerebral palsy and severe spasticity following intrathecal baclofen pump implantation. The Questionnaire scores showed improvement after intrathecal baclofen pump implantation, consistent with subjective reports of patient and caregiver satisfaction.
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A health economic analysis of osteoporotic fractures: who carries the burden?

Filed under: Rehab Centers

Arch Osteoporos. 2013 Dec; 8(1-2): 126
Hansen L, Mathiesen AS, Vestergaard P, Ehlers LH, Petersen KD

This is a cost-of-illness study of osteoporotic fractures in Denmark estimating the incremental societal cost associated with osteoporotic fractures, with both direct cost and productivity cost. This study includes cost regarding hospitals, general practices, the patients, the municipalities and regions. The total cost of osteoporotic fractures in Denmark was estimated at EUR 1.563 billion. PURPOSE: The aim of this study is to estimate the societal burden imposed by osteoporotic fractures in Denmark. In contrast to prior studies, this study will present a comprehensive model for the cost of osteoporotic fractures regarding hospitals, general practices, the municipalities, the regions and the patients. METHODS: This cost-of-illness study applied an incidence-based bottom-up approach from a societal perspective, including both direct costs and productivity costs. The study focused on incremental cost associated with osteoporotic fractures using a Markov model. Danish citizens ?50 years with an osteoporotic fracture between 2001 and 2010 were studied. RESULTS: The total cost of osteoporotic fractures in Denmark was estimated to EUR 1.563 billion in 2011, at EUR 628 million and EUR 936 million for men and women, respectively. The most expensive fracture for both genders was first hip fracture. The municipalities carried the majority of the costs, with 55-57 % of incremental lifetime cost. CONCLUSIONS: This study showed that the incremental societal burden of osteoporotic fractures is an important health problem. Medical costs of the osteoporotic fractures were substantial cost for the health care sector, but were by far exceeded by the cost for the municipality in terms of social services and rehabilitation.
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Prognostic factors of synkinesis after Bell’s palsy and Ramsay Hunt syndrome.

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Auris Nasus Larynx. 2013 Feb 15;
Morishima N, Yagi R, Shimizu K, Ota S

OBJECTIVE: This study evaluated the prognostic factors of synkinesis following Bell’s palsy and Ramsay Hunt syndrome. METHODS: A total of 345 patients consisting of 309 cases of Bell’s palsy and 36 cases of Ramsay Hunt syndrome were enrolled in our study. The following 13 factors were considered as candidate prognostic factors for the presence of synkinesis at 6 months from onset: age, sex, diagnosis, diabetes mellitus, initial onset or recurrence, electroneurography (ENoG), number of days from onset to first visit to our hospital, the lowest Yanagihara grading system score, the change in Yanagihara score after 1 month, otalgia, hearing loss, vertigo and taste disturbances. These factors were analyzed by logistic regression. RESULTS: Logistic regression analysis clarified the lowest Yanagihara score, the change in Yanagihara score after 1 month, and the ENoG value for a prognosis of synkinesis. The most predictive prognostic factor was the lowest Yanagihara score, and the adjusted odds ratio in the multivariate model was 11.415. As for other prognostic factors, the adjusted odds ratios ranged from 7.017 (ENoG value) to 8.310 (the change in Yanagihara score after 1 month). These findings were therefore considered as high risk factors for synkinesis. CONCLUSION: It is possible to predict synkinesis following Bell’s palsy and Ramsay Hunt syndrome on the basis of clinical symptoms. The lowest Yanagihara score, and the change in Yanagihara score after 1 month, together with the ENoG value at the onset, were found to be especially important factors for predicting synkinesis following Bell’s palsy and Ramsay Hunt syndrome.
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Annals of PRM, an international bilingual journal of physical rehabilitation medicine.

Filed under: Rehab Centers

Ann Phys Rehabil Med. 2013 Feb; 56(1): 1-2
Rode G, Thevenon A, Pérennou D

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