Rehab Centers: The Utility of the Children’s Revised Impact of Event Scale in Screening for Concurrent PTSD Following Admission to Intensive Care.
The Utility of the Children’s Revised Impact of Event Scale in Screening for Concurrent PTSD Following Admission to Intensive Care.
Filed under: Rehab Centers
J Trauma Stress. 2012 Oct 9;
Dow BL, Kenardy JA, Le Brocque RM, Long DA
Although there is some information available regarding the utility of the Children’s Revised Impact of Event Scale (CRIES) in screening for posttraumatic stress disorder (PTSD), data are scarce and limited to studies sampling children predominantly injured in road traffic accidents. This study investigated the utility of 2 versions, the CRIES-8 and CRIES-13, in identifying those children meeting criteria for PTSD following admission to a pediatric intensive care unit (PICU). The Children’s PTSD Inventory (CPTSDI), a diagnostic interview, and the CRIES-13 were administered to 55 children, aged 6-16 years, 6 months following admission to the PICU. Of the 55, 14 (25%) met criteria on the CPTSDI. Cutoff scores of 14.5 on the CRIES-8 and 22.5 on the CRIES-13 maximized sensitivity and specificity and correctly classified 78%-86% of children. Both cutoff scores were lower than those reported in other samples. The CRIES-13 appeared to offer greater utility than the CRIES-8, also in contrast to previous findings. Methodological or sampling differences may account for the discrepancy with prior studies. The proposed cutoffs are recommended specifically for use with PICU patients and replication and further validation of the CRIES with other samples is warranted.
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Clinical predictors of a positive response to guided diagnostic block into the subacromial bursa.
Filed under: Rehab Centers
J Rehabil Med. 2012 Oct 10; 44(8): 877-84
Cadogan A, Laslett M, Hing W, McNair P, Taylor S
Objective: To compare the accuracy of combinations of clinical examination findings for predicting a positive response to injection of local anaesthetic into the subacromial bursa. Design: Prospective, cohort, diagnostic validity design. Subjects: Consecutive patients with shoulder pain recruited from primary care physiotherapy and general medical practices. Methods: All subjects underwent a standardised clinical examination (index test) followed by a diagnostic injection of xylocaineTM into the subacromial bursa (reference standard test) performed under ultrasound guidance. Clinical examination variables associated with a positive anaesthetic response (??80% post-injection reduction in pain intensity) were identified (p?HubMed – rehab
Pregait balance rehabilitation in acute stroke patients.
Filed under: Rehab Centers
Int J Rehabil Res. 2012 Oct 7;
Rao N, Zielke D, Keller S, Burns M, Sharma A, Krieger R, Aruin AS
Rehabilitation interventions designed to enhance balance control in individuals with acute stroke are quite limited. The goal was to develop and assess a technique of early pregait balance training involving the use of a combination of force platform visual feedback and the unweighting system in individuals with recent stroke. A total of 28 individuals with acute stroke were randomly divided into the experimental and control groups: individuals included in the experimental group received 1 week of treatment on the basis of retraining balance utilizing visual biofeedback (Balance Master) while provided with a body weight support harness system, whereas the individuals in the control group received conventional treatment. Both the groups undertook identical tests (Fugl-Meyer Balance test, Functional Independence Measure test for gait, and Fugl-Meyer lower extremity assessment) before the start of treatment and after its completion. Individuals in the experimental group showed larger gains as seen in the increased scores of the Fugl-Meyer Balance test and the Functional Independence Measure test for gait as compared with the control group. The outcome of the study provides a basis for future investigations of the applicability of the intervention in early balance rehabilitation of individuals with neurological disorders.Interventionen in der Rehabilitation zur Verbesserung der Gleichgewichtskontrolle von Personen nach akutem Schlaganfall sind beschränkt. Das Ziel der vorliegenden Studie war die Konzipierung und Evaluierung einer Technik für das frühzeitige gangvorbereitende Gleichgewichtstraining mit der Verwendung einer Kombination aus Kraftmessdruckplatten, visuellem Feedback und der Gewichtsentlastung bei Personen nach kürzlich erfolgtem Schlaganfall. Insgesamt 28 Personen nach akutem Schlaganfall wurden randomisiert Versuchs- und Kontrollgruppen zugeordnet: Die Personen in der Versuchsgruppe wurden eine Woche lang auf der Basis des Gleichgewichts-Neutrainings mittels visuellem Biofeedback (Balance Master) mit einem Körpergewicht-Stützgurt behandelt, die Personen in der Kontrollgruppe dagegen mittels einer konventionellen Therapie. Beide Gruppen wurden vor Therapiebeginn und danach identischen Tests unterzogen (Fugl-Meyer Gleichgewichtstest, funktionaler Selbständigkeitsindex-Test für den Gang und Fugl-Meyer-Test der unteren Extremität). Die Personen in der Versuchsgruppe wiesen im Vergleich zur Kontrollgruppe größere Nutzen auf, wie die erhöhten Scores des Fugl-Meyer Gleichgewichtstests und der funktionale Selbständigkeitsindex-Test für den Gang zeigten. Das Ergebnis der Studie liefert eine Grundlage für weitere Untersuchungen der Anwendbarkeit der Interventionen bei der frühen Rehabilitation des Gleichgewichts von Personen mit neurologischen Störungen.Las intervenciones de rehabilitación diseñadas para mejorar el control del equilibrio en individuos con accidente cerebrovascular agudo son bastante limitadas. El objetivo de este estudio fue desarrollar y evaluar una técnica de entrenamiento temprano del equilibrio pre-marcha, mediante la combinación del feedback visual de una plataforma de fuerza y un sistema de descarga de peso en individuos con accidente cerebrovascular reciente. Se dividió de forma aleatoria entre el grupo experimental y el grupo control a un total de 28 individuos con accidente cerebrovascular agudo: los sujetos incluidos en el grupo experimental recibieron una semana de tratamiento mediante reentrenamiento del equilibrio a partir de biofeedback visual (Balance Master) y el uso de un sistema de arneses de sujeción del peso corporal, mientras que los sujetos del grupo control recibieron un tratamiento convencional. Ambos grupos fueron sometidos a pruebas similares (el test de equilibrio de Fugl-Meyer, el test de medida de independencia funcional de la marcha y la evaluación de las extremidades inferiores de Fugl-Meyer) antes de comenzar el tratamiento y tras finalizarlo. Los individuos del grupo experimental presentaron un mayor grado de mejora, tal y como muestra el incremento de las puntuaciones del test de equilibrio de Fugl-Meyer y el test de medida de independencia funcional de la marcha, en comparación con el grupo control. El resultado del estudio ofrece una base para futuras investigaciones sobre la aplicabilidad de la rehabilitación temprana del equilibrio en individuos con trastornos neurológicos.Les interventions de rééducation visant à améliorer le contrôle de l’équilibre chez les personnes ayant subi un AVC aigu sont très limitées. L’objectif était de développer et d’évaluer une technique d’entraînement à l’équilibre avant-marche impliquant l’utilisation d’une combinaison de rétroaction visuelle d’une plate-forme de force et du système d’allègement chez les personnes ayant subi un AVC récent. 28 personnes ayant subi un AVC aigu ont été réparties de façon aléatoire dans des groupes expérimentaux et témoins: les participants du groupe expérimental ont reçu 1 semaine de traitement reposant sur la rééducation de l’équilibre au moyen de la bio-rétroaction visuelle (Balance Master), combinée avec le port d’un harnais de support de poids corporel , tandis que les sujets du groupe témoin ont reçu un traitement conventionnel. Les deux groupes ont effectué des tests identiques (test d’équilibre de Fugl-Meyer, mesure d’indépendance fonctionnelle de la marche et évaluation des extrémités inférieures de Fugl-Meyer) avant le début du traitement et après son achèvement. Les sujets du groupe expérimental ont présenté des gains plus importants que les groupe témoin, comme en témoignent leurs scores accrus au test d’équilibre de Fugl-Meyer et au test de mesure de l’indépendance fonctionnelle pour la marche. Les résultats de l’étude fournissent une base pour de futures études de l’applicabilité d’une intervention précoce de rééducation de l’équilibre chez les personnes souffrant de troubles neurologiques.
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Normative wideband reflectance measures in healthy neonates.
Filed under: Rehab Centers
Int J Pediatr Otorhinolaryngol. 2012 Oct 6;
Aithal S, Kei J, Driscoll C, Khan A
OBJECTIVE: Presently, normative wideband reflectance data are available for neonates who have passed a distortion product otoacoustic emission test. However, passing the distortion product otoacoustic emission test alone does not ensure normal middle ear function. The objective of this study was to establish normative wideband reflectance data in healthy neonates with normal middle ear function, as justified by passing a battery of tests. METHOD: Wideband reflectance was measured in 66 infants (mean age=46.0h, SD=21.0, range=13.3-116.5h) who passed a test battery that included high frequency (1000Hz) tympanometry, acoustic stapedial reflex, transient evoked otoacoustic emissions and distortion product otoacoustic emissions. RESULTS: The analysis of variance (ANOVA) results showed significant variations of reflectance across the frequencies. There was no significant difference between ears and genders. The median reflectance reached a minimum of 0.21-0.24 at 1-2kHz, but increased to 0.45-0.59 below 1kHz and 0.24-0.52 above 2kHz. CONCLUSIONS: The normative reflectance data established in the present study were in agreement with, but marginally smaller than, those of previous normative studies, except for the Keefe et al. (2000) study. While the use of a test battery approach to ensure normal middle ear function in neonates has resulted in slightly reduced reflectance across most frequencies when compared to studies that have used only otoacoustic emissions, further research is needed to accurately determine the middle ear status of neonates using test performance measures.
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