A comparison of comprehensive rehabilitation and comprehensive rehabilitation with feed-back balance training for acute stroke patients

"60% of stroke survivors become disabled due to motor and cognitive disorders that have an effect on the person’s quality of life. Early comprehensive rehabilitation after acute stroke is very important, because it affects the course of the disease, functional independence level and conditions the better quality of life. Most important factors affecting on the patient’s functional independence is a level of balance disorders in patients after stroke. Therefore the influence of different factors on the results of comprehensive rehabilitation in early period of stroke and the relation between the balance disorders and functional independence, the relation between balance tests and various factors that can influence the results of balance alteration has been presented in this paper. In the paper are described different influences of comprehensive rehabilitation and comprehensive rehabilitation with feed-back balance training on balance improvement in patients groups after stroke. It was formed some conclusions: comprehensive rehabilitation program increase balance and functional independence of the stroke patients; correlation between functional independence tests, routine balance tests and „MTD-balance“ system indications tests (p < 0.01) was determined, comprehensive rehabilitation program with feed-back balance training (using „MTD-balance“ system) improve balance and functional independence of stroke patients better than comprehensive rehabilitation program only

Physical capacity and balance ability after lower limb amputation

"The mean causes of lower extremity amputation, and the main goals and means of comprehensive rehabilitation in period of prior to surgery, acute postoperative and prosthetic training has been presented in this paper. In the paper are described most common problems after lower limb amputation, such as deterioration of muscle strength and balance and scientific search of optimal rehabilitation programs for patients after lower limb amputation on regaining and development balance and walking ability. It was formed some conclusions: applied individual comprehensive rehabilitation program increase lower limb amputees physical capacity and functional independence; properly selected and fitted lower limb prosthesis improves patients balance and walking abilities

A comparison of comprehensive rehabilitation and comprehensive rehabilitation with feed-back balance training for acute stroke patients

"60% of stroke survivors become disabled due to motor and cognitive disorders that have an effect on the person’s quality of life. Early comprehensive rehabilitation after acute stroke is very important, because it affects the course of the disease, functional independence level and conditions the better quality of life. Most important factors affecting on the patient’s functional independence is a level of balance disorders in patients after stroke. Therefore the influence of different factors on the results of comprehensive rehabilitation in early period of stroke and the relation between the balance disorders and functional independence, the relation between balance tests and various factors that can influence the results of balance alteration has been presented in this paper. In the paper are described different influences of comprehensive rehabilitation and comprehensive rehabilitation with feed-back balance training on balance improvement in patients groups after stroke. It was formed some conclusions: comprehensive rehabilitation program increase balance and functional independence of the stroke patients; correlation between functional independence tests, routine balance tests and „MTD-balance“ system indications tests (p < 0.01) was determined, comprehensive rehabilitation program with feed-back balance training (using „MTD-balance“ system) improve balance and functional independence of stroke patients better than comprehensive rehabilitation program only

Education of physical and rehabilitation medicine specialists across Europe: a call for harmonization

BACKGROUND: Physical and rehabilitation medicine (PRM) is well established in Europe and officially recognized by the European Union of Medical Specialists (UEMS). The European PRM Board works to promote patient safety and quality of care through the development of the highest standards of medical training and healthcare across Europe as well as the harmonization of PRM specialists' qualifications. In its Action Plan for 2014-2018, the UEMS PRM Board has included the harmonization of the PRM curriculum among the EU countries, as one of its main goals. Based on a European Directive, the Belgian Superior Council is envisaging a reform of the PRM curriculum. AIM: The aim of this paper is to present the current situation of PRM education in Europe according to the survey carried out by the Belgium Task Force. DESIGN: An online survey was posted on May 3rd 2015 to all delegates of the UEMS PRM Section and Board. Two questions were formulated: 1) What is the duration and curriculum of PRM training in your country? 2) Does a Postgraduate Rehabilitation training exist for other medical specialties? RESULTS: The majority of the PRM training programs in Europe have a duration ranging from 4 to 5 years, and are not aiming at downsizing the duration to the European minimal training period of 3 years. The vast majority (70%) of the responding countries don't offer an additional accreditation of Rehabilitation for other medical specialties CONCLUSIONS: Comparing PRM training programs in Europe can support the long-awaited reform of the PRM postgraduate curriculum in Belgium and gives perspective to agree on a transparent and comparable specialty training throughout Europe. Providing a more comparable training promotes the establishment of PRM and its rehabilitation service provisions in the world

Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population:A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey

Background As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods Data from 6’635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.</p

Harmonization of training and assessment of medical specialists in physical and rehabilitation medicine across Europe - The contribution of the UEMS Board of Physical and Rehabilitation Medicine

Background.- The main goals of the European Board of Physical and Rehabili-tation Medicine (EBPRM), founded in 1991 as the third speciality board of theUnion of European Medical Specialists (UEMS), are to harmonize pre-graduate,post-graduate and continuous medical education in physical and rehabilitationmedicine (PRM) all over Europe. The harmonization of curricula of the medi-cal specialities and the assessment of medical specialists has become one of thepriorities of the UEMS and its working groups to which the EBPRM contributes.Action.- The EBPRM will continue to promote a specific minimal undergraduatecurriculum on PRM including issues like disability, participation and handicapto be taught all over Europe as a basis for general medical practice. The EBPRMwill also expand the existing EBPRM postgraduate curriculum into a detailedcatalogue of learning objectives. This catalogue will serve as a tool to boostharmonization of the national curricula across Europe as well as to structurethe content of the MCQ examination. It would be a big step forward towardsharmonization of European PRM specialist training if an important number ofcountries would use the certifying MCQ examination of the Board as a part ofthe national assessments for PRM specialists

Educational resources offered by the European Board of Physical and Rehabilitation Medicine (EBPRM)

Background .- Physical and Rehabilitation Medicine (PRM) is a very demanding medical speciality. To ensure high standard of research and care in PRM all across Europe, it is crucial to attract gifted trainees and offer them high quality education. At undergraduate level, many medical schools in Europe omit to offer teaching on disabled persons and on basic PRM knowledge. Thus PRM is hardly known to medical students. For postgraduate trainees access to evidence-based knowledge as well as teaching of research methodology specific to PRM, rehabilitation methodology, disability management and team building also need to be strengthened to increase the visibility of PRM. Action .- To address these issues the EBPRM proposes presently a specific undergraduate curriculum in PRM including the issues of disability, participation and handicap as a basis for general medical practice and postgraduate rehabilitation training. For PRM trainees many educational documents are now available on the EBPRM website. A growing number of educational sessions for PRM trainees take place during international and national PRM Congresses which can be accessed at low cost. Educational papers published regularly in European rehabilitation journals and European PRM Schools are offered free or at very low cost to trainees