Introduction There is little known about the acute status of TKA patients, as many studies have focused on the long-term outcomes (Aarons et al., 1996). Knowing the acute status can aid physiotherapists in planning postoperative treatment protocols and help with discharge planning. This research examines the postoperative status of total knee arthroplasty (TKA) patients on discharge from an acute setting. The objectives of the study were to establish pain, ROM of the operated knee, functional level, socio-demographic factors, clinical data and the relationship between identified factors and postoperative functional status of TKA patients in the acute setting. Materials and Methods This study is classified as a quantitative, cross-sectional design. Sociodemographic and clinical data, pain, range of movement (ROM) and function of TKA patients were collected on day three post operation. A selfdesigned data capture sheet, the goniometer, VAS (Visual Analogue Scale) and ILOA (Iowa Level of Assistance) were used to measure data. Results Forty-four patients were assessed. There were 41% males and 59% females. The average age was 67 years and BMI was 30kg/m2. All patients had decreased ROM and 82% had poor quadriceps strength. Pain on walking was 5.8 on the VAS and correlated with the ILOA score. Pain on rest was 3.3 and when climbing stairs was 2.4. Sixty-one percent of subjects performed supine to sit, 59% performed sit to stand and 43% performed ambulation independently. Men performed better with an ILOA score of 24. Females had an ILOA score of 31. Length of stay (LOS) was 5.7 days. Females, older subjects and those with no medical conditions were more likely to stay in hospital for longer. Conclusion Knowledge of these factors will help to give patients a likely prognosis following a TKA and target future rehabilitation. Patients should receive adequate pain control to improve their functional ability. More attention should be given to female patients as they perform worse than men. Patients in this population should be referred for outpatient physiotherapy post-discharge, as their status on day three post operation reflected poor ROM, quadriceps muscle strength and function which may affect their rehabilitation outcome.

A research report submitted to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy Johannesburg, April 2017 / The study sought to compare the caregivers’ evaluation of the occupational performance and assistance needed by children with cerebral palsy (CP) to that of treating therapists to ascertain agreement about the children’s strengths/weaknesses so goals for intervention can be set. The Paediatric Evaluation of Disability Inventory (PEDI) parent/caregiver and therapist scores of 50 children with CP in Harare aged four to six and half years were analysed. The association between PEDI scores and the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels as well as the internal consistency of the PEDI for this sample were also determined. Correlations for the caregivers’ and therapists’ scores on the PEDI were strong to excellent. A marked decrease in functional skills on the PEDI was noted in relation to the GMFCS and MACS levels with a negative moderate correlation between the PEDI scores and the GMFCS levels for self care, a negative strong correlation for mobility but a negative weak correlation for social function. The similarity of scores indicates positive correlation that allows for collaborative goal setting and Family Centred Therapy with these children. Internal consistency was excellent for all functional skills domains and caregiver assistance. / MT2017

Thesis (M.S.)--Boston University

Digitized by Kansas Correctional Industries

Thesis (M.S.)--Boston University

Thesis (M.A.)--University of the Witwatersrand, Faculty of Arts, 1970.

Adipositas ist eine chronische, schwer zu behandelnde Erkrankung. Die Therapieerfolge stationärer medizinischer Rehabilitation halten oft nicht lange an. Ziel der Studie ist es, zu klären, ob bei adipösen Patienten nach stationärer medizinischer Rehabilitation überhaupt ein Nachsorgebedürfnis besteht und wenn ja, wie die Nachsorge bezüglich Inhalt und Form gestaltet sein soll, damit sie hilfreich ist. / Obesity is a chronic disease, that is hard to treat. The success of therapy of inpatient medical rehabilitation often doesn´t last for a long time. The purpose of this study is to find out, if obese patients have a need for aftercare after inpatient medical rehabilitation and what kind of aftercare contents and design would be helpful.

No description available.

The majority of people with stroke regard walking in their community as very important (Lord et al 2004). Walking in the community is limited by slow walking speeds and poor walking capacity (Lord et al 2004; Patterson et al 2007). Slow walking speeds and poor walking capacity are identified sequela in people with stroke (Hill et al 1997). By the end of rehabilitation approximately 80% of people with stroke achieve independent walking (Dean & Mackay 1992; Hill et al 1997). However, less than 10 percent are able to easily walk in their community (Hill et al 1997). Optimal motor learning requires task-specific practice (Carr & Shepherd 2003). Treadmills offer the opportunity for repetitive practice of complete gait cycles (Shepherd & Carr 1999), potentially providing greater intensity and longer duration walking practice than usual physiotherapy rehabilitation. Recently there has been some suggestion that high-intensity interventions may improve walking in people with stroke (Moseley et al 2005). Low levels of cardiorespiratory fitness in people with stroke have been shown to impact on walking, in particular walking capacity (Kelly et al 2003). Treadmills, commonly used to retrain cardiorespiratory fitness in the healthy population, have been used to implement high-intensity interventions, improving cardiorespiratory fitness in people with chronic stroke (Macko et al 2005). Therefore it is possible that exercise aimed at improving cardiorespiratory fitness may improve walking in people with stroke. The aim of these four studies was to investigate in those following stroke if walking on a treadmill at high-intensity during inpatient rehabilitation could improve walking capacity without compromising pattern and quality. The first study determined, in an Australian setting, the duration and intensity of usual physiotherapy rehabilitation. Study 2 compared walking pattern immediately following overground and treadmill walking practice at the same intensity. Study 3 examined the effect of treadmill walking at intensities high enough to influence cardiorespiratory fitness on walking pattern and quality. The final study, investigated the feasibility of implementing a high-intensity treadmill intervention in addition to usual physiotherapy rehabilitation in people following stroke able to walk undergoing inpatient rehabilitation. Intensity in all studies was calculated using heart rate reserve or the Karvonen method. Heart rate is a valid, accurate and stable indicator of exercise intensity due to its relatively linear relationship with oxygen consumption (ACSM 2006). For those people taking beta-blocker medication, the heart rate-lowering effect of this type of medication was accommodated. A target intensity of 40% heart rate reserve was used; as this is the minimum required improve cardiorespiratory fitness (ACSM 2006). Walking pattern and quality were measured in Studies 2-4. Walking pattern was measured by linear kinematics using GAITRite (CIR Systems, Clifton, NJ, USA) and angular kinematics using a 2-dimensional webcam application. Walking quality was determined by observation of the webcam footage and scored using the Rivermead Visual Gait Assessment, Wisconsin Gait Scale and a vertical visual analogue scale by blinded assessor. The first study found that people with stroke spent an average of 21 (SD 11) minutes participating in standing and walking activities that are associated with reaching the target intensity during physiotherapy rehabilitation. Those who could walk spent longer in these activities (25 minutes, SD 12) compared to those would couldn’t walk (17 minutes, SD 9). However, the intensity of these activities was low; walkers reached a maximum of 30% heart rate reserve and non-walkers reached 35% heart rate reserve. Using the treadmill as a mode of task-specific physiotherapy rehabilitation, the second study in this thesis found that walking pattern was similar following 10 minutes of treadmill and overground walking practice at the same intensity. The third study found that during walking on the treadmill at intensities high enough to influence cardiorespiratory fitness (up to 60% heart rate reserve), many of the linear and angular kinematic parameters moved closer to a more normal pattern and walking quality was not compromised. The final study in this thesis, a randomised controlled trial, found that a 6-week high-intensity treadmill walking intervention was feasible in people with stroke able to walk who were undergoing rehabilitation. Participants attended 89% of the treadmill sessions, reaching an average duration of more than 20 minutes and an intensity of 40% heart rate reserve after two weeks. The intervention also appeared effective with significant improvements in walking speed and capacity following the treadmill walking intervention. Improvements in walking speed were maintained at 3 months. In summary, these studies found that usual physiotherapy in people with stroke was of low intensity. In addition, it was found that treadmill walking was safe and feasible as a means of increasing the intensity of physiotherapy rehabilitation, without compromising walking quality and pattern. Therefore, it may be possible to improve walking in people with stroke using high-intensity treadmill walking.

Previous research has indicated success using Social Stories with preschoolers with mild levels of autism. The purpose of this study was to determine if Social Stories implemented in the home setting would be effective with preschool children diagnosed with moderate to severe autism. Social Stories were implemented with 3 male preschool-aged participants. Two were classified as in the moderate range and one was in the severe range of autism. A variety of socially inappropriate behaviors were addressed including inappropriate dinnertime behaviors, transitioning to bedtime, and inappropriate touching. Data revealed no significant change in target behaviors (dinnertime behaviors and transitioning to bedtime) exhibited by moderately functioning preschool children. However, data did reveal a decrease in the frequency of inappropriate touching from the child who fell in the severe range of functioning. It is not clear from the current research whether it was the severity level of autism or the types of target behaviors that may have resulted in a lack of success using the Social Story intervention.