The Rudie family knows all too well how dangerous lawn mowing can be when proper safety precautions are not taken. In July 2009, Mrs. Brenda Rudie’s two-year-old son Brandon suffered devastating facial injuries in a lawn mower accident. His father was mowing the lawn and Brandon was in a cart behind him with his 5-year-old cousin. Somehow Brandon fell out of the front and his father backed up, accidentally running him over.

“We never thought this would happen. We thought he was safe,” said Mrs. Rudie. “Brandon had deep cuts on the left side of his face – to the bone, his ear was severed, and his eye, mouth, and chest were badly injured. His plastic surgeon took tissue from his arm and back to repair his face. It took two months before we could bring Brandon home. Please don’t let your kids near lawn mowers, it’s just not safe.”

Unfortunately, 247,000 people were treated for lawn mower-related injuries last year, more than 18,000 of them children under age 19, the U.S. Consumer Product Safety Commission reports. Lawn mower-related injuries have increased 7 percent since 2008.

With the summer mowing season approaching, the American Society for Reconstructive Microsurgery (ASRM), American Society of Plastic Surgeons (ASPS), American Society of Maxillofacial Surgeons (ASMS), American Academy of Pediatrics (AAP), and American Academy of Orthopaedic Surgeons (AAOS) are working together to prevent injuries and educate adults and children about the importance of lawn mower safety.

“Lawn mower injuries are not only among the most devastating I’ve seen in over 20 years of practice, they are also the most preventable,” said ASRM President Peter Neligan, MD. “When a lawn mower injury happens to a child it is even more devastating because it is invariably due to the inattention of an adult. Don’t let your life or the life of your child be irrevocably changed by a moment of inattention.”

Many lawn mower-related injuries require a team of physicians from various specialties – plastic surgery, microsurgery, maxillofacial surgery, pediatrics, and orthopaedics – to properly repair them. Often, patients must endure painful reconstructive operations for months, sometimes years, to restore form and function.
“Lawn mower injuries often include deep cuts, loss of fingers and toes, limb amputations, broken and dislocated bones, burns, and eye injuries,” said ASPS President Michael McGuire, MD. “Most are caused by careless use and can be prevented by following a few simple safety tips.”

The ASRM, ASPS, ASMS, AAP and AAOS offer the following tips to help prevent lawn mower-related injuries:

- Children should be at least 12-years-old before they operate any lawn mower, and at least 16- years-old for a ride-on mower.

- Children should never be passengers on ride-on mowers.

- Always wear sturdy shoes while mowing – not sandals.

- Young children should be at a safe distance from the area you are mowing.

- Pick up stones, toys and debris from the lawn to prevent injuries from flying objects.

- Always wear eye and hearing protection.

- Use a mower with a control that stops it from moving forward if the handle is released.

- Never pull backward or mow in reverse unless absolutely necessary – carefully look for others behind you when you do.

“Lawn mower injuries can be very severe, ranging anywhere from a small fracture or tendon tear to an amputation,” said AAOS President John J. Callaghan, MD. “Operating lawn mowers improperly can heighten the chance of injury, so it is our duty as orthopaedic surgeons, to educate the public about the dangers and provide people with a safe approach to lawn care.”

Hear, firsthand, Mrs. Rudie and her son’s plastic surgeon, Dr. Robert Whitfield, discuss the life altering effects of lawn mower injuries by downloading their video blog at plasticsurgery/x10363.xml.

Source
American Society of Plastic Surgeons

Neuroscience researchers at the University of Louisville will be the only team collaborating with an international group of scientists that last week announced they had enabled paralyzed rats to walk while supporting their own weight.

Dr. Susan Harkema, the University of Louisville’s Owsley Brown Frazier Chair in Neurological Rehabilitation, rehabilitation director at the university’s Kentucky Spinal Cord Injury Research Center (KSCIRC) and the director of research at Frazier Rehab Institute, is evaluating how to translate into humans the success accomplished in the animals.

“We have been collaborating with this particular group of researchers for a number of years,” Harkema said. “The results they have shown are very exciting and we look forward to determining how to take their animal findings and move it into applications for humans.”

The research team at UCLA found that a combination of drugs, electrical stimulation and regular exercise was enough to allow the rats to walk. One of the key things demonstrated is that regeneration of severed nerve fibers is not required for the animals to learn to walk again.

“Spine cells in mammals generate a current that helps make muscles and parts of the body move. If we can find ways to harness that current and stimulate appropriate areas with electrical stimulation to enhance that current, we may be able to help people who have complete spinal cord injuries stand and walk on their own,” Harkema said.

Statistics from the University of Alabama National Spinal Cord Injury Statistical Center show that approximately 250,000 Americans are spinal cord injured. Fifty two percent of spinal cord injured individuals are considered paraplegic and 47% quadriplegic. Approximately 11,000 new injuries occur each year. Fifty-six percent of injuries occur between the ages of 16 and 30. The average age of a spinal cord injured person is 31.

Source:
Gary Mans

University of Louisville Health Sciences Center

Frozen shoulder, also known as adhesive capsulitis, is a common condition in which the articular shoulder capsule (a sac of ligaments surrounding the joint) swells and stiffens, restricting its mobility. It typically affects only one shoulder, but one in five cases affect both.

The term “frozen shoulder” is often used incorrectly for arthritis, even though the two conditions are unrelated. Frozen shoulder refers specifically to the shoulder joint, while arthritis may refer to other/multiple joints.

The shoulder has a spheroidal joint (ball – and – socket joint), in which the round part of one bone fits into the concavity of another. The proximal humerus (round head of the upper arm bone) fits into socket of the scapula (shoulder blade). Frozen shoulder is thought to cause the formation of scar tissue in the shoulder, which makes the shoulder joint’s capsule (not to be confused with the rotator cuff) thicken and tighten, leaving less room for movement. Therefore, movement may be stiff and even painful.

The modern English words “adhesive capsulitis” are derived from the Latin words adhaerens meaning “sticking to” and capsula meaning “little container” and the Greek word itis meaning “inflammation”.

According to MediLexicon’s medical dictionary, adhesive capsulitis is: “A condition in which joint motion becomes restricted because of inflammatory thickening of the capsule; a common cause of shoulder stiffness.”

Frozen shoulder is a condition that targets people between 40 and 60 years of age – women more often than men.
What causes frozen shoulder?
The cause of frozen shoulder is not fully understood and in some cases is unidentifiable. However, most people with frozen shoulder have suffered from immobility as a result of a recent injury or fracture. It is common in people with diabetes.
What are the risk factors for frozen shoulder?
A risk factor is something that elevates the risk of developing a disease or condition. For example, smoking is a risk factor for cancer – it elevates the risk of developing lung cancer.
Common risk factors for frozen shoulder are:

Age – being over 40 years of age.
Gender – 70% of people with frozen shoulder are women.
Recent surgery or arm fracture – immobility of recovery may cause the shoulder capsule to stiffen.
Diabetes – two to four times more likely to develop frozen shoulder for unknown reasons; symptoms may be more severe.
Having suffered a stroke.
Hyperthyroidism (overactive thyroid).
Hypothyroidism (underactive thyroid).
Cardiovascular disease (heart disease).
Parkinson’s disease.

What are the signs and symptoms of frozen shoulder?
A symptom is something the patient feels and/or reports, while a sign is something others, including the doctor observe. For example, pain is usually a symptom, while a rash could be a sign.

The most pervasive sign or symptom of frozen shoulder is a persistently painful and stiff shoulder joint. Signs and symptoms of frozen shoulder develop gradually; usually in three stages in which signs and symptoms worsen gradually and resolve within a two – year period.

There are three stages of frozen shoulder:

Painful stage – the shoulder becomes stiff and then very painful with movement. Movement becomes limited. Pain typically worsens at night.
Frozen/adhesive stage – the shoulder becomes increasingly stiff, severely limiting range of motion. Pain may not diminish, but it does not usually worsen.
Thawing stage – movement in the shoulder begins to improve. Pain may fade, but occasionally recur.

How is frozen shoulder diagnosed?
Doctors will most likely diagnose frozen shoulder based on signs and symptoms and a physical exam; paying close attention to the arms and shoulders. The severity of frozen shoulder is determined by a basic test in which a doctor presses and moves certain parts of the arm and shoulder.

Structural problems can only be identified with the help of imaging tests, such as an X – ray or MRI. An X-ray is a type of electromagnetic radiation that can penetrate most solid objects to create images of an object’s interior. An MRI (magnetic resonance imaging) uses magnetic signals to create image “slices” of the soft tissues inside the human body.
What are the treatment options for frozen shoulder?
The aim of treatment for frozen shoulder is to alleviate pain and preserve mobility and flexibility in the shoulder. However, recovery may be slow, as symptoms tend to persist for several years.

Treatment options for frozen shoulder include:

Painkillers – relieve symptoms of pain. Nonsteroidal anti – inflammatory drugs (NSAIDs), such as ibuprofen, are over – the – counter (OTC, no prescription required) painkillers and may reduce inflammation of the shoulder in addition to alleviating mild pain. Acetaminophen (paracetamol, Tylenol) is recommended for extended use. Prescription painkillers, such as codeine (an opiate – based painkiller) may also reduce pain. Not all painkillers are suitable for every patient; be sure to review options with your doctor.
Exercise – frequent, gentle exercise can prevent and even reverse stiffness in the shoulder.
Hot or cold compression packs – help to reduce pain and swelling. It is often helpful to alternate between the two.
Corticosteroid injections – a type of steroid hormone that reduces pain and swelling. Corticosteroids may be injected into the shoulder joint to alleviate pain, especially in the ‘painful stage’ of symptoms. However, repeated corticosteroid injections are discouraged as they could cause damage to the shoulder.
Transcutaneous electrical nerve stimulation (TENS) – numbs the nerve endings in the spinal cord that control pain and sends small pulses of electricity from the TENS machine to electrodes (small electric pads) that are applied to the skin on the affected shoulder.
Physical therapy (UK: physiotherapy) – can teach you exercises to maintain as much mobility and flexibility as possible without straining the shoulder or causing too much pain.
Shoulder manipulation – the shoulder joint is gently moved while you are under a general anesthetic (a drug that makes you completely unconscious).
Shoulder arthroscopy – a minimally invasive type of surgery used in a small percentage of cases. A small endoscope (tube) is inserted through a small incision into the shoulder joint to remove any scar tissue or adhesions.

Your doctor will suggest a suitable option depending on the severity of your signs and symptoms.

If you experience stiffness in the shoulder joint it is recommended that you seek medical attention sooner rather than later in order to prevent permanent stiffness.
How can frozen shoulder be prevented?
Frozen shoulder can only be prevented if it is caused by an injury that makes shoulder movement difficult, in which case the patient should talk to a doctor about what exercises can maintain mobility and flexibility of the shoulder joint.

Caroline Gillott

The Military Construction-Veterans Affairs appropriations bill (HR 2642), which exceeds President Bush’s budget request by $4 billion, is expected to pass in the Senate on Thursday, the AP/San Jose Mercury News reports. The legislation would provide $65 billion in discretionary spending and $41 billion in disability benefits.

The White House issued a veto threat in May, but with an override likely, the administration retreated from that position in its official policy statement Tuesday, according to the AP/Mercury News. The White House now indicates that Bush will sign the bill but says that Congress should identify cuts elsewhere to offset the increases (Taylor, AP/San Jose Mercury News, 9/5). Senate Majority Leader Harry Reid (D-Nev.) said he hopes to complete work on the bill “in a very expeditious manner” (Yoest, CQ Today, 8/4).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Research conducted by Speech Remedy, LLC, a leading provider of speech therapy rehabilitation materials, shows that many health professionals are frustrated by the lack of current, multicultural, functional, “real life” applicable materials for those 16 and older. To address this need, Speech Remedy founders Joanna Boyer and Terri Tarnoff Snyder, both certified practicing speech-language pathologists, created SR-Cognition, a multi-sensory therapeutic tool kit for adult rehabilitation.

This new, up-to-date tool-kit, with a hands-on, interactive approach to learning is available at speechremedy The kit will help to rehabilitate individuals who have sustained a stroke, traumatic brain injury, cranial resection, tumor, or are suffering from degenerative conditions such as dementia, ALS, or multiple sclerosis. It may also aid high school aged individuals with developmental challenges by providing functional and independent life skills training.

The comprehensive kit contains two workbooks (one with easel option and one with re-useable, reproducible pages) featuring hundreds of therapeutic activities, photo cards, picture cards, and a dry erase marker, all in a sturdy portable tote box.

Activities and exercises feature realistic every-day scenarios, in real world environments using current cues for memory and language building.

After extensively reviewing the limited number of existing adult therapeutic materials, Speech Remedy conducted research and collected feedback from the SLP community to develop, what they believe is the most comprehensive, up-to-date adult speech therapy product on the market today.

The kit can be used in a one-on-one or group setting.

The kit targets five major areas of cognition: 1) orientation; 2) attention and scanning; 3) memory; 4) receptive and expressive language; 5) reasoning and problem solving. Research shows that with early intervention, speech-language-cognitive rehabilitation can substantially help people achieve their best possible long-term outcomes.

Speech Remedy products incorporate a multi-sensory (auditory, visual and tactile) approach which is generally recognized as the most effective treatment therapy for learning difficulties.

The peer reviewed and tested materials are designed to stimulate minds of patients and provide the necessary support to foster independence. “SR-Cognition is a wonderful piece of equipment. Every therapist should have it in their arsenal of therapy materials,” says Lawrence Friedman, speech pathologist clinical mentor for Evergreen Health Care in Tracy, California.

About Speech Remedy

Speech Remedy, LLC was founded in 2006 to provide cutting-edge adult multisensory therapeutic materials to the SLP (Speech Language Pathology) community. Speech Remedy’s products are developed by Joanna (Light) Boyer, M.S., M.A. CCC-SLP a published cognitive psychologist and certified speech-language pathologist and Terri Tarnoff Snyder, M.A. CCC-SLP, a practicing speech-language pathologist of over 25 years and rehabilitation director of Breakthrough, Inc. Speech Remedy’s products are being used by health professionals in leading home health care agencies, assisted living centers, board and care facilities, acute hospitals, skilled nursing facilities, adult day health centers and high schools. Speech Remedy will be launching new products at the ASHA 2007 national convention – Boston, Massachusetts, November 15-17, 2007.

SR Cognition is a great starter kit for the beginning clinician, an up-to-date addition to an existing library of materials and an easy-to-use product for family carry-over and long term recovery. SR-Cognition’s re-usable design makes it convenient as well as environmentally friendly. SR-Cognition tool kit is $299 and available online at speechremedy.

Contents of SR Cognition kit include:

– A master workbook: This modernized versatile workbook can be used in a standard workbook manner and also as a flipchart to provide a scaffolding framework for the client, when activity items prove to be too challenging. This book includes 300+ pages of therapeutic activities, including but not limited to immediate and delayed recall, following directions, convergent/divergent naming, verbal sequencing, problem solving of life skills situations and emergency preparedness.

– A supplemental reproducible workbook: This colorful laminated workbook provides supplemental multi-sensory stimuli for activities presented in the Master Workbook. This book includes re-useable, reproducible pages, including, but not limited to, caregiver information, activities of daily living, calendars, schedules, menus, maps, signs and symbols. The pages in this book may be used time and time again and may be reproduced and distributed to the client, his/her family and/or caregivers as desired.

– 85 photo cards with up to date pictures and illustrations: Four sets of 5″x7″ colorful photographic cards (85 cards total) are designed for confrontational naming, categorization and scanning, sequencing and problem solving. These cards include up-to-date photographs of everyday objects, animals, actions, categories and pictorial absurdities.

– 20 picture cards: Twenty 2″ x 2″ double-sided, laminated, full-color picture cards may be used alone or in conjunction with the activities provided in the Workbooks. These cards allow for tactile manipulation during activities including, but not limited to: memory, word finding, following directions, and language building.

– A tote box: This sturdy tote box houses all of the kit contents; allowing for ease of mobility and increased organization. Also included is a dry erase pen.

speechremedy

Physical therapy students from across the nation will learn the latest in physical therapist research and treatment techniques during the American Physical Therapy Association’s (APTA’s) 17th Annual National Student Conclave (NSC) at the Hyatt Regency Miami in Miami, FL, October 30 – November 1, 2009.

“This conference gives students critical information at a formative stage in their careers,” said APTA Student Assembly President Nate Thomas, PT. “By providing each student with the opportunity to network with leaders in the profession, we are helping them transition into the work force and make the kinds of choices that will advance the profession in the coming years.”

Highlights include “Meet a Living Legend,” with APTA member physical therapist Steven Wolf, PT, PhD, FAPTA, FAHA, a renowned eresearcher, author, and presenter on stroke; keynote address by Scott Chesney, an international speaker, consultant, and life coach; panel discussions for new professionals, and in-depth clinical sessions on physical therapy specialty areas such as acute care, geriatrics, neurology, orthopedics, pediatrics, sports, and women’s health, in addition to rГ©sumГ© critiquing and mock interview sessions.

NSC sessions will include “the Physical Therapist’s role in Social Responsibility and Global Health Initiatives,” “Risk Management: Understanding the Basics of Employment Contracts and ‘Bonus’ Programs,” “Own Your Future: Is an Opportunity in Private Practice for You?,” Embracing Clinical Education Standards: A Work in Progress,” and Financial Management: Protecting the Value of Your Prime Financial Assets – Your Degree and Career Earnings.”

Elections for the 2009-2010 Student Assembly Board of Directors and Nominating Committee will take place at the Conclave, and all registered student members will receive a ballot. Attendees will meet with employers, manufacturers, and publishers in the two-day NSC Exhibit Hall.

Source
American Physical Therapy Association

The Robert Wood Johnson Foundation (RWJF) has announced its selection of Dr. Uwe Jacobs, clinical and executive director of Survivors International, San Francisco, to receive a Community Health Leaders Award. He is one of 10 extraordinary Americans to receive the RWJF honor for 2009 at a ceremony at the Mayflower Hotel in Washington, D.C.

Jacobs has provided therapeutic care to more than 1,000 individuals who have experienced torture. He is also a leader in efforts to officially recognize and define gender-based violence as torture. “Dr. Jacobs has organized an outstanding interdisciplinary team of individuals from the health professions and the legal profession to help victims of torture to heal and rebuild their lives,” said Janice Ford Griffin, national program director for the award. “He is a leader in the effort to expand the legal definition of torture to encompass individuals who have suffered at the hands of non-uniformed actors.”

In working with a wide array of people from different nations and backgrounds, and with victims of genocide from around the world, Jacobs realized that a lot of the people who were being persecuted were victims of domestic violence, female genital mutilation, sex trafficking and the threat of honor killings. Seeing the tremendous need, he developed a program to provide services to victims of gender-based violence who seek asylum in the United States. This program has demonstrated that survivors of gender-based violence have levels of trauma that are comparable to those of most torture victims.

“I am deeply honored by this award, and I hope it brings attention to the importance of helping victims of torture to heal,” said Jacobs. “I owe a tremendous debt of gratitude to all the lawyers who help these victims obtain asylum so that they can truly begin to rebuild their lives.”

Jeffrey S. Kaye, Ph.D., a staff clinician at Survivors International, said that in his opinion, “Dr. Jacobs’ greatest contribution – possibly his greatest talent – is his ability to transfer his considerable clinical experience and knowledge to the greater community.”

The Community Health Leaders Award honors exceptional men and women from all over the country who overcome significant obstacles to tackle some of the most challenging health and health care problems facing their communities and the nation. The award elevates the work of the leaders by raising awareness of their extraordinary contributions through national visibility, a $125,000 award and networking opportunities. This year the Foundation received 532 nominations from across the United States and selected 10 outstanding individuals who have worked to improve health conditions in their communities with exceptional creativity, courage and commitment.

There are nine other 2009 Community Health Leaders in addition to Jacobs.

Source:
Jennifer Combs

Robert Wood Johnson Foundation Community Health Leaders

Current post-operative pain control methods have proved inadequate for those who have undergone total knee replacement (TKR), according to University of Iowa College of Nursing researcher.

Barbara Rakel Ph.D., assistant professor of nursing, was recently awarded a $2.1 million grant from the National Institute of Nursing Research to study the use of balanced nonpharmacologic and pharmacologic strategies to improve movement-evoked pain and enhance function in TKR patients.

Rakel’s study will evaluate a new approach to transcutaneous electrical nerve stimulation (TENS), a decades-old pain control therapy which involves application of electric impulses to nerve endings through electrodes placed on the skin.

This project distinguishes pain with movement — the type of pain largely uncontrolled with current pain treatments — from pain at rest. It uses a new TENS approach to target movement-evoked pain after surgery. Rakel will test the effectiveness of intense (high amplitude) TENS, applied intermittently as a supplement to current drug therapy during recovery activities.

The aim is to decrease pain, improve function and prevent the development of new chronic pain syndromes in older adults after TKR.

The study will compare the effectiveness of active TENS to placebo TENS and standard care in 321 patients. TENS will be used during exercise sessions for six weeks after TKR. Various methods will be used to measure pain sensitivity, pain intensity, function and chronic pain syndrome. This study translates bench (animal model) science to human subjects by testing the effect of TENS on severe pain sensitivity.

Rakel teaches in the Systems and Practice Area of Study in the UI College of Nursing.

###

The UI College of Nursing educates nurses at the undergraduate, graduate and doctoral levels, providing both clinical experience and research opportunities. Ranked No. 1 in nursing administration education and adult and gerontologic nursing among the nation’s public universities, the college also excels in child and family health, informatics and genetics. Known for the development of evidence-based protocols for care that are used throughout the nursing community, UI College of Nursing scientists seek to improve clinical outcomes and enhance nursing practice worldwide.

University of Iowa College of Nursing, 101 Nursing Building, Iowa City, Iowa 52242

Source: Michele Francis

University of Iowa

Older women who receive rehabilitation services after hip surgery from a variety of health care professionals as inpatients are slightly more likely to do better than those who receive usual hospital care, a new review shows. The authors suggest that such multidisciplinary rehabilitation also might help if applied in patient or caregiver homes.

“Because hip fracture is so common, the possible improvement for these 10 percent of patients represents a large number of people,” said review co-author Dr. Ian Cameron at the University of Sydney in Australia. “The trend towards better functioning for people who had rehab is most important, especially since older people fear disability as a result of hip fracture.”

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The authors analyzed 13 studies conducted in Australia, Canada, Spain, Sweden, Taiwan and the UK involving 2,498 senior mostly female patients who had undergone surgery following hip fracture.

In 11 studies where care was mainly in-hospital or inpatient and the authors were better able to pool the statistics, they found a marginal improvement in the death rate, hospital readmissions and number of people able to stay in their homes instead of being placed in institutions between the groups receiving multidisciplinary rehab versus those receiving usual care. The data at least do confirm that multidisciplinary rehab does no harm.

According to the American Academy of Orthopaedic Surgeons, 350,000 hospital admissions each year and 60,000 nursing home admissions are the result of hip fractures. Over four percent of these patients die during their initial hospitalization; 24 percent die within a year and 50 percent never walk again.

Generally, hip rehab involves a wide range of treatments in a hospital ward under the supervision of orthopedic staff. Some treatments aim to restore mobility and the ability to perform basic tasks such as dressing and bathing independently. Occasionally, help from geriatricians, physiotherapists and other health professionals supplements these programs. Often, family and caregivers are involved. The level of rehab depends greatly on the patient’s health and, because of this, can take place in a hospital setting or externally.

For this review, the authors defined multidisciplinary rehab as that delivered by a multidisciplinary team supervised by a geriatrician or rehab physician. Since “usual care” varied so widely among the studies, the authors were only able to define it as orthopedic or medical care of lesser intensity or with different components than multidisciplinary rehab.

The disparity of the data collected in the individual studies, such as the age gap between patients, the definition of usual care and the duration of hospital stay, did not allow the authors to pool all the findings. Such variations precluded the authors from stating conclusively that multidisciplinary rehab in-hospital or out after hip surgery is beneficial, although slight tendencies do point in that direction.

“Because a broad range of treatments were applied in diverse settings to patients in different states of health, an effective treatment can be lost in the mix,” said Dr. Karim Khan of the Centre for Hip Health and Mobility in Vancouver, British Columbia.

For instance, said Khan, who had no connection with the review, clinicians rarely employed resistance-training programs to prevent subsequent falls in this population until very recently. “The authors prove convincingly that a ‘shotgun approach’ will not prevent death or deterioration of function leading to increased dependency or institutional care. As is often the case with a complex medical condition such as fall-related hip fracture, there is no magic bullet.”

The authors found inconclusive evidence from three studies that multidisciplinary rehab does not place an extra burden on caregivers. In fact, in the only study that compared home-based multidisciplinary rehab with usual inpatient rehab, caregivers of the home-based patients reported a significantly lower long-term burden even though the duration of the rehab was longer.

Another study showed that doubling the number of weekly home-based rehab visits had no effect on patients’ eventual mobility.

The authors say that the limitations of the findings are partly because of the difference in populations studied and the fact that the studies do not represent some patient groups fully, such as those with dementia or those living in nursing homes. Khan said that well over half of all people who have hip fractures have cognitive impairment dementia and pre-dementia which can have a big effect on outcome and compliance with rehabilitation.

The Cochrane Library contains high quality health care information, including Systematic Reviews from The Cochrane Collaboration. These reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.

Handoll HHG, et al. Multidisciplinary rehabilitation for older people with hip fractures. The Cochrane Database of Systematic Reviews 2009, Issue 4.

Source: Health Behavior News Service

Children with speech, language and reading disorders may soon be able to be treated remotely by using a UQ-designed telerehabilitation system.

The PC-based system, allows speech pathologists to assess and treat children living in rural and remote areas via the internet.
The system, consisting of webcams, headsets, a robotic arm, touchscreen and computer, was designed by the Telerehabilitation Research Unit in UQ’s School of Health and Rehabilitation Sciences.

UQ Speech pathology PhD student Monique Waite said preliminary results using the system were encouraging.

Ms Waite said a pilot study found ratings of speech and oral motor functions made over the Internet were the same as face-to-face ratings more than 90 percent of the time.

The 24-year-old from McDowall said ratings of language skills of 12 children online matched face-to-face ratings with almost 100 percent agreement.

Ms Waite and her team need suitable volunteers to further test the system to determine if it is possible to assess and treat speech, language and reading disorders over the Internet.

She said they were seeking children with difficulties in speech, language, or literacy to participate, including:

– Delayed speech, aged 4-9 years
– Delayed language, aged 5-9 years
– Reading difficulties, aged 8-13 years

Participation involves a free screening assessment conducted by a qualified speech pathologist either across the Internet between two rooms or face-to-face at UQ.

The session will take between one and one-and-a-half hours and a report of the child’s results will be provided.

Telehealth software such as this system are increasingly being used to help children in rural and remote areas access speech pathology services.

Ms Waite is midway through her postgraduate degree and studying under an Australian Postgraduate Award.

The University of Queensland, Brisbane Australia