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У статті розкрито зміст, сутність та особливості формування професійної компетентності майбутніх фахівців реабілітологів. Використання нових технологій при навчанні майбутнього фахівця із залученням відповідних стандартів та принципів суспільства забезпечує формування визначеної компетентності. У статті підкреслюється, що для фізичного реабілітолога велике значення має також комунікаційна компетентність, оскільки фахівцю під час виконання своїх обов’язків необхідно вміти контактувати з пацієнтами, бути стриманим при спілкуванні, співпереживати та вміти правильно реагувати на звертання пацієнтів. The article reveals the content, essence and features of the formation of professional competence of future rehabilitation specialists. The use of new technologies in studying of a future specialist with the involvement of relevant standards and principles of society ensures the formation of a certain competence. The article emphasizes that communication competence is of great importance for a physical rehabilitator, because a specialist, while performing his duties, must be able to communicate with patients, be restrained when communicating, empathize and be able to respond correctly to patients' appeals. The main issue remains the development of a new system of education and training of specialists who will have sufficient scientific and technical potential, possess the necessary innovative technologies in the modern conditions of the development of world society. To achieve the goal of the research, a set of research methods was used: theoretical (comparative, logical, terminological, generalization, abstraction, analysis and synthesis) and empirical (observation, survey, ascertaining pedagogical experiment). In the conditions of a rapidly changing world and an increase in the flow of information, fundamental subject knowledge is a necessary but not sufficient goal of education. Students should not just master the required amount of knowledge, skills and abilities, which is what the Ukrainian education system is aimed at. It is much more important and difficult to instill in students the ability to independently acquire, analyze, structure and effectively use information for maximum self- realization and useful participation in society (competence).

Background This study aimed to evaluate the association between a Certified Driving Rehabilitation Specialist's (CDRS) ratings of on-road driving performance by older drivers and at-fault crash and near-crash involvement using naturalistic driving techniques where crashes and near-crashes are recorded in everyday driving through in-vehicle instrumentation. Methods This is a cohort study of 144 drivers aged 70 years and over who were recruited due to a recent ophthalmology clinic visit at the University of Alabama at Birmingham. Baseline measurements consisted of demographics, visual status, and other health variables. At-fault crashes and near-crashes over 6 months were identified through instrumentation placed in their personal vehicle that recorded vehicle kinematics and video. After 6 months, a CDRS completed an on-road assessment and provided a composite rating on specific driving behaviors and a global score. Results Rate ratios examining the association between older drivers with worse CDRS composite scores and rates of at-fault crashes, at-fault near-crashes, and combined at-fault crashes and near-crashes were significantly higher compared to drivers with better scores. Results were similar for the CDRS global score. Conclusions Motor vehicle administrations use CDRS ratings to make decisions about licensure, and in clinical programs such as those based at rehabilitation clinics use them to make recommendations about fitness to drive and rehabilitation. This study suggests that these decisions and recommendations are valid from a safety standpoint.

AIMS. The aim of the research was assessment of the medical and social losses due to socially significant diseases (malignant neoplasms and diseases of the circulatory system) in population living in the ecologically unfavorableregion of Kazakhstan (East Kazakhstan Region (EKR)). MATERIALS AND METHODS.The materials for the research were provided by the Department of Statistics, the Republican Center of Electronic Health Care and the Regional Oncology Center for 5 years depth (2011-2015 yy.). Statistical data of the entire population of the region was analyzed. Years of Life Lost (YLL), YLL due to death integral indicators were calculated according to the standardized methodology recommended by the World Health Organization (WHO). RESULTS AND CONCLUSION. Significant premature loss of years due to socially significant diseases in the study region was observed in the research group of 45-69 years with a gender prevalence in male. The fraction of direct economic loss as a result ofhealth losses due to circulatory system diseases and malignant neoplasms averaged about 5% of the Gross Domestic Product (GDP). The medical and social losses of years depend on a number of social and economic factorsin the region (environmental pollution, population income, centralized water supply and the fraction of economically active population).

Wiktor Dega – a remarkable medical doctor and educator (1896–1995) – reminiscences on the 20th anniversary of his deathThis elaboration concerns reminiscences on a remarkable human being, medical doctor – an orthopaedist and educator – Wiktor Dega. It consists of two fundamental parts: a biographical part and the other showing the professor’s role in treating and developing a medical care for a child with motor dysfunction. It also presents Wiktor Dega’s academic and didactic activity and his efforts in arranging the first free of charge courses in orthopaedic gymnastics in Poznań primary schools for children with poor posture. This activity was deeply rooted in the professor’s interest in rehabilitation. Wiktor Dega was a co-founder and the first president of the Polish Association for Combating Disability [Towarzystwo do Walki z Kalectwem]. He was a member of the Executive Board of the Polish Academy of Sciences, a member of the Scientific Council at the Ministry of Health and Social Care, an expert for rehabilitation at the WHO and one of advisers of the World Health Fund in New York. For many years he was also a national rehabilitation specialist, the president of the Polish Orthopaedic and Traumatology Association as well as chief editor of the magazine called “Chirurgia Narządów Ruchu i Ortopedii Polskiej”. He was also an honorary citizen of Poznań.

Substance Use Disorder (SUD) is a category of symptoms consisting of behavioral, cognitive, and physiological characteristics arising from the persistent use of the substance despite significant substance-related difficulties in life. Substance usage is growing consistently across the globe as well as in Pakistan. According to one of the studies conducted in 2018; Pakistan has had up to 6.7million drug users, more than 4 million of whom meet the criteria of Substance Use Disorder. Another study also identified a high prevalence of substance use disorders among young adults; making it a national concern. The high prevalence of drug use in the country is attributed to a rise in social adversities and health disparities. Since Pakistan is a transit route for drugs to other countries, it becomes more vulnerable to substance use. It is difficult to provide a strong monitoring system; therefore there must be a way to minimize the demand and supply. Also previously substance use was perceived to be a moral act and a deficiency in character, now it is changing from a taboo to a social status in some social groups which further increases its consumption among young adults

Self-care allows one to maintain the health and well-being of the person and may be compromised. Approaches to Orem’s theory and rehabilitation specialist nurse competencies allow the development of intervention plans to minimize the person’s dependence on self-care. Objective: To identify Orem’s theoretical contributions to self-care and their relevance to Rehabilitation Nurse practice. Methods: Integrative literature review through search engines (EBSCO, RCAAP and Google Scholar), using the descriptors self-care, nursing, and Orem, assisting us from the Boolean operator “AND”. Results: Nine articles were selected, the results of which we grouped into two studies of a theoretical nature and three groups according to Orem’s theory (fully compensatory systems, partially compensatory systems and educational support systems). Conclusions: Praying to privilege your approach to self-care, can differentiate their performance, with visible gains in the health of the person.

The sport of gymnastics is one of the most demanding in the world, exposing young athletes to extremely high forces at end ranges of motions and at high volumes. Due to the nature of the events and skills performed in gymnastics, multiple body regions are common sites of injury within the upper extremity, spine, and lower extremity. This combination of factors presents a unique challenge to the rehabilitation specialist who is looking to assist gymnasts back to full practice and competition following injury. It is crucial that professionals working in gymnastics have an in-depth understanding of the forces related to gymnastics skills, workload ratios, the five-stage progression of rehabilitation, and the unique pathomechanics that exist in gymnastics injuries. The principles of current scientific literature must be combined with gymnastics coaching principles to provide the athlete with the best opportunity to not only return to their pre-injury capacity level, but also build a higher degree of resiliency toward injury. This chapter aims to overview the most current research and practical guidelines for the rehabilitation of gymnasts.

Anoxic brain injury results after reduced or absent oxygenation of the brain tissue. Clinically it presents in a heterogeneous nature depending on the underlying etiology and severity of the anoxic event. Rehabilitation specialists typically provide support in the functional management of the brain injury. However, in some settings, acute management may also be directed by a brain rehabilitation specialist. This chapter reviews the etiology, pathophysiology, acute care, and rehabilitation management of persons with anoxic brain injury.

During the past several years, advancement in the surgical techniques and rehabilitation for the multiple ligament injured knee has allowed patients to return to a higher level of function than previously considered following these devastating knee injuries. This chapter will provide guidelines for developing a rehabilitation program based on current scientific theories and experience gained over the past 21 years treating this challenging patient population. It is not intended as the final word but as the blueprint for implementing rehabilitation programs that can be modified depending on each individual patient’s need. Communication between the surgeon and the rehabilitation specialist is essential to assure that patients are able to progress steadily without compromising the surgically treated structures.

Musculoskeletal (MSK) disorders are very prevalent in a rehabilitation setting. These disorders involve muscle, tendon, ligaments, as well as nerves, and are related to overuse due to work or sports, and degeneration due to aging. These conditions are usually diagnosed based on clinical signs and symptoms; however, a more accurate diagnosis is required. The imaging techniques for diagnosis include radiography, magnetic resonance imaging (MRI), and ultrasounds (US). In this review article, US is proposed to be an effective technique in diagnosing MSK pathologies, which, in hands of a Rehabilitation specialist, constitute a dynamic, accurate, economic, and cost-effective tool.

в данной статье приведены требования к реабилитологам и их компетенциям. Отражены содержание и основные этапы подготовки специалистов в области комплексной реабилитации. Представлены достигнутые результаты в обучении специалистов по комплексной реабилитации., the article describes the requirements for rehabilitation and their competences, the content and main stages of their training, the results achieved in the training of professionals for comprehensive rehabilitation

Background: Cardiovascular diseases are the most common causes of mortality in the world including Iran and are one of the main causes of disability. Cardiac Rehabilitation (CR) is a multidisciplinary program that helps CVD patients recover faster after a heart attack and avoid any subsequent incident. This report determined the current state of CR in Yazd, Iran. Characteristics of the program: Hospital-based Afshar CR program in Yazd, Iran, is the only CR facility in Yazd province, which is located in the centre of Iran. Currently, the Afshar CR program has four phases including inpatient, sub-acute, outpatient and maintenance. The CR team includes cardiologists and heart surgeons as physicians, and physical medicine rehabilitation specialist, outpatient and inpatient resident medical officers, psychiatrists, nutritionists, psychologists, physiotherapists and social workers. Discussion: Given the facilities and training programs mentioned above, the rate of patient referral to the center by the inpatient CR team during the short life of CR in this center was 60%, the patient participation rate was 6.9% and the enrollment rate was 55%. In addition, over the past three years, 57% of registered patients completed the program. Conclusion: The Afshar CR is trying to get closer to the world standard setting. But it seems that it is necessary to develop the standard of CR in Iran based on the culture and socio-economic status of Iranian community. Keywords: Cardiac rehabilitation, Low-middle income countries, Referral rate, Attendance rate, Enrollment rate, Completion rate

To compare self-reported driving difficulty by persons with hemianopic or quadrantanopic field loss with that reported by age-matched drivers with normal visual fields; and to examine how their self- reported driving difficulty compares to ratings of driving performance provided by a certified driving rehabilitation specialist (CDRS).Participants were 17 persons with hemianopic field loss, 7 with quadrantanopic loss, and 24 age-matched controls with normal visual fields, all of whom had current driver's licenses. Information was collected via questionnaire regarding driving difficulties experienced in 21 typical driving situations grouped into three categories (involvement of peripheral vision, low visibility conditions, and independent mobility). On-road driving performance was evaluated by a CDRS using a standard assessment scale.Drivers with hemianopic and quadrantanopic field loss expressed significantly more difficulty with driving maneuvers involving peripheral vision and independent mobility, compared to those with normal visual fields. Drivers with hemianopia and quadrantanopia who were rated as unsafe to drive based upon an on-road assessment by the CDRS were no more likely to report driving difficulty than those rated as safe.This study highlights aspects of driving that hemianopic or quadrantanopic persons find particularly problematic, thus suggesting areas that could be focused on driving rehabilitation. Some drivers with hemianopia or quadrantanopia may inappropriately view themselves as good drivers when in fact their driving performance is unsafe as judged by a driving professional.

Krystyna Walton started her clinical career in rheumatology before moving into neurorehabilitation and leading on major trauma rehabilitation.

An athlete often presents to the rehabilitation specialist with either a nonspecific referral, such as "hip pain," or with a diagnosis of a more specific hip pathology. The highly skilled clinician is trained to look at the "linkage" between the trunk and all parts of the lower extremity. Why is the hip not transferring the load well? Where is the breakdown? The gluteus medius, pelvic stability, and supportive muscular slings are of great importance when optimizing the function of the hip. The hip is subjected to forces equal to multiples of the body weight and requires osseous, articular and myofascial integrity for stability. This is the mind set when devising an athlete's rehabilitative program, looking at all influential factors that affect joint movement and integrity.

The shoulder remains one of the more challenging joints for clinicians to clearly identify, diagnose, and treat within the athletic population. Its complexities involving the glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints moving in tandem require the physician and rehabilitation specialist to have a comprehensive understanding of the biomechanics and arthrokinematics associated with athletic activity. This chapter focuses on the evaluation, classification, mechanism of injury, and initial treatment of widespread shoulder injuries involved in sports.

This chapter introduces the reader to the importance of community mobility for the older adult. Driving is the primary means of maintaining community mobility for most people. Implications for this method of transportation will be discussed for medically-at-risk drivers and in particular, the cognitively-impaired driver. We discuss stakeholders’ responsibilities in assuring individual and public safety. We acquaint the health care professional to the current state of screening and assessment of fitness-to-drive in persons with dementia. This includes the importance of referring the driver for the appropriate service at the right time in the disease process, including referrals to a driving rehabilitation specialist. We describe the transition from driver to passenger for the person with cognitive impairment and introduce the concept of supportive transportation while recognizing the need for the development of such services for persons with dementia and their care partners including strategies for meeting those needs.

To determine the stability of Gross Motor Function Classification System (GMFCS) levels between approximately 12 years of age and adulthood (i.e. > 16y) using a matched chart review. Adult health records from the Ottawa Rehabilitation Centre were matched with childhood health records from the Ottawa Children's Treatment Centre (OCTC). Health records were available for 103 adults (52 males, 51 females) with cerebral palsy (CP; age range 17-38y; mean age 22y [SD 4y]) who had also been seen at the OCTC at a mean age of 12 years (SD 1y). GMFCS levels as adults were: Level I, n= 10; Level II, n= 24; Level III, n= 21; Level IV, n= 30; and Level V, n= 18. Adult participants were classified using the GMFCS at the time they were last seen by a rehabilitation specialist, sometime between June 2002 and June 2005. Corresponding paediatric charts were reviewed and classified by two independent raters blinded to the adult GMFCS levels. GMFCS levels around age 12 were: Level I, n= 20; Level II, n= 13; Level III, n= 22; Level IV, n= 35; and Level V, n= 13. Interrater reliability for childhood health records was determined with a quadratic weighted kappa and was 0.978. Stability of GMFCS levels was also assessed using the quadratic weighted kappa and was 0.895. The positive predictive value of the GMFCS at 12 years of age to predict walking without mobility aids by adulthood is 0.88. If the child is a wheelchair user at around age 12 years, the positive predictive value is 0.96 that the individual will still be a wheelchair user as an adult. This study supports previous findings that interrater reliability when using the GMFCS is very high. It also shows that the GMFCS level observed around the age of 12 years is highly predictive of adult motor function. This provides important information for individuals with CP, their families, and care providers as they plan for future care needs and rehabilitation intervention.

Background: Preliminary observation shows that pulmonary rehabilitation (PR) is not routinely practiced in most clinical settings in Nigeria; hence we sought to investigate physicians9 knowledge and perceived barriers to PR. Aim of study: To investigate physicians9 knowledge and perceived barriers to pulmonary rehabilitation in Nigeria. Methods: We conducted a cross-sectional survey of knowledge and perceived barriers to PR during the national scientific conference of respiratory clinicians in Nigeria. A 20-item self-administered questionnaire was used to collect information on variables of interest. Responses were summarized in frequency and percentages. Results: Forty clinicians (17 (43%) consultants and 23 (54%) registrars) from 23 states in Nigeria participated in the study. Most (87.5%) of the clinicians had knowledge of the components of pulmonary rehabilitation, 92.5% agreed that exercise is not contraindicated in chronic lung diseases and that PR is effective in improving functional capacity. 14(35%) participants were familiar with any PR guidelines. Five top barriers to PR identified include: unavailable/insufficient rehabilitation specialist, lack of rehab equipment, non-availability of institutionalized documented pulmonary rehab protocols, inadequate training on PR and cost of care to patients. 60% of the respondents feel they lack sufficient skill and competence to integrate PR programme in their institutions. Conclusion: Although most physicians showed good knowledge of pulmonary rehabilitation and indicated willingness to incorporate PR into their scope of care, it appears a concerted multi-disciplinary approach may be required to overcome identified barriers.

Cardiac disease is a leading cause of disability. This article reviews the epidemiology, pathophysiology, and risk factors for coronary heart disease. We explore the latest research in risk stratification, exercise training, and screening for cardiac rehabilitation in the elderly patient. The rehabilitation specialist will see how this select population differs in their medical and rehabilitative needs.

Elif Yalcin MD, Physical Medicine Rehabilitation Specialist, Sehim Kutlay MD, Physical Medicine Rehabilitation Specialist, Olcay Ilgu MD, Physical Medicine Rehabilitation Specialist, Mufit Akyuz MD, Physical Medicine Rehabilitation Specialist a Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine & Rehabilitation Training and Research Hospital of the Ministry of Health, Ankara, Turkey b Department of Physical Medicine and Rehabilitation, Ankara University of Faculty of Medicine, Ankara, Turkey c Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine & Rehabilitation Training and Research Hospital of the Ministry of Health, Ankara, Turkey

Neuropathic (Charcot) arthropathies of the foot or ankle can be devastating and disabling complications of diabetes mellitus. The etiogenesis of acute-onset Charcot arthropathy remains poorly understood, however the bony and joint destructions have been attributed to injury or trauma in the presence of severe sensory neuropathy. The purpose of this descriptive report is to alert rehabilitation specialists that severe sensory neuropathy need not precede the onset of acute Charcot arthropathies of the foot or ankle. The prevailing hypotheses for the development of acute Charcot arthropathies are briefly reviewed. Additionally, the characteristics of two samples of subjects with acute Charcot arthropathy of the foot or ankle referred to physical therapy for treatment are presented so rehabilitation specialists may better recognize this potentially disabling complication of diabetes mellitus. Understanding the range of clinical characteristics of patients presenting to physical therapy for treatment may allow...

Arlene Brown outlines the role of the specialist nurse in a cardiac rehabilitation programme, shares her personal experiences and offers advice for readers interested in taking on a similar role.

Complex regional pain syndrome is chronic neuropatic pain condition which usually arise after trauma. It is associated with some of the sensory, vasomotor, sudomotor, motor and trophic symptoms and sings. Due to variability of symptoms and long-lasting pain, these patients are hard to rehabilitate. They exhibit activity related fear and so have pronounced functional limitations. Adequate rehabilitation procedures, frequently long lasting, are essential for their optimal recovery, so rehabilitation specialist should constantly update their knowledge on this issue. Emerging researches on pathophysiology, diagnosis and treatment of CRPS created a need for systematization of current body of evidence. Available researches on efficacy of different treatment options are still insufficient to create precise therapy guidelines, so future researches are needed in order to promote better rehabilitation outcomes.

The authors present a case study on the development of auditory hallucinations secondary to right temporal lobe damage. Surgical resection in the study patient was of the right superficial middle and inferior temporal gyri. Carbamazepine at a dosage of 800 mg daily was the most effective medication used. A multidisciplinary approach involving the neurosurgeon, psychiatrist, family, and rehabilitation specialist is necessary in managing the psychiatric sequelae of brain injury.

Rehabilitation following injury or surgery for the athlete who employs overhead motion is extremely challenging. Shoulder pathophysiology and the repetitive intense demands required during athletic activity need to be fully appreciated for successful rehabilitation. This article discusses new anatomic and biomechanical concepts that require the rehabilitation specialist to reconsider previously accepted notions. Treatment rationale is discussed based on these concepts. Rehabilitation principles and phases are described in a sequentially progressive program based on tissue reactivity and signs and symptoms.

The training of severely disabled individuals on the use of electric power wheelchairs creates many challenges, particularly in the case of children. The adjustment of equipment and training on a per-patient basis in an environment with limited specialists and resources often leads to a reduced amount of training time per patient. Virtual reality rehabilitation has recently been proven an effective way to supplement patient rehabilitation, although some important challenges remain including high setup/equipment costs and time-consuming continual adjustments to the simulation as patients improve. We propose a design for a flexible, low-cost rehabilitation system that uses virtual reality training and games to engage patients in effective instruction on the use of powered wheelchairs. We also propose a novel framework based on Bayesian networks for self-adjusting adaptive training in virtual rehabilitation environments. Preliminary results from a user evaluation and feedback from our rehabilitation specialist collaborators support the effectiveness of our approach.

The paper deals with construction of rehabilitation insole for medical use. The purpose of its application is in time indication of rehabilitated leg overloading. The patient has to follow the limited burden of the injured leg at a certain stage of the rehabilitation process. As recommended by doctor, rehabilitation specialist defines partial load of limb from 10 kg to full load with adjustable insole support. Rehabilitation insole monitors loading of the leg and provide the feedback to the patient. The system is fully integrated and with the exception of charging it needs no special approach during application by the patient.

Background: To comply with the Best Practice Tariff for Major Trauma, rehabilitation prescriptions are completed for patients with an Injury Severity Score above 8, which covers a broader, previously-undefined population. This project uses the rehabilitation prescription to define the characteristics and rehabilitation needs of the orthopaedic major trauma population. Methods: A total of 336 patients with orthopaedic major trauma had an initial rehabilitation prescription completed in 1 year. Over a 7-month period, 143 of these patients were clinically assessed by a trauma rehabilitation specialist physiotherapist. Demographic data and rehabilitation needs identified from initial and follow-up rehabilitation prescriptions were recorded and analysed. Results: Orthopaedic injuries affect the largest number of major trauma patients (n=336/692). Falls (30%) and road accidents (29%) are the most common mechanisms of trauma for patients of all ages (mean 55.6 years). At initial assessment, mobility (97%), pain (95%), and independence with activities of daily living (IADL) (79%) were the most prevalent rehabilitation needs identified. Five months after injury, patients had a reduced rehabilitation need for mobility (60%), IADL (30%), and pain (27%). The need for psychological support increased from 2% to 22%, while vocational needs remained stable (initial 29%, review 26%). Difficulties with mood were first identified at the review stage in 94% of cases. Of patients who were reassessed, 48% had unmet rehabilitation needs requiring referral to physiotherapy (25%), health psychology (13%), and orthopaedic review (6%). Conclusions: Rehabilitation from orthopaedic major trauma continues beyond the acute hospital admission. Mobility, pain and IADL are most affected by injury, and mobility problems can persist for many months after injury. Rehabilitation needs can change, with difficulties managing emotions developing over time. Physiotherapists play a lead role in addressing the most frequent rehabilitation needs, but patients need multidisciplinary support, including health psychology and pain specialists, to meet their ongoing rehabilitation needs. Implications: Orthopaedic major trauma patients require access to specialist multidisciplinary rehabilitation throughout their recovery journey. Reassessment of the rehabilitation prescription is necessary to evaluate an individual's changing rehabilitation needs and improve access to appropriate professionals.

As a multisystem chronic illness, two areas come to the forefront for management by the rehabilitation specialist. Pain and neuromuscular deficits may be a result of direct insult by the human immunodeficiency virus (HIV) or opportunistic infections affecting functional abilities. A brief overview of pathologic findings reveals that the types of pain experiences is based upon the disease processes that are occurring secondary to HIV. The management of pain and resultant functional changes depends on the source, symptoms and signs of pain. Physical and Occupational therapists are key health care professionals to conduct pain assessments and evaluate functional impairment to better employ non-invasive techniques for management of HIV complications. This article presents various modalities and modes of therapeutic intervention to enhance full participation of the person with HIV in activities of daily living.

Rationale: In this study, information was gathered from five disciplines on their usual management methods for fibromyalgia (FM) in order to asses whether treatment regimens have changed in the Netherlands during a period of 6 years. In addition, insight was gained into the therapeutic motives of the professionals. Method: A questionnaire was sent to a sample of 150 persons per discipline: general practitioners (GPs), rheumatologists (RMTs), rehabilitation specialists (RS), physical therapists and psychologists. Results: The overall response rate was 40.4%. The referral behaviour changed (significantly), especially between GPs and RMTs. An increased choice for aerobic exercise (RS: P = 0.023) and multidisciplinary therapy (RMT: P = 0.046) was found. RMTs and RS showed decreased medication prescribing (RMT: P = 0.024). Preferences of treatment for FM differ per discipline. The choice is principally made on the basis of subjective, professional group-bound factors. Particularly for GPs, dynamic patient factors are an important motive in the management of FM. Conclusions: Despite the fact that most changes found are in conformity with the literature, the absolute application percentages of recommended therapies are still very low. The differences in practice between the several disciplines seem explicable on the basis of the factors that have a prominent role in the choice of a therapy for FM. This study underlines the need for further research into methods and processes of the management of FM, and their clinical effectiveness. An effective way of dissemination, especially of guidelines, is essential. © 2008 The Authors.

Rationale: In this study, information was gathered from five disciplines on their usual management methods for fibromyalgia (FM) in order to asses whether treatment regimens have changed in the Netherlands during a period of 6 years. In addition, insight was gained into the therapeutic motives of the professionals. Method: A questionnaire was sent to a sample of 150 persons per discipline: general practitioners (GPs), rheumatologists (RMTs), rehabilitation specialists (RS), physical therapists and psychologists. Results: The overall response rate was 40.4%. The referral behaviour changed (significantly), especially between GPs and RMTs. An increased choice for aerobic exercise (RS: P = 0.023) and multidisciplinary therapy (RMT: P = 0.046) was found. RMTs and RS showed decreased medication prescribing (RMT: P = 0.024). Preferences of treatment for FM differ per discipline. The choice is principally made on the basis of subjective, professional group-bound factors. Particularly for GPs, dynamic patient factors are an important motive in the management of FM. Conclusions: Despite the fact that most changes found are in conformity with the literature, the absolute application percentages of recommended therapies are still very low. The differences in practice between the several disciplines seem explicable on the basis of the factors that have a prominent role in the choice of a therapy for FM. This study underlines the need for further research into methods and processes of the management of FM, and their clinical effectiveness. An effective way of dissemination, especially of guidelines, is essential. © 2008 The Authors.

Intensive repetitive therapy shows promise to improve motor function and quality of life for stroke patients. Intense therapies provided by individualized interaction between the patient and rehabilitation specialist to overcome upper extremity impairment are beneficial, however, they are expensive and difficult to evaluate quantitatively and objectively. The development of a pneumatic muscle (PM) driven therapeutic device, the RUPERT/spl trade/ has the potential of providing a low cost and safe take-home method of supplementing therapy in addition to in the clinic treatment. The device can also provide real-time, objective assessment of functional improvement from the therapy.

We report the development and initial evaluation of a device for robotic assisted upper extremity repetitive therapy (RUPERTtrade). Intense repetitive physical therapies provided by individualized interaction between the patient and a rehabilitation specialist to overcome upper extremity impairment after stroke are beneficial, however, they are expensive and difficult to evaluate quantitatively and objectively. The need is urgent and growing for a low cost, safe and easy to use robotic device to assist the patient and the therapist to fully achieve the potential benefit of task-based repetitive physical therapies. We designed a pneumatic muscle (PM) driven therapeutic device, the RUPERTtrade, that is wearable and provides assistive forces required to move the arm during performance of several critical tasks of daily living. The robot has four degrees of freedom at shoulder, elbow and wrist. The sensors feedback position and force information for quantitative evaluation of task performance. It has the potential of providing a take-home method of supplementing therapy. The device can also provide real-time, objective assessment of functional improvement of therapy

Through access to a lot of relevant information on the role of the rehabilitation nurse specialist functions, explore how rehabilitation specialist nurse qualifications provides a basis for our rehabilitation specialist nurse cultivating and development.

Edited by M. Christine Zink and Janet B. Van Dyke 484 pages, paperback, £62.99. Wiley-Blackwell. 2013. ISBN 978 0 8138 1216 8 ![Graphic][1] THERE is a dearth of useful texts for the professional involved in the rehabilitation of sporting dogs, so this book, edited by two highly respected professionals in the field, is much-needed to fill a void. Twenty-three chapters covering a good variety of topics provide a comprehensive resource for any rehabilitation specialist involved with the canine athlete. The editors have assembled an impressive selection of veterinary professionals as contributors, and the subject areas are well researched with extensive practical guidance. The book has a logical structure and … [1]: /embed/inline-graphic-1.gif

The sequelae of human immunodeficiency virus (HIV) disease include a host of devastating conditions involving the lower extremity. These include rheumatologic dysfunction, Kaposi's sarcoma, peripheral neuropathies, and skin ulcers. Pain, weakness, and loss of range of motion caused by these conditions can lead to changes in gait pattern, loss of mobility and function, and limited quality of life. The role of the rehabilitation specialist in the care and treatment of HIV disease as it affects the lower extremity, and the treatment strategies, precautions, and suggestions will be discussed.