ABSTRACT
Spina bifida is a disease that requires cross-disciplinary treatment for each life stage from the neonatal period to adulthood. Various rehabilitation therapies are required depending on the life stage of patients. In this study, we aimed to clarify the current status of rehabilitation services at children's hospitals in order to improve quality of rehabilitation care for children with spina bifida. We performed a survey targeted at the Japanese Association of Children's Hospitals and Related Institutions. The framework of the cross-disciplinary co-operation of medical treatments for spina bifida existed in 67% of children's hospitals surveyed. In most of these hospitals, the departments of rehabilitation medicine participated in these frameworks. In the medical treatment for children with spina bifida, acute phase rehabilitation after orthopaedic surgery was adequately provided in children's hospitals. However, convalescent and community-based phase rehabilitation therapies, and the co-operation with education institutions or habilitation/rehabilitation facilities for children were determined to be inadequate. Regarding general paediatric rehabilitation, convalescent and community-based phase rehabilitation therapies were mainly provided outside children's hospitals：habilitation/rehabilitation facilities for children mainly provided convalescent and community-based phase rehabilitation therapies and were considered to be the desirable setting for such therapies. To improve paediatric rehabilitation, including the rehabilitation for children with spina bifida, several factors need to be considered. These include the construction of appropriate frameworks for medical services (such as personnel training and the recruitment of rehabilitation doctors, therapists, and related staff), and co-operation with regional education institutions or habilitation/rehabilitation facilities for children.
ABSTRACT
Spina bifida is a disease that requires cross-disciplinary treatment for each life stage from the neonatal period to adulthood. Various rehabilitation therapies are required depending on the life stage of patients. In this study, we aimed to clarify the current status of rehabilitation services at children's hospitals in order to improve quality of rehabilitation care for children with spina bifida. We performed a survey targeted at the Japanese Association of Children's Hospitals and Related Institutions. The framework of the cross-disciplinary co-operation of medical treatments for spina bifida existed in 67% of children's hospitals surveyed. In most of these hospitals, the departments of rehabilitation medicine participated in these frameworks. In the medical treatment for children with spina bifida, acute phase rehabilitation after orthopaedic surgery was adequately provided in children's hospitals. However, convalescent and community-based phase rehabilitation therapies, and the co-operation with education institutions or habilitation/rehabilitation facilities for children were determined to be inadequate. Regarding general paediatric rehabilitation, convalescent and community-based phase rehabilitation therapies were mainly provided outside children's hospitals：habilitation/rehabilitation facilities for children mainly provided convalescent and community-based phase rehabilitation therapies and were considered to be the desirable setting for such therapies. To improve paediatric rehabilitation, including the rehabilitation for children with spina bifida, several factors need to be considered. These include the construction of appropriate frameworks for medical services (such as personnel training and the recruitment of rehabilitation doctors, therapists, and related staff), and co-operation with regional education institutions or habilitation/rehabilitation facilities for children.
ABSTRACT
Children's hospitals and related institutions, along with habilitation/rehabilitation facilities for children with disabilities, practice pediatric rehabilitation medicine. However, the status of rehabilitation medical services at children's hospitals has not been examined. To help improve pediatric rehabilitation medicine, we aimed to clarify it with this study. We performed a nationwide survey targeting the Japanese Association of Children's Hospitals and Related Institutions. The median numbers of full-time rehabilitation doctors, board-certified rehabilitation doctors, and board-certified instructors per institution were one, zero, and zero, respectively. The median numbers of full-time physical therapists, occupational therapists, speech-language-hearing therapists, and clinical psychologists were nine, five, three, and two, respectively. Demand for increasing the number of rehabilitation staff members was high across all specialties. Only about half the institutions surveyed were certified as training facilities by the Japanese Association of Rehabilitation Medicine. Some institutions did not meet the health insurance system's higher-level criteria for rehabilitation facilities. The construction of an appropriate medical service framework and an increase in hospital services, including staff assignment, will be needed to improve pediatric rehabilitation and to expand research and education in this field.
ABSTRACT
Children's hospitals and related institutions, along with habilitation/rehabilitation facilities for children with disabilities, practice pediatric rehabilitation medicine. However, the status of rehabilitation medical services at children's hospitals has not been examined. To help improve pediatric rehabilitation medicine, we aimed to clarify it with this study. We performed a nationwide survey targeting the Japanese Association of Children's Hospitals and Related Institutions. The median numbers of full-time rehabilitation doctors, board-certified rehabilitation doctors, and board-certified instructors per institution were one, zero, and zero, respectively. The median numbers of full-time physical therapists, occupational therapists, speech-language-hearing therapists, and clinical psychologists were nine, five, three, and two, respectively. Demand for increasing the number of rehabilitation staff members was high across all specialties. Only about half the institutions surveyed were certified as training facilities by the Japanese Association of Rehabilitation Medicine. Some institutions did not meet the health insurance system's higher-level criteria for rehabilitation facilities. The construction of an appropriate medical service framework and an increase in hospital services, including staff assignment, will be needed to improve pediatric rehabilitation and to expand research and education in this field.
ABSTRACT
Bed rest for pregnant women recovering from threatened abortion and premature labor to prevent abortion can cause deconditioning syndrome, but it is not clear what kind of physical exercise should be provided for these patients. To better provide appropriate rehabilitation for threatened abortion and premature labor patients, we investigated patient clinical records retrospectively. In 11 patients who were provided rehabilitation within the past three years, eight delivered during hospitalization and three became independent in ADLs and were discharged while still pregnant. All patients who delivered during their hospitalization became independent in ADLs immediately after delivery, and as a result, the maternal prognosis was good. Choosing an appropriate rehabilitation approach for patients with threatened premature labor may help alleviate their deconditioning during pregnancy without any adverse impact.