Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective.

INTRODUCTION: This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. METHODOLOGY: Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. RESULTS: Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. CONCLUSION: This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.

Ethics teaching in rehabilitation: results of a pan-Canadian workshop with occupational and physical therapy educators.

PURPOSE: Ethical practice is an essential competency for occupational and physical therapists. However, rehabilitation educators have few points of reference for choosing appropriate pedagogical and evaluation methods related to ethics. The objectives of this study were to: (1) identify priority content to cover in ethics teaching in occupational therapy (OT) and physical therapy (PT) programmes and (2) explore useful and innovative teaching and evaluation methods. METHOD: Data for this qualitative descriptive study were collected during a 1-d knowledge exchange workshop focused on ethics teaching in rehabilitation. RESULTS: Twenty-three educators from 11 OT and 11 PT Canadian programmes participated in the workshop. They highlighted the importance of teaching foundational theoretical/philosophical approaches and grounding this teaching in concrete examples drawn from rehabilitation practice. A wide range of teaching methods was identified, such as videos, blogs, game-based simulations and role-play. For evaluation, participants used written assignments, exams, objective structured clinical examinations and reflective journals. The inclusion of opportunities for student self-evaluation was viewed as important. CONCLUSION: The CREW Day provided ethics educators the opportunity to share knowledge and begin creating a community of practice. This space for dialogue could be expanded to international rehabilitation ethics educators, to facilitate a broader network for sharing of tacit and experiential knowledge. Implications for Rehabilitation According to the study participants, rehabilitation ethics education should include learning about foundational knowledge related to ethical theory; be grounded in examples and cases drawn from clinical rehabilitation practice; and contribute to building professional competencies such as self-knowledge and critical thinking in students. Regardless of the methods used by occupational therapy (OT) and physical therapy (PT) educators for teaching and evaluation, the value of creating spaces that support open discussion for students (e.g. protected discussion time in class, peer-discussions with the help of a facilitator, use of a web discussion forum) was consistently identified as an important facet. Educators from OT and PT programmes should work with various professionals involved in OT and PT student training across the curricula (e.g. clinical preceptors, other educators) to extend discussions of how ethics can be better integrated into the curriculum outside of sessions specifically focused on ethics. The CREW Day workshop was the first opportunity for Canadian rehabilitation ethics educators to meet and discuss their approaches to teaching and evaluating ethics for OT and PT students. Including international rehabilitation ethics educators in this dialogue could positively expand on this initial dialogue by facilitating the sharing of tacit and experiential knowledge amongst a larger and more diverse group of ethics educators.

Successful treatment of anaplastic meningioma metastatic to cervical lymph nodes.

BACKGROUND: Cervical lymph node metastases of meningioma represent an important diagnostic and treatment challenge. Not only has this entity been rarely described, but successful treatment has never been reported in the literature. METHODS AND RESULTS: This case report was conducted using reviews of the literature. A 58-year-old man with a history of resected anaplastic meningioma was referred for a right neck mass. Excisional biopsy revealed metastatic meningioma, and a metastatic workup was negative. Modified radical neck dissection showed positivity in 5 lymph nodes. The patient received adjuvant intensity-modulated radiation therapy (IMRT), for a mean target dose of 60 Gray (Gy). Two years after treatment, the patient was disease free. Eleven cases of cervical lymph node metastasis of meningioma were identified in our literature search, and none described successful treatment of this entity. CONCLUSION: Cervical lymph node metastasis of anaplastic meningioma is potentially treatable with surgical resection and IMRT, although further studies with long-term follow-up are necessary.