Use of whole body vibration therapy in individuals with moderate severity of cerebral palsy- a feasibility study.

BACKGROUND: This pilot study was to examine the feasibility and tolerance of whole body vibration therapy (WBVT) for children and adults with moderate severity of cerebral palsy (CP) being graded as levels III or IV on the Gross Motor Function Classification Scale (GMFCS). METHODS: Study participants received the additional WBVT when standing still on the vibration platform for three 3-min bouts of vibration (20 Hz, 2 mm amplitude), 4 days per week for 4 weeks. In addition to questions relating to feasibility and participants' opinions, assessment at baseline and completion of the intervention included the Gross Motor Function Measure-66 Item Set (GMFM-66 IS), 2-min walk test (2MWT), Timed Up and Go test (TUG) and Pediatric Evaluation of Disability Inventory (PEDI). Wilcoxon Signed Ranks test was used to compare the results. RESULTS: Fourteen participants (mean age = 25.25 years SD 3.71; 9 males, 64%; GMFCS level III n = 13, 92%) were recruited and completed the study. The attendance rate was over 90% with no adverse events. All participants tolerated the protocol which was satisfactorily delivered in a clinical setting. CONCLUSIONS: The present WBVT protocol was feasible, safe and well-tolerated by the participants with moderate severity of CP, justifying future studies with larger samples and more rigorous study design. TRIAL REGISTRATION: The present study has been registered under the ClinicalTrials.gov (NCT03375736) and the date of registration commenced on 18 December 2017.

Feasibility of Whole Body Vibration Therapy in Individuals with Dystonic or Spastic Dystonic Cerebral Palsy: A Pilot Study.

OBJECTIVE: To examine the feasibility and practicality of whole body vibration therapy for individuals with dystonic or spastic dystonic cerebral palsy. DESIGN: Pilot study. SUBJECTS: Children and adults with dystonic or spastic dystonic cerebral palsy. METHODS: Study participants received total body vibration therapy when standing still on a vibration platform for 3 bouts, duration 3-min, of vibration (20 Hz, 2 mm amplitude), 4 days per week for 4 weeks in addition to their usual therapy. All participants were assessed at baseline and completion of the study using the Gross Motor Function Measure Item Set, Timed Up and Go test, Barry-Albright Dystonia Scale, Edinburgh Visual Gait Score, and Pediatric Evaluation of Disability Inventory. RESULTS: Ten participants (mean age 18.60 years (standard deviation (SD) 14.68); 9 males, Gross Motor Function Classification System level II-IV) completed the study with more than 90% attendance rate. All participants tolerated the protocol with no adverse events. CONCLUSION: The vibration treatment protocol was feasible and safe for all participants. With no significant differences found in all the outcome measures, future studies with more rigorous study designs are required before this intervention is recommended for this population group.

Sitting tai chi improves the balance control and muscle strength of community-dwelling persons with spinal cord injuries: a pilot study.

Objective. To investigate the effects of sitting Tai Chi on muscle strength, balance control, and quality of life (QOL) among survivors with spinal cord injuries (SCI). Methods. Eleven SCI survivors participated in the sitting Tai Chi training (90 minutes/session, 2 times/week for 12 weeks) and eight SCI survivors acted as controls. Dynamic sitting balance was evaluated using limits of stability test and a sequential weight shifting test in sitting. Handgrip strength was also tested using a hand-held dynamometer. QOL was measured using the World Health Organization's Quality of Life Scale. Results. Tai Chi practitioners achieved significant improvements in their reaction time (P = 0.042); maximum excursion (P = 0.016); and directional control (P = 0.025) in the limits of stability test after training. In the sequential weight shifting test, they significantly improved their total time to sequentially hit the 12 targets (P = 0.035). Significant improvement in handgrip strength was also found among the Tai Chi practitioners (P = 0.049). However, no significant within and between-group differences were found in the QOL outcomes (P > 0.05). Conclusions. Twelve weeks of sitting Tai Chi training could improve the dynamic sitting balance and handgrip strength, but not QOL, of the SCI survivors.

Reliability of dynamic sitting balance tests and their correlations with functional mobility for wheelchair users with chronic spinal cord injury.

The purpose of this study is to develop a reliable and valid tool for measuring the dynamic sitting balance of wheelchair users with spinal cord injury. The balance tests were performed in nine patients with chronic spinal cord injury (average of 17.2 years postinjury) between levels C6 and L1, while they were sitting in their wheelchairs and on a standardized stool (unsupported sitting), twice, 7 days apart. Limits of stability (LOS) and sequential weight shifting (SWS) were designed in this study. The balance tests measured participants' volitional weight shifting in multiple directions within their base of support. Their mobility scores on the Spinal Cord Independence Measure III were correlated with the balance test results. The LOS results showed moderate to excellent test-retest reliability (intraclass correlation coefficients ranged from 0.673 to 0.990) for both the wheelchair and the unsupported sitting. The SWS results showed moderate to excellent reliability (intraclass correlation coefficients ranged from 0.688 to 0.952). The LOS results correlated significantly with the Spinal Cord Independence Measure III mobility scores only in case of unsupported sitting, but the SWS test results showed significant correlations in both sitting conditions. To sum up, the sitting LOS and SWS tests are reliable and valid tools for assessing the dynamic sitting balance control of patients with spinal cord injury.

International Progress and Understanding of Discharge Planning / 中国康复理论与实践

With the social development and the transformation of medical model, providing patients with continuous services and seam-less transfer between different medical institutions, namely continuity care, is inevitable. Discharge planning take patients as the center and patient's needs as the guidance. Patients and their families should actively take part in the plan. Through multi-disciplinary and multi-institu-tional cooperation, patients can continue to enjoy health services after discharge. Discharge planning is the basis of continuous medical ser-vice. This article summrized the background and situation of discharge planning in the United States, Canada, Brazil, the United Kingdom, Ireland, Australia, Japan, India, South Africa, and Hong Kong, Taiwan and mainland in China. When heavy medical burden, aging, im-balence between supply and demand occurred, discharge planning could be helpful to make rational use of medical resources, save medical costs, guarantee the quality of medical service continuity, avoid the occurrence of adverse events after discharge and improve the patients' function and quality of life. This article reviewed group members, time, institutions and process of discharge planning in order to provide ev-idence-based basis for the development of discharge planning in China.

Discharge Planning in China / 中国康复理论与实践

Discharge planning is the basis of continuous medical service. It could shorten the length of hospital stay, improve bed occu-pancy, reduce readmission rate, save medical costs, and improve the quality of life. It's considered to be important and supplemented by rele-vant policies and regulations to promote development in the United States, the United Kingdom, Canada, Australia and other developed countries. In China, even though Hong Kong and Taiwan have issued discharge planning policies, the mainland is still at the stage of explora-tion. Discharge planning in Chinese mainland has problems like restricted objectives, imperfect content, un-optimized process, unestablished professionals and organizations and so on. Standardized discharge planning guide still needs further research. As the health service system including hospitals, public health institutions and primary health institutions coverd urban and rural gradually, and the new pattern of grad-ing diagnosis and treatment established, it's necessary to analyze the necessity, importance, obstacles and measures of discharge planning in China.

Tentative Discussion on Administerial and Professional Training for Community-based Rehabilitation / 中国康复理论与实践

Personnel training is always a key element in community-based rehabilitation (CBR) work. For trainers as well as organiz-ers, the aim of CBR trainings is to develop applied talents who are able to understand, practice and service in accordance with trainees' back-ground, roles and responsibilities, needs of persons with disabilities. This paper reviewsed tentative approaches such as progressive training, participatory training, and field visit in the CBR training project developed by China Disabled Persons' Federation and Hong Kong Society for Rehabilitation. It finally puts forward some suggestions and references for further trainings on CBR or similar topic.