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‘Good Start’ for spinal cord injury management: an occupational therapy initiative of Bangladesh

  • Bangladesh Health Professions Institute


This paper aims to share the experience of a recent occupational therapy practice initiative for assisting in successful transition from the rehabilitation centre to the home setting. Considering the low resources and limited funds availability, this project has shown how the occupational therapist (OT) can facilitate a ‘Good Start ’ for the life of a person with spinal cord injury at home. A smooth transition to home can be facilitated by traveling along with the patient and his/her family after discharge, by sharing the transport cost, and by physically observing the patient’s home and giving technical support to family members to modify the home environment. This project is a good model for OTs working within developing countries like Bangladesh.
... Hanson, Nabavi, et Yuen, 2001); comme étant la réalisation des habitudes de vie selon le modèle de processus de production du handicap (PPH; ex. Dumont, Gervais, Fougeyrollas, et Bertrand, 2005;Lemay, 2011); ou comme étant la reprise des activités et des rôles sociaux antérieurs en fin de réadaptation (Ullah et Erna, 2013). Cette absence de consensus s'inscrit même au niveau des terminologies employées, tant pour l'IC que pour la participation sociale. ...
... Stratégies de recherche par mots-clés : ("OccupaƟonal therap*" OR "OccupaƟonal therapy pracƟce*" OR "OccupaƟonal therapy intervenƟon*") AND ("Community integraƟon" OR "Community reintegraƟon" OR "Social integraƟon" OR "Social reintegraƟon" OR Inclus* OR "Inclusive communit*" OR "Social parƟcipaƟon" OR "Social inclusion") AND ("Stroke" OR "MulƟple sclerosis" OR "TraumaƟc brain injur*" OR "TBI*" OR "TraumaƟc brain injur*" OR "Acquired brain injur*" OR "Head injur*" OR "Spinal cord injur*" OR Parapleg* OR Quadripleg*). Plusieurs avenues d'interventions soulevées pour cette population peuvent être classées dans la dimension physique de l'IC car elles ont pour objet les déplacements dans la communauté (Lemay, 2011), l'accessibilité de l'environnement (Barclay, McDonald, Lentin, et Bourke-Taylor, 2016;Lysack, Komanecky, Kabel, Cross, et Neufeld, 2007;Price et al., 2011;Sekaran et al., 2010;Ullah et Erna, 2013), la disponibilité des soins de santé, les politiques gouvernementales en matière de santé (Lysack et al., 2007;Sekaran et al., 2010), et la pratique d'activités sportives. ...
Description Bien que l’intégration communautaire (IC) constitue l’ultime but en réadaptation, elle s’actualise rarement en clinique. But Le but de cette étude était de (a) synthétiser l’état des connaissances ergothérapiques liées à l’IC auprès de personnes atteintes d’un trouble neurologique et (b) dresser un portrait de l’opérationnalisation du concept d’IC au sein de ces écrits. Méthodologie Un examen de la portée fut réalisé en double sélection pour ultimement retenir 47 écrits, touchant quatre populations sélectionnées. Les thématiques propres à l’ensemble des clientèles ont été dégagées par analyse de contenu et les constats touchant l’évolution des connaissances ont fait l’objet de synthèses itératives. Résultats Les écrits retenus concernent le traumatisme craniocérébral ( n = 21, 9 devis expérimentaux [EXP]), les blessures médullaires ( n = 11, 4 EXP), l’accident vasculaire cérébral ( n = 9, 4 EXP) et la sclérose en plaques ( n = 4, 1 EXP). L’IC est employée de façon interchangeable avec la participation sociale: 51 % des écrits définissent l’IC uniquement à partir d’un outil de mesure et 10 % n’offrent aucune définition de l’IC. La dimension physique de l’IC est plus étudiée que les dimensions sociale et psychologique. Conséquences Les pratiques innovantes doivent viser l’affiliation et l’exercice d’une pleine citoyenneté afin de soutenir une habilitation durable.
Background: Trauma is the most frequent cause of significant functional impairment that leads to the deterioration in health and often delayed functional and psychosocial recovery. Fundamentally, rehabilitation of those with traumatic injuries surpasses the acute management extending into the reintegration of patients to home life and the wider community. Consequently, rehabilitation from a traumatic injury is a multidisciplinary process that incorporates the continuum of care across different settings and organizations. Planning and maintaining effective rehabilitation across organizations and sectors is a significant challenge. Unmet rehabilitation needs can prolong discharge, limit the patient's activities, restrict participation, decrease quality of life and increase dependence on significant others. Objectives: The objective of this systematic review was to identify and synthesize the best available evidence on the effectiveness of collaborative care models in relation to traumatic injury rehabilitation. Review question: What is the effectiveness of collaborative care models that facilitate rehabilitation from a traumatic injury? Inclusion criteria: Types of participants: This review considered all studies that included adult patients above 18 years of age and of either gender with a traumatic physical injury requiring rehabilitation across different settings/organizations. Types of interventions: Interventions of interest were models of collaborative care that facilitate those rehabilitating from a traumatic physical injury across different care types and settings. The comparator was usual care. TYPES OF STUDIES: This review aimed to identify randomized controlled trials; however, with the absence of any randomized controlled trials, other research designs were considered. Types of outcome measures: This review considered studies that reported on participation, functionality, quality of life, pain, psychosocial outcomes and goals. Search strategy: The search strategy aimed to find both published and unpublished studies without language or publication date restrictions. A three-step search strategy was utilized in this review. Methodological quality: The studies were independently assessed by two reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute. Data extraction: No studies progressed to data extraction. Data synthesis: Data synthesis was not undertaken as no study was identified of sufficient quality. Results: This systematic review identified only one paper that met the inclusion criteria. It described the United States Veterans Affair's system of Veteran-centred, post-combat care rehabilitation programs that fundamentally relies on the collaborative care of social workers and nurses to support service members, veterans and their families proceed through the initial recovery, rehabilitation and re-integration into post-combat society and their home communities. Unfortunately, there was no formal evaluation provided that addressed the review's outcomes of interest and therefore the study was excluded. Conclusions: This review has highlighted the lack of research concerning collaborative models of care that facilitate rehabilitation from a traumatic injury. It found insufficient data to enable any conclusions to be made about the effectiveness of collaborative models of care that facilitate rehabilitation from a traumatic injury. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH: Further research investigating viable collaborative models of care that facilitate the rehabilitation journey across different healthcare sectors is required.
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This study assessed the efficacy of a community-based program designed to provide Independent Living services (ILS) to people with new, traumatic spinal cord injuries (SCI). The program was implemented in six communities throughout the US served by Model SCI Care Systems where services are provided by Centers for Independent Living. Participants consisted of eighty-one people with new, traumatic SCI (38% intervention participants and 62% comparison group members). Each group was assessed with regard to ILS received, unmet needs for services, satisfaction with services and three outcomes: perceived control, quality of life and societal participation. Results show that program participants and comparison group subjects differed little in terms of either measures of ILS or the outcome measures. There were numerous associations between ILS and outcomes; those who felt that they did not need ILS tended to have superior outcomes to both those who received these services and those who said that they had unmet needs. Advocacy services had the strongest association with study outcomes. The study highlights the importance of minimizing the need for ILS. It also indicates that there is a need for improved communication among rehabilitation professionals working in large medical institutions and those working in community organizations.
Spinal cord injury (SCI) implies a drastic change in the quality of life of an individual, and this fact must be considered by the physiatrist. The aim of this study was to assess the degree of disability shown by patients with spinal cord injury at 5 years post-SCI. For this purpose we used the Craig Handicap Assessment and Reporting Technique (CHART) scale which included the evaluation of occupation, physical independence, mobility, social integration and economic self-sufficiency. A questionnaire was mailed to 243 patients who were admitted over a one-year period to the Hospital Nacional de Parapléjicos in Toledo, Spain. From these, we received 90 answers. No significant differences were observed when they were compared to the 90 patients who answered the questionnaire. 30% of the patients had less than 333 points on the scale, meaning that they could be considered severely disabled, while a score higher than 438 points was seen in 46.7% of the patients: most of these individuals were younger than 18 and had less severe neurologic injuries. Despite the enormous impact of SCI, according to the scale used most patients have scores above the disability level.
Challenges to complete home environment modification for persons with paraplegia using wheel chair following rehabilitation at CRP. Unpublished Undergraduate Thesis
  • S M Rashiduzzaman