Promoting equity at the population level: Putting the foundational principles into practice through disability advocacy.

Rehabilitation psychology is based on foundational principles that can guide us toward health equity among disabled and nondisabled communities. We summarize the literature on disparities in the disability community and underscore the urgency to address underlying inequities to eliminate disparities. We include examples of population-level interventions that promote equity in the disability community. We conclude with a call for a broader mission for rehabilitation psychologists based on the field's foundational principles, and outline emerging opportunities to widen our impact and advance equity. Our foundational principles, built on systems theory, call on rehabilitation psychologist to work at macrosystemic levels. As rehabilitation psychologists, we need to widen our focus from the micro (individual) to the macro (population) level. We need to bring the respect, dignity, and collaborative spirit that inspire our work with individuals to the broader community by advocating for structures and policies that promote equity for disabled persons. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Family-directed approach to brain injury (FAB) model: a preliminary framework to guide family-directed intervention for individuals with brain injury.

PURPOSE: This article proposes a theoretical framework to help professionals include family as active members in brain injury rehabilitation. A trend towards greater family involvement has lead to the development of family-collaboration models. However, current models appear to focus on information sharing rather than increasing the capability of family members. This article introduces a family-directed approach to brain injury model, which provides a theoretical framework for supporting family as facilitators of change. METHODS: Family-collaboration models and literature regarding family experiences following brain injury and support needs are reviewed to identify the driving forces behind family engagement in rehabilitation, including effective professional-family relationships, and important factors in the delivery of education underpinned by evidence-based practices. RESULTS: The family-directed approach to brain injury model is based on principles of hope, family expertise, education/skill building, and family-directed intervention. CONCLUSIONS: The family-directed approach to brain injury model provides a theoretical framework for educating and training family members as facilitators in the management process: promoting competence rather than dependency on service systems. Guiding recommendations encourage professionals to reflect on the importance of their therapeutic relationships and their capacity to positively impact rehabilitation outcomes beyond the technical aspects of health care and treatment. Implications for Rehabilitation Training family members as facilitators in the rehabilitation process is suggested to reduce dependency on the service system, address families' unmet support needs, and to optimize rehabilitation outcomes for individuals with brain injury. The family-directed approach to brain injury model is proposed to guide the increased involvement of family as active members in the rehabilitation team and to define potential active ingredients in this process.

Training and support needs of scleroderma support group facilitators: the North American Scleroderma Support Group Facilitators Survey.

Purpose: Peer-facilitated support groups are an important resource for people with scleroderma, but little is known about challenges faced by support group facilitators. The objective was to identify training and support needs of scleroderma support group facilitators to inform the development of an educational training program. Methods: A 32-item survey assessed confidence of support group facilitators to execute tasks necessary for successfully facilitating support groups. Survey items were grouped into seven themes using content analysis. Results: Eighty North American scleroderma support group facilitators completed the survey. Facilitators were generally confident in their ability to complete tasks related to: (1) Organizing, Structuring, and Facilitating the group; (2) Addressing Individual Member Needs and Diversity of the Group; (3) Helping Members Cope with Grief and Loss; and (4) Attaining and Responding to Member Feedback. They were less confident in their ability to perform tasks related to (1) Managing Difficult Group Dynamics; (2) Promoting and Sustaining the Group; and (3) Balancing Personal and Group Needs. Conclusion: Results suggest that a training program for scleroderma support group facilitators should address a broad range of topics, including managing difficult group interactions, promotion and maintaining the group, and balancing personal and support group needs. Implications for Rehabilitation Many patients with the rare autoimmune connective tissue disease scleroderma depend on peer-facilitated support groups for disease-related education and peer support, but the lack of training for facilitators is a barrier to forming and sustaining groups. Rehabilitation professionals can support the formation and management of local support groups by providing education and support to peer group facilitators or by referring them to national scleroderma organizations who are developing training resources. Training for support group facilitators should focus on areas where facilitators were least confident in their abilities, including managing difficult group dynamics, promoting and sustaining the group, and balancing personal and group needs.

Opening editorial: Rehabilitation Psychology.

Since 1972 Rehabilitation Psychology has played a fundamental role in disseminating theoretical, scientific, clinical, and educational advances in the field of rehabilitation psychology. In the author's view, the journal's role is not only to promote and communicate these advances but also, as aptly stated more than 50 years ago in an editorial on the purpose of scientific journals, to "be maximally useful to its readers" (Comroe, 1966, p. 3). As the new editor of Rehabilitation Psychology, she looks forward to maximizing its usefulness over the next 6 years. Joining her in this venture are two capable associate editors, Anna Kratz and Paul Perrin, a dedicated editorial board, numerous generous ad hoc reviewers, and an engaged rehabilitation psychology community. Innovative, rigorous, and theory-driven science will always have a home in the journal, and during the author's editorial term I will especially seek theoretical, conceptual, and empirical submissions that: (a) promote methodological advances in rehabilitation research; (b) build the evidence base underpinning rehabilitation psychology services and practices; and (c) advance disability research relevant to public policy and social justice. (PsycINFO Database Record

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

OBJECTIVES: To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. DATA SOURCES: Seven databases were searched in May 2015. STUDY SELECTION: Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. DATA EXTRACTION: This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. DATA SYNTHESIS: The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. CONCLUSIONS: Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence.

Psychometric Evaluation of the Occupation-Centered Intervention Assessment.

A challenge of intervention research is the lack of a means to identify and measure clinical practice from an occupation-centered approach. The objective of this study is to establish basic psychometric properties of the Occupation-Centered Intervention Assessment (OCIA). The study is approached by establishing content validity and utility through expert panel and two focus groups. Interrater reliability (IRR) was determined through standardized video analysis and Krippendorff's alpha. Results from the expert panel and focus groups indicated an overall agreement that the OCIA was able to capture the full range of elements of rehabilitation-focused interventions for older adults (occupational, contextual, and personal relevance) and a good fit with the occupational therapy intervention process model. IRR found adequate level of agreement (α = .76). The OCIA has demonstrated initial basic psychometrics for observation of rehabilitation-focused interventions with older adults.

Study protocol for a multicenter investigation of reablement in Norway.

BACKGROUND: Reablement is a promising new rehabilitation model, which is being implemented in some Western countries to meet current and future needs for home-based services. There is a need for further investigation of the effects of reablement among community-dwelling adults in terms of clinical and economic outcomes. This study will investigate the effectiveness of reablement in home-dwelling adults compared with standard treatment in terms of daily activities, physical functioning, health-related quality of life, coping, mental health, use of health care services, and costs. METHODS/DESIGN: The study is a multicenter controlled trial. In total, 44 Norwegian municipalities will participate, including eight municipalities as a control group. For three municipalities with two zones, one will be assigned to the control group and the other to the intervention group. The experimental group will be offered reablement and the control group standard treatment. The sample will comprise approximately 750 participants. People will be eligible if they are home-dwelling adults, understand Norwegian, and have functional decline. Participants will be assessed at baseline, and after 10 weeks, 6 months, and 12 months. The primary outcome will be activity and participation measured by the Canadian Occupational Performance Measure. Physical functioning will be measured by the Short Physical Performance Battery and health-related quality of life by the European Quality of Life Scale. Coping will be measured by the Sense of Coherence questionnaire and mental health by the Mental Health Continuum Short Form. Costs will be generated based on registered working hours in different professions. Data analyses will be performed according to intention to treat. Univariate analysis of covariance will be used to investigate differences between the groups at baseline and the end of intervention. The data will be organized into two levels using a multilevel structure, i.e., individuals and municipalities, which will be analyzed using linear mixed-effects models. The working hours data (panel data) will be analyzed with random mixed-effects regression models. The cost-effectiveness of reablement will be evaluated according to the incremental cost-effectiveness ratio and uncertainty will be explored via the bootstrap method. DISCUSSION: The findings will make an important contribution to knowledge of rehabilitation approaches for community-dwelling adults. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov on October 24, 2014, identifier: NCT02273934 .

Self-perceived job insecurity and the demand for medical rehabilitation: does fear of unemployment reduce health care utilization?

An inverse relationship between job insecurity and sickness absence has been established in the literature, which is explained by employees avoiding to send signals of both poor health and uncooperative behavior towards the employer. In this paper, we focus on whether the same mechanism applies to the demand for medical rehabilitation measures. This question has recently gained much interest in the context of the current public debate on presenteeism. Using county-level unemployment rates as instrument for the employees' fear of job loss on the individual level, we find that an increase in subjective job insecurity substantially decreases the probability of participating in medical rehabilitation.

Incorporating patients with chronic heart failure into outpatient cardiac rehabilitation: practical recommendations for exercise and self-care counseling-a clinical review.

PURPOSE: A recent policy change from the Centers for Medicare and Medicaid Services includes coverage of cardiac rehabilitation (CR) for patients with chronic heart failure (CHF) with reduced ejection fraction. This article provides a framework by which CR programs can incorporate disease-specific services for patients with CHF who participate in CR. DISCUSSION: Cardiac rehabilitation should include self-care counseling that targets improved education and skill development (eg, medication compliance, monitoring/management of body weight). Various tools are available for assessing exercise tolerance (eg, stress test with gas exchange and 6-minute walk), health-related quality of life, and other outcome-related parameters. Exercise should be prescribed in a manner that progressively increases intensity, duration, and frequency, to a volume of exercise equivalent to 3 to 7 metabolic equivalent task (MET)-hr per week. The benefits of exercise training are limited by patient adherence; therefore, CR providers need to identify the adherence challenges unique to each patient and address each accordingly. To optimize the referral of patients with CHF to CR, program staff should develop strategies to raise both health care provider and patient awareness about the benefits of CR, as well as work collaboratively to set up system-based approaches to CR referral. CONCLUSIONS: The referral of patients with CHF to CR will increase in 2014 and beyond, due partly to a policy change from the Centers for Medicare and Medicaid Services that allows coverage for CR. These patients should be integrated into existing programs, with the intent of providing both standard CR services and CHF-specific education and disease management activities that target improved outcomes.

State-by-state variations in cardiac rehabilitation participation are associated with educational attainment, income, and program availability.

PURPOSE: Wide geographic variations in cardiac rehabilitation (CR) participation in the United States have been demonstrated but are not well understood. Socioeconomic factors such as educational attainment are robust predictors of many health-related behaviors, including smoking, obesity, physical activity, substance abuse, and cardiovascular disease. We investigated potential associations between state-level differences in educational attainment, other socioeconomic factors, CR program availability, and variations in CR participation. METHODS: A retrospective database analysis was conducted using data from the US Census Bureau, the Centers for Disease Control and Prevention, and the 1997 Medicare database. The outcome of interest was CR participation rates by state, and predictors included state-level high school (HS) graduation rates (in 2001 and 1970), median household income, smoking rates, density of CR program (programs per square mile and per state population), sex and race ratios, and median age. RESULTS: The relationship between HS graduation rates and CR participation by state was significant for both 2001 and 1970 (r = 0.64 and 0.44, respectively, P < .01). Adding the density of CR programs (per population) and income contributed significantly with a cumulative r value of 0.74 and 0.71 for the models using 2001 and 1970, respectively (Ps < .01). The amount of variance accounted for by each of the 3 variables differed between the 2000 and 1970 graduation rates, but both models were unaltered by including additional variables. CONCLUSIONS: State-level HS graduation rates, CR programs expressed as programs per population, and median income were strongly associated with geographic variations in CR participation rates.

Measuring perceived rehabilitation needs of Caregivers of People with Schizophrenia in mainland China.

This paper reports the development and validation of the Wuxi version of the Rehabilitation Needs Questionnaire for Caregivers of People with Schizophrenia (PRNQ-C-WX) based on the original Hong Kong version (PRNQ-C-HK). PRNQ-C-WX was validated by exploratory factor analysis (EFA) using a convenience sample consisting of 200 caregivers of people with schizophrenia. EFA yielded an eight-factor solution accounting for 63.8 % of the total variance which resulted in a 50-item PRNQ-C-WX. The questionnaire has excellent internal consistencies. Its factor structure is similar to the Hong Kong version. Some suggestions for policy, service and research development in mental health in mainland China are made.

What does the language we use about arthritis mean to people who have osteoarthritis? A qualitative study.

PURPOSE: To explore the meanings and issues surrounding the use of existing medical terms for osteoarthritis from the perspective of members of the public who have consulted healthcare practitioners for arthritic symptoms and from lay people who have not sought a consultation. METHODS: Five qualitative focus groups of 6-8 respondents and six individual in-depth interviews were conducted amongst a purposive sample of men and women aged 45 years and over, with a spread of and a range of socio-economic groupings. Key terms were used as stimulus materials. Focus groups and individual interviews were audio taped, fully transcribed and underwent line by line analysis, identifying concepts and coded. RESULTS: Patients were familiar with many of the terms such as arthritis, osteoarthritis, rheumatism, inflammation, etc. but their level of comprehension varied. Most terms had little emotional impact. Terms used to describe pathophysiology elicited negative emotional impact, especially in women. Terms such as rehabilitation and "self management" were poorly understood and produced negative emotional impact. CONCLUSIONS: Healthcare professionals should not assume that patients' familiarity with medical terms correlate to understanding the term. They should be aware of the potential for negative emotional impact related to some terms. Implications for Rehabilitation Few of the existing medical terms were understood and accepted by lay participants in the way discussed and expected by health professionals. Misunderstandings, unintended meanings and negative emotional responses to terms were common within the study focus groups. Cutting the jargon and checking understanding of seemingly simple medical terms is important to improve communication with patients. As patient access to treatment notes and correspondence increases in the UK, the impact of written terms, as well as verbal, needs careful consideration and attention.

Pessoas com deficiência moradoras de bairro periférico da cidade de São Paulo: estudo de suas necessidades / Disabled people from the outskirts of São Paulo: a study of their needs

Este estudo apresenta as demandas e necessidades de saúde de pessoas com deficiência que participaramde um grupo de convivência, realizado em parceria entre serviço de atenção primária à saúde, universidadee centro comunitário. Compreendeu-se necessidade de saúde como um fenômeno relacionado a formas deprodução e reprodução dos diferentes grupos sociais e que podem ser identificadas a partir do reconhecimentodos modos de trabalhar, de consumir, de viver, de se relacionar e das características do território. Participaram dogrupo dez adultos com deficiências, moradores de bairro periférico, sendo 6 mulheres e 4 homens. Cinco delesapresentavam deficiência intelectual; 3 deficiência física e 2 deficiências múltiplas. Foram realizadas entrevistassemiestruturadas com questões sobre as atividades cotidianas, experiências em saúde e reabilitação, educação,trabalho e participação comunitária; foram 5 entrevistados participantes do grupo, que o representavam em termosde idade, sexo e tipo de deficiência. Estudar, realizar tratamento em reabilitação, ter uma moradia digna, alimento,trabalho, benefício previdenciário, deslocar-se, passear e conversar foram as principais demandas apresentadas.Necessidades histórica e socialmente determinadas situam-se entre a natureza e a cultura dos sujeitos e dizemrespeito não apenas à manutenção da vida, mas também à realização de um projeto de vida em que a pessoaacessa direitos sociais. Porém, as necessidades dessas pessoas expressaram também a vivência de processosde exclusão social. Alternativas assistenciais em reabilitação podem ser implementadas por profissionais dasaúde a partir das necessidades relatadas pelas pessoas com deficiência e suas famílias, articuladas aos recursosassistenciais e comunitários existentes.

In this study, it is showed the health demands and needs of people with disabilities who participated in a support group conducted in partnership with primary health care service, university and community center. We understand health needs as phenomena related to forms of production and reproduction of different social groups that can be identified by the recognition of different ways of working, consuming, living, and relating, as well as by the characteristics of the territory. Ten adults with disabilities participated in the group: six women and four men, all residents of a peripheral neighborhood of the city. Five of them presented intellectual disability, three were physically disabled, and two showed multiple disabilities. We conducted semi-structured interviews comprising questions on daily life activities, experiences in health and rehabilitation, education, work and community participation, with five members of the group, who were representative in terms of age, gender and disability. Studying; performing rehabilitation treatment at home; having adequate housing, food, employment, and social security benefits; being able to move, go out, and have conversations were the main needs presented. Historically and socially determined needs are part of both nature and culture of these individuals and relate not only to maintaining life, but also to the realization of a life project in which a person can have access to social rights. However, those people?s needs also reflect their experience of social exclusion processes. Alternative care in rehabilitation can be implemented by health professionals based on the needs reported by people with disabilities and their families, who take active participation in existing community resources and assistance.

[Presentation of the Psycho-Cardiological schedule and convergence levels analyses among the psycho-cardiological screening and the psychological assessment]. / Presentazione della Scheda Psico-Cardiologica (SPC) e analisi dei livelli di convergenza tra screening psico-cardiologico e valutazione psicologica.

UNLABELLED: In Cardiovascular Rehabilitation the increasing inpatients complexity suggests the necessity to develop screening methods which allow to identify those patients that require a psychological intervention. MATERIAL AND METHODS: A Psycho-Cardiological Schedule (PCS) was developed with the aim of detecting the critical situation indicators or the presence of psychological, social and cognitive problems. The PCS, compiled by a nurse or cardiologist in collaboration with a psychologist, allows to assess the need for a deeper psychological examination, clinical and/or with tests. Aim of the present study is to identify the convergence levels among the observational and anamnestic data of the PCS collected by a nurse and the clinical and/or test data of the psychological deeper assessment. RESULTS: Among the 87 patients recruited in January-February 2010, 28 (aged 53.5 +/- 12.6, M = 20, F = 8) fulfilled the criteria for a deeper psychological examination: age < or = 50, manifestation of psychological/behavioural problems, neuropsychological disorders, low adherence to prescriptions, inadequate disease knowledge/representation. From data comparisons emerged convergence levels with 100% concordance as to smoke habits and problems in social-family support. High convergence levels also resulted as to emotional and/or behavioural problems (92.8%) and inadequate adherence to prescriptions (89.3%). Lower levels of concordance (82.1%) emerged when considering disease knowledge/representation, issues specifically linked to cognition and subjective illness experience, not directly detectable from behaviour. CONCLUSIONS: our data confirm the synergic efficacy of the two evaluations: the Psycho-Cardiological Schedule reliably identifies the problematic macro-categories, mainly if they are characterized by behavioural indicators, which facilitate the detection. The psychological approach appears more suitable for better specifing macro-categories characteristics and for detecting critical aspects not overt but not less important, providing therefore advice for a therapeutic psychological management.

Inpatient paediatric rehabilitation in chronic respiratory disorders.

Inpatient pulmonary rehabilitation programs have evolved from tuberculosis sanatoriums to modern medical centres providing standardized comprehensive care in a multidiciplinatory environment. Goals of rehabilitation programs for children and adolescents include restoration of professional activity, improvement of health condition, compliance and disease management as well as restoration of quality of life. Eligibility for an intervention is assessed by defined social and medical criteria. Comprehensive pulmonary rehabilitation programs provide a wide range of health care recourses, including diagnostic procedures, specific medical care, educational interventions and a multiprofessional team. Paediatric rehabilitation programs for chronic respiratory diseases, such as asthma or cystic fibrosis, have been shown to reduce symptoms, increase aerobic fitness and physical strength, improve pulmonary function and inflammation and enhance compliance, self-management, quality of life and psychological symptoms. Regional climatic effects have demonstrated an additional positive effect on the rehabilitation outcome. In addition, first evidence suggests an overall reduction of health care costs.

Structured community-based inpatient rehabilitation of older patients is better than standard primary health care rehabilitation: an open comparative study.

PURPOSE: To compare the outcome of multi-disciplinary, structured rehabilitation of older patients in a district inpatient rehabilitation centre (Model 1) versus standard primary health care rehabilitation (Model 2). METHOD: Open, prospective, comparative observational study. Totally 302 patients, 202 in Model 1 and 100 in Model 2, aged ≥ 65 years, with stroke, osteoarthritis, hip fracture or other chronic diseases, considered to have a rehabilitation potential. Referred from district hospital, nursing- or own homes. OUTCOMES: Primary: Sunnaas ADL Index (SI). Secondary: Umeaa Life Satisfaction Checklist (LSC). Cognitive (MMSE), emotional (SCL-10) and marital status, residence, length of rehabilitation and hours/week care services. Follow-up 3 months after end of rehabilitation. RESULTS: Patients in Model 1 improved and persisted 1.9 points higher in SI (CI (1.0, 2.8), p < 0.001) compared to Model 2, with 2.4 weeks shorter rehabilitation (CI (1.6, 3.1), p < 0.001). LSC indicated similar satisfaction within both models. Fewer Model 1 patients received home care services >3 h/week (OR = 0.6 CI (0.4, 0.8), p = 0.002). Cognitive status predicted the SI gain positively, and level of care services negatively, in both models. CONCLUSIONS: Disabled older patients increase their independency significantly more within shorter time upon structured, multi-disciplinary rehabilitation in a district inpatient centre compared to standard primary health care rehabilitation. [Box: see text].

[Medical and socio-economic effects of early rehabilitation of patients with acute cerebral vascular accidents].

Acute ischemic brain injury (stroke, stroke), a leader among the causes of morbidity and mortality in the world. This pathology is one of the most pressing health and social problems that cause enormous economic damage to society, due to the high fatality rate, significant disability and social maladjustment of patients, which is based in most cases are the motor and cognitive impairment. Despite the fact that, currently established risk factors and pathophysiological basis of this disease, the availability of effective methods of diagnosing illness, still a practicing neurologist in some cases difficult to find adequate therapy that could effectively reach a well-established neurological deficit. Therefore the search for treatments that effectively reduce the health and social consequences of vascular damage to the brain, is one of the priority areas of neurology.

Avaliação e reabilitação neuropsicológica: desenvolvimento histórico e perspectivas atuais / Neuropsychological assessment and rehabilitation: historical development and current perspectives

Este artigo tem por objetivo, a partir da compreensão histórica de como o campo da Neuropsicologiase constituiu, propor diretrizes para a pesquisa em avaliação e a reabilitação neuropsicológica noBrasil. A história da Neuropsicologia é apresentada através de três grandes temáticas: hipótesecardíaca versus hipótese cerebral, localizacionismo versus holismo e funcionalismo versuscognitivismo. Estes temas influenciaram as pesquisas em Neuropsicologia e delimitaram as práticasatuais na área. O presente artigo enfoca dois temas importantes na atualidade da Neuropsicologia,especialmente no Brasil: primeiro, o tópico da avaliação neuropsicológica no contexto dodesenvolvimento humano e, segundo, a temática da reabilitação neuropsicológica em diversos grupos.O estudo sobre as diferenças no funcionamento cerebral nas diferentes faixas etárias, crianças e idososé brevemente apresentado como campo relevante para a construção teórica e prática daneuropsicologia. Finalmente, as dificuldades encontradas em implementar intervenções emreabilitação no Brasil são discutidas

The present paper aimed to briefly present a historical view of Neuropsychology and later, to proposeresearch topics in Brazil. Neuropsychology history encompassed at least three major themes: thecardiac hypothesis versus the brain hypothesis, localizationism versus holism and functionalismversus cognitivism. These themes influenced research in neuropsychology and based current practice.Furthermore, two important aspects of neuropsychology are discussed: neuropsychologicalassessment in different age groups and neuropsychological rehabilitation. Major topics involved onthe study of the differences in brain functioning through life span are briefly presented and their rolein building evidence-based practice and in supporting theoretical models is showed. Finally, severaldifficulties found in adapting neuropsychological rehabilitation to the Brazilian context are discussed

Promoting walking amongst older patients in rehabilitation: are accelerometers the answer?

The role of physical activity amongst older people in inpatient rehabilitation settings has been little studied. Walking has a number of potential benefits for older people in rehabilitation but it is not known whether increased walking improves outcomes in this population. Until now mobility monitoring has not been possible in routine practice. Recently tri-axial accelerometers have been validated for ambulatory activity monitoring in older adults. Accelerometry has the potential to explore the role of walking in older patients in rehabilitation. Providing data regarding activity levels may improve patient motivation and assist clinicians with activity prescription. Future research could determine the relationship between activity levels and patient outcomes.