Background. The role of positive psychological factors in acute rehabilitation after total hip replacement (THR) is unclear. Purpose. (a) Examine the trajectory of functional ability among older adults after THR from presurgery to discharge from acute rehabilitation and (b) determine which physical and psychological factors at admission would predict functional ability at discharge and length of stay in rehabilitation. Methods. This prospective cohort study included 30 participants (age M = 76.20 years) from an inpatient geriatric rehabilitation center. They completed the Geriatric Depression Scale and Positive Affect questionnaire. The FIM® Motor domain of Functional Independent Measure (mFIM) was recorded presurgery, at admission, and upon discharge. Findings. Functional ability improved at discharge; however, the presurgery functional ability was not regained. Positive affect explained the length of stay in rehabilitation above and beyond the presurgery mFIM. Implications. Occupational therapists should improve ways to enhance self-care and positive affect in acute rehabilitation.

Due to the aging of the population, in 70% of cases, a new cancer diagnosis equals a cancer diagnosis in a geriatric patient. In this population, beyond the concept of mortality and morbidity, functional capacity, disability, and quality of life remain crucial. In fact, when the functional status is preserved, the pathogenetic curve towards disability will stop or even regress. The present systematic review investigated the effectiveness of physical exercise, as part of a holistic assessment of the patient, for preventing disability and improving the patient’s quality of life, and partially reducing all-cause mortality. This evidence must point towards decentralization of care by implementing the development of rehabilitation programs for elderly cancer patients either before or after anti-cancer therapy.

Depuis au moins 20 ans en France, la mutation du regard sur le handicap a amorcé des changements législatifs et de politique publique, dont une des caractéristiques est l’émergence de nouvelles méthodes sous tendant l’accompagnement du handicap. Parmi elles, la réhabilitation psycho-sociale (RPS). Dans cet article, nous aborderons comment l’injonction institutionnelle de réorienter selon l’approche de la Réhabilitation un service d’accueil de jour (AJ) fondé sur la psychothérapie institutionnelle a amené l’équipe à développer un dispositif qui tente de métisser les deux approches en développant l’atelier du Jeu Michael’s Game (MG).
Nous aborderons succinctement le fonctionnement de l’AJ dans son ancrage historique à la thérapie institutionnelle, puis la construction toujours en cours d’une intégration de la Réhabilitation notamment par l’articulation des deux approches au travers du jeu MG.

Objective
Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of PR to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programmes in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of PR using minimal equipment for aerobic and/or resistance training in people with COPD.

Methods
Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs, for exercise capacity, health-related quality of life (HRQoL), and strength.

Results
Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = −27 to 56). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99; 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N; 95% CI = −2 to 13) or lower limb strength (20 N; 95% CI = −30 to 71).

Conclusions
In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength.

Impact
Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.

Objective
The primary objective of this observational study was to analyze the time to the first edge-of-bed (EOB) mobilization in adults who were critically ill with severe versus non-severe COVID-19 pneumonia. Secondary objectives included the description of early rehabilitation interventions and physical therapy delivery.

Methods
All adults with laboratory-confirmed COVID-19 requiring intensive care unit admission for ≥72 hours were included and divided according to their lowest PaO2/FiO2 ratio into severe (≤100 mmHg) or non-severe (>100 mmHg) COVID-19 pneumonia. Early rehabilitation interventions consisted of in-bed activities, EOB or out-of-bed mobilizations, standing, and walking. The Kaplan–Meier estimate and logistic regression were used to investigate the primary outcome time-to-EOB and factors associated with delayed mobilization.

Results
Among the 168 patients included in the study (mean age = 63 y [SD = 12 y]; Sequential Organ Failure Assessment = 11 [interquartile range = 9–14]), 77 (46%) were classified as non-severe, and 91 (54%) were classified as severe COVID-19 pneumonia. Median time-to-EOB was 3.9 days (95% CI = 2.3–5.5) with significant differences between subgroups (non-severe = 2.5 days [95% CI = 1.8–3.5]; severe = 7.2 days [95% CI = 5.7–8.8]). Extracorporeal membrane oxygenation use and high Sequential Organ Failure Assessment scores (adjusted effect = 13.7 days [95% CI = 10.1–17.4] and 0.3 days [95% CI = 0.1–0.6]) were significantly associated with delayed EOB mobilization. Physical therapy started within a median of 1.0 days (95% CI = 0.9–1.2) without subgroup differences.

Conclusion
This study shows that early rehabilitation and physical therapy within the recommended 72 hours during the COVID-19 pandemic could be maintained regardless of disease severity. In this cohort, the median time-to-EOB was fewer than 4 days, with disease severity and advanced organ support significantly delaying the time-to-EOB.

Impact
Early rehabilitation in the intensive care unit could be sustained in adults who are critically ill with COVID-19 pneumonia and can be implemented with existing protocols. Screening based on the PaO2/FiO2 ratio might reveal patients at risk and increased need for physical therapy.

Rehabilitation patients have complex conditions often requiring multiple medications. The term "polypharmacy" represents a well-known risk for those taking multiple medications. Polypharmacy, however, is more than duplications, overuse, or insufficient doses. In fact, there are over 130 published definitions of polypharmacy, as identified by Masnoon et al. (2017). Generally, the concept means taking five or more medications; however, such a definition does not take into account comorbidities and the safety and efficacy of drug combinations. The following is a case study that exemplifies the need to review medication lists beyond drug numbers and dosages. In addition, medications to help one condition can be contraindicated for treating another health issue. Evidence-based (and commonsense) practice requires comparisons and follow-up to identify inconsistencies, contraindications, and even the need for additional medications. Ironically, even more "polypharmacy" may be indicated when there are comorbidities. Usually, nurses perform medication reviews at every appointment, admission, or home visit. Beyond medication safety concerns, rehab nurses, in particular, recognize how quality of life can be compromised when medication problems exist.

Depuis au moins 20 ans en France, la mutation du regard sur le handicap a amorcé des changements législatifs et de politique publique, dont une des caractéristiques est l’émergence de nouvelles méthodes sous tendant l’accompagnement du handicap. Parmi elles, la réhabilitation psycho-sociale (RPS). Dans cet article, nous aborderons comment l’injonction institutionnelle de réorienter selon l’approche de la Réhabilitation un service d’accueil de jour (AJ) fondé sur la psychothérapie institutionnelle a amené l’équipe à développer un dispositif qui tente de métisser les deux approches en développant l’atelier du Jeu Michael’s Game (MG).
Nous aborderons succinctement le fonctionnement de l’AJ dans son ancrage historique à la thérapie institutionnelle, puis la construction toujours en cours d’une intégration de la Réhabilitation notamment par l’articulation des deux approches au travers du jeu MG.

Depuis au moins 20 ans en France, la mutation du regard sur le handicap a amorcé des changements législatifs et de politique publique, dont une des caractéristiques est l’émergence de nouvelles méthodes sous tendant l’accompagnement du handicap. Parmi elles, la réhabilitation psycho-sociale (RPS). Dans cet article, nous aborderons comment l’injonction institutionnelle de réorienter selon l’approche de la Réhabilitation un service d’accueil de jour (AJ) fondé sur la psychothérapie institutionnelle a amené l’équipe à développer un dispositif qui tente de métisser les deux approches en développant l’atelier du Jeu Michael’s Game (MG).
Nous aborderons succinctement le fonctionnement de l’AJ dans son ancrage historique à la thérapie institutionnelle, puis la construction toujours en cours d’une intégration de la Réhabilitation notamment par l’articulation des deux approches au travers du jeu MG.

Open Access

Neurorehabilitation (neuroscience-based rehabilitation) is a medical approach that utilizes the brain’s plasticity to help patients recover from nervous system injury. Remarkable progress has been made in this field, thus attracting increased attention from the scientific community. The concept of neurorehabilitation is widely accepted in physical therapy, and evaluation and treatment based on this concept are currently being practiced. This book provides a comprehensive overview of neurorehabilitation with chapters on motor imagery, repetitive peripheral magnetic stimulation, virtual reality, neurofunctional interventional approaches, and much more.

Objectives: Comprehensive review of existing types and effectiveness of community-based interventions delivered to adults (mean age 18-65 years) with long-lasting (>=6 months) difficulties following acquired brain injury (ABI).

Design: Systematic review of controlled intervention studies published until February 2021.

Main Measures: Systematic searches in databases (MEDLINE, PsycINFO, Database of Abstracts of Reviews of Effects [Cochrane Library], and Cochrane Central Register of Controlled Trials [Cochrane Library]) and inclusion of English peer-reviewed full-text articles; randomized or controlled community-based intervention studies; sample size of 20 or more participants; and 3 or more intervention sessions. Two reviewers independently extracted data for the synthesis and assessed the methodological quality. Data extraction included study characteristics, demographics of participants, content and dose of intervention, outcome measures, and findings.

Result: The search returned 7386 publications, of which 49 eligible studies were included, revealing a diverse range of community-based interventions and a myriad of outcome measures applied for assessing functional capacities, participation, and quality of life in the chronic phase of ABI. Intervention types encompassed 14 holistic, 23 physical, and 12 specific interventions. A large heterogeneity regarding intervention frequency and intensity was found. Meta-analyses performed on the holistic, physical, and specific interventions did not indicate any significant pooled effects but showed highly variable effects between individuals, both in persons with traumatic and nontraumatic brain injuries.

Conclusions: Because of lack of pooled effects within types of community-based interventions, specific evidence-based recommendations within holistic, physical, and specific interventions designed to mitigate long-lasting ABI problems cannot be made. This review highlights the need for future studies to address methodological issues concerning larger sample size, lack of clear description interventions and comparator, missing reports of effects in change scores, need for consistent use of recommended outcome measures, and investigating the wide variety in intervention responsiveness among participants with ABI. Systematic review registration: PROSPERO (CRD42019124949).

Purpose
Early intervention vocational rehabilitation (EIVR) can improve return to work (RTW) outcomes for people with spinal cord injury (SCI). However, mechanisms explaining how and why EIVR works are not well understood. This study aims to develop a conceptual framework describing key mechanisms of EIVR intervention effect following SCI.

Methods
We synthesised data from a realist literature review with data from interviews of people with SCI (n = 30), a survey of people with SCI who had received EIVR (n = 37), a focus group of EIVR providers and a focus group of community vocational providers. We first synthesised the literature review and interviews to develop an initial programme theory describing the contexts in which mechanisms are activated to produce EIVR outcomes. Then we used data from the survey and focus groups to further refine the EIVR programme theory. Finally, a conceptual framework was developed to support knowledge dissemination.

Results
By ensuring consistent messaging across the multi-disciplinary team, EIVR programmes establish and maintain hope that work is possible following injury. Conversations about work allow individuals to determine the priority of work following injury. These conversations can also improve self-efficacy by providing individualized support to envisage pathways toward RTW goals and maintain worker identity. The synthesised study findings highlight the contexts and resources required to trigger activation of these mechanisms.

Conclusions
EIVR key mechanisms of effect are not specific to SCI as a health condition, therefore enabling this framework to be applied to other populations who face similar impairments and return to work barriers.

Purpose of review: To summarize the incidence, features, pathogenesis, risk factors, and evidence-based therapies of prolonged intensive care unit (ICU) acquired weakness (ICU-AW). We aim to provide an updated overview on aspects of poor physical recovery following critical illness.

Recent findings: New physical problems after ICU survival, such as muscle weakness, weakened condition, and reduced exercise capacity, are the most frequently encountered limitations of patients with postintensive care syndrome. Disabilities may persist for months to years and frequently do not fully recover. Hormonal and mitochondrial disturbances, impaired muscle regeneration due to injured satellite cells and epigenetic differences may be involved in sustained ICU-AW. Although demographics and ICU treatment factors appear essential determinants for physical recovery, pre-ICU health status is also crucial. Currently, no effective treatments are available. Early mobilization in the ICU may improve physical outcomes at ICU-discharge, but there is no evidence for benefit on long-term physical recovery.

Summary: Impaired physical recovery is observed frequently among ICU survivors. The pre-ICU health status, demographic, and ICU treatment factors appear to be important determinants for physical convalescence during the post-ICU phase. The pathophysiological mechanisms involved are poorly understood, thereby resulting in exiguous evidence-based treatment strategies to date.

Purpose: The purpose of this article was to explore the extent to which nonlinguistic cognitive factors demonstrate a relationship with aphasia treatment outcomes. To that end, we conducted a scoping review to broadly characterize the state of the literature related to this topic.

Methods: Reporting guidelines from the PRISMA extension for scoping reviews were used to conduct our study, which queried two common databases used in the health science literature, PubMed and Web of Science. Search terms and eligibility criteria are provided. Results are organized by the four nonlinguistic domains of cognition explored across the included studies (i.e., attention, memory, executive functioning, and visuospatial skills).

Results: Of 949 unique articles identified from our database searches, 17 articles with 18 distinct studies were included in the final scoping review. Notably, most studies included in the scoping review targeted impairment-based aphasia treatments. Most studies also examined multiple domains of nonlinguistic cognition. A relationship between cognition and poststroke aphasia therapy outcomes was identified in nine of 15 studies addressing executive functioning, four of nine studies examining memory, four of eight studies examining visuospatial skills, and two of five studies exploring attention.

Discussion: The results among included studies were mixed, with few discernible patterns within each of the four cognitive domains, though it appears that the influence of nonlinguistic cognition may depend on the timing (i.e., immediate vs. delayed post-treatment) and type (i.e., trained vs. untrained, generalized) of aphasia therapy outcomes. Future study designs should address maintenance, by including outcome measures at follow-up, and generalization, by including measures of performance on either untrained stimuli or trained stimuli in untrained contexts. Future work should also strive for larger sample sizes, perhaps through collaborations, or prioritize replicability to produce more reliable conclusions.

Aphasia is a debilitating language disorder, resulting from focal damage to eloquent language areas and dysfunctional connectivity with homologous and remote language regions. Currently, the mainstay treatment for aphasia is speech and language therapy (SLT). Although SLT generally shows benefits compared to no therapy, many aphasia patients can continue to have significant communication difficulties despite participation in SLT. In response, adjuvant therapies to SLT, like pharmacotherapy, non-invasive brain stimulation, virtual reality and neurofeedback have been proposed to help enhance its effect and optimize recovery. In this review we present studies on the efficacy of these rehabilitation techniques in patients with aphasia, to highlight the current advances in the field. Although generally more research is needed for definitive conclusions regarding their efficacy in improving language measures, the results are promising. Therapies adjuvant to SLT could help address the current difficulty of assigning patients to an optimal therapy by offering more treatment options to patients and clinicians. Moreover, neurofeedback could help address the important current limitation of predicting treatment outcome by dynamically and continually assessing activity in the language network, thought to underlie language deficits.

Importance: Sustaining a stroke frequently leads to difficulties in returning to work, leisure, and social participation. These outcomes are important for occupational therapy practitioners to address.

Objective: To determine the current evidence for the effectiveness of interventions within the scope of occupational therapy practice to improve social participation, work, and leisure among adults poststroke.

Data Sources: MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases.

Study Selection and Data Collection: Primary inclusion criteria were peer-reviewed journal articles published between January 1, 2009, and December 31, 2019, within the scope of occupational therapy that evaluated an intervention to address work, leisure, or social participation poststroke (levels of evidence ranged from Level 1b to Level 2b). Reviewers assessed records for inclusion, quality, and validity following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Findings: Forty-seven articles met the inclusion criteria. Forty-four articles related to social participation were categorized as follows: occupation-based approaches, metacognitive strategy training, education and training approaches, impairment-based approaches, and enriched environment approaches. Three articles related to work and 3 articles related to leisure were not further categorized (2 articles were each included in two categories). Seventeen Level 1b and 30 Level 2b articles were included. The strength of evidence to support occupational therapy interventions for social participation, work, and leisure outcomes is predominantly low.

Conclusions and Relevance: Occupational therapy interventions may improve work, leisure, and social participation outcomes poststroke, with the strongest evidence existing for client education, upper extremity training, and cognitive training for improving social participation.

What This Article Adds: Occupational therapy practitioners may use the available literature along with clinical reasoning to improve work, leisure, and social participation outcomes among clients poststroke. Additional research is required to build stronger evidence to support clinical decision making in stroke rehabilitation in these areas.

Background
Different degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention.

Objective
To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19.

Methods
This paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores).

Results
After 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups.

Conclusions
Six-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.

Background
Different degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention.

Objective
To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19.

Methods
This paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores).

Results
After 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups.

Conclusions
Six-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.

BACKGROUND: Increased life expectancy and improved surgical techniques have led to a sharp rise in healthcare resource consumption by
older patients. In these patients early recovery of walking ability after abdominal surgery may shorten length of hospital stay and reduce overall
healthcare costs, but it is important to understand what factors determine this recovery.
AIM: To assess preoperative and postoperative determinants of walking ability recovery after major abdominal surgery in older patients.
DESIGN: Prospective observational study.
SETTING: General Surgery Unit.
POPULATIO N: The study included 327 consecutive older inpatients who underwent major acute-care abdominal surgery.
METHODS: Data on demographic characteristics, diagnosis, comorbidities defined by Charlson Comorbidity Index (CCI), preoperative walking
ability, and early postoperative physical deconditioning (PPDS) were gathered. All patients underwent an individually-tailored rehabilitation
program. At discharge, pain (by a Visual Analogue Scale, VAS-pain, 0-10), transfers and walking ability were assessed. Number of rehabilitation
sessions attended and discharge setting were recorded.
RESULTS: Of 320 patients included in the analysis (7 died), 72% had CCI>5, signifying presence of >1 comorbidities. Before hospitalization,
79% of patients were completely independent in walking at home, 12% needed assistive devices or direct assistance from the caregiver, and 9%
were unable to walk. Complex postoperative physical deconditioning was detected in 25%. At discharge, most patients (87%) had achieved their
rehabilitative goal and returned home. Only PPDS and VAS-pain were able to predict both walking ability and the discharge setting, PPDS alone
showing adequate sensitivity (82%) and specificity (70%).
CONCLUSIONS: PPDS was the sole early postoperative predictor of recovery of walking ability and the discharge setting. Pain therapy might
be a key factor influencing the postoperative functional decline. Age and severity of preoperative comorbidities seem not important determinants
of functional decline in older surgical patients.
CLINICAL REHABILITATIO N IMPACT : An early postoperative assessment of physical deconditioning might be able to predict the walking
ability at discharge (hence, the discharge setting), in older patients undergoing major surgery.
(Cite this article as: Petrucci L, Monteleone S, Ricotti S, Giromini E, Gullace M, Ambrosini E, et al. Disability