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Richard Iorio - One of the best experts on this subject based on the ideXlab platform.
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Home Health Services Are Not Required for Select Total Hip Arthroplasty Candidates: Assessment and Supplementation With an Electronic Recovery Application.
The Journal of arthroplasty, 2018Co-Authors: Roy I. Davidovitch, Afshin A. Anoushiravani, James E. Feng, Kevin K. Chen, Raj Karia, Ran Schwarzkopf, Richard IorioAbstract:At our institution, all postoperative total hip arthroplasty (THA) candidates have received home health services (HHS), consisting of visiting nurses, physical and occupational therapists. However, with a more technologically inclined Patient population, electronic Patient Rehabilitation applications (EPRAs) can be used to deliver perioperative care at the comfort of the Patient's home. The aim of this study is to investigate the clinical utility and economic burden associated with digital Rehabilitation applications in primary THA recipients. We conducted a single-center, retrospective review of Patients operated between November 2016 and November 2017. Before surgery, and at the discretion of the surgeon, Patients were assigned to EPRA with HHS or EPRA alone. Patient baseline demographics, EPRA engagement, and validated Patient-reported outcomes (PROs) were collected (Veterans Rand 12-Item Health Survey [VR-12] and Hip Disability and Osteoarthritis Outcome Score Junior) at baseline and 12 weeks. These PRO scores were correlated with cohort assignments to assess noninferiority of EPRA alone. In total, 268 Patients received either EPRA-HHS (n = 169) or EPRA (n = 99) alone. Patients receiving EPRA only were on average younger (60.8 vs 65.8; P < .0001), but otherwise similar to Patients in the EPRA-HHS cohort. EPRA-only Patients demonstrated no differences in VR-12 (P > .05) and Hip Disability and Osteoarthritis Outcome Score Junior (P > .05) when compared with EPRA-HHS. The integration of electronic Rehabilitation tools is gaining acceptance within the orthopedic community. Our study demonstrated that EPRA alone was clinically noninferior while substantially less costly than EPRA-HHS. Copyright © 2018 Elsevier Inc. All rights reserved.
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Home Health Services Are Not Required for Select Total Hip Arthroplasty Candidates: Assessment and Supplementation With an Electronic Recovery Application.
The Journal of Arthroplasty, 2018Co-Authors: Roy I. Davidovitch, Afshin A. Anoushiravani, James E. Feng, Kevin K. Chen, Raj Karia, Ran Schwarzkopf, Richard IorioAbstract:Abstract Background At our institution, all postoperative total hip arthroplasty (THA) candidates have received home health services (HHS), consisting of visiting nurses, physical and occupational therapists. However, with a more technologically inclined Patient population, electronic Patient Rehabilitation applications (EPRAs) can be used to deliver perioperative care at the comfort of the Patient's home. The aim of this study is to investigate the clinical utility and economic burden associated with digital Rehabilitation applications in primary THA recipients. Methods We conducted a single-center, retrospective review of Patients operated between November 2016 and November 2017. Before surgery, and at the discretion of the surgeon, Patients were assigned to EPRA with HHS or EPRA alone. Patient baseline demographics, EPRA engagement, and validated Patient-reported outcomes (PROs) were collected (Veterans Rand 12-Item Health Survey [VR-12] and Hip Disability and Osteoarthritis Outcome Score Junior) at baseline and 12 weeks. These PRO scores were correlated with cohort assignments to assess noninferiority of EPRA alone. Results In total, 268 Patients received either EPRA-HHS (n = 169) or EPRA (n = 99) alone. Patients receiving EPRA only were on average younger (60.8 vs 65.8; P P > .05) and Hip Disability and Osteoarthritis Outcome Score Junior ( P > .05) when compared with EPRA-HHS. Conclusion The integration of electronic Rehabilitation tools is gaining acceptance within the orthopedic community. Our study demonstrated that EPRA alone was clinically noninferior while substantially less costly than EPRA-HHS.
Roy I. Davidovitch - One of the best experts on this subject based on the ideXlab platform.
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Home Health Services Are Not Required for Select Total Hip Arthroplasty Candidates: Assessment and Supplementation With an Electronic Recovery Application.
The Journal of arthroplasty, 2018Co-Authors: Roy I. Davidovitch, Afshin A. Anoushiravani, James E. Feng, Kevin K. Chen, Raj Karia, Ran Schwarzkopf, Richard IorioAbstract:At our institution, all postoperative total hip arthroplasty (THA) candidates have received home health services (HHS), consisting of visiting nurses, physical and occupational therapists. However, with a more technologically inclined Patient population, electronic Patient Rehabilitation applications (EPRAs) can be used to deliver perioperative care at the comfort of the Patient's home. The aim of this study is to investigate the clinical utility and economic burden associated with digital Rehabilitation applications in primary THA recipients. We conducted a single-center, retrospective review of Patients operated between November 2016 and November 2017. Before surgery, and at the discretion of the surgeon, Patients were assigned to EPRA with HHS or EPRA alone. Patient baseline demographics, EPRA engagement, and validated Patient-reported outcomes (PROs) were collected (Veterans Rand 12-Item Health Survey [VR-12] and Hip Disability and Osteoarthritis Outcome Score Junior) at baseline and 12 weeks. These PRO scores were correlated with cohort assignments to assess noninferiority of EPRA alone. In total, 268 Patients received either EPRA-HHS (n = 169) or EPRA (n = 99) alone. Patients receiving EPRA only were on average younger (60.8 vs 65.8; P < .0001), but otherwise similar to Patients in the EPRA-HHS cohort. EPRA-only Patients demonstrated no differences in VR-12 (P > .05) and Hip Disability and Osteoarthritis Outcome Score Junior (P > .05) when compared with EPRA-HHS. The integration of electronic Rehabilitation tools is gaining acceptance within the orthopedic community. Our study demonstrated that EPRA alone was clinically noninferior while substantially less costly than EPRA-HHS. Copyright © 2018 Elsevier Inc. All rights reserved.
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Home Health Services Are Not Required for Select Total Hip Arthroplasty Candidates: Assessment and Supplementation With an Electronic Recovery Application.
The Journal of Arthroplasty, 2018Co-Authors: Roy I. Davidovitch, Afshin A. Anoushiravani, James E. Feng, Kevin K. Chen, Raj Karia, Ran Schwarzkopf, Richard IorioAbstract:Abstract Background At our institution, all postoperative total hip arthroplasty (THA) candidates have received home health services (HHS), consisting of visiting nurses, physical and occupational therapists. However, with a more technologically inclined Patient population, electronic Patient Rehabilitation applications (EPRAs) can be used to deliver perioperative care at the comfort of the Patient's home. The aim of this study is to investigate the clinical utility and economic burden associated with digital Rehabilitation applications in primary THA recipients. Methods We conducted a single-center, retrospective review of Patients operated between November 2016 and November 2017. Before surgery, and at the discretion of the surgeon, Patients were assigned to EPRA with HHS or EPRA alone. Patient baseline demographics, EPRA engagement, and validated Patient-reported outcomes (PROs) were collected (Veterans Rand 12-Item Health Survey [VR-12] and Hip Disability and Osteoarthritis Outcome Score Junior) at baseline and 12 weeks. These PRO scores were correlated with cohort assignments to assess noninferiority of EPRA alone. Results In total, 268 Patients received either EPRA-HHS (n = 169) or EPRA (n = 99) alone. Patients receiving EPRA only were on average younger (60.8 vs 65.8; P P > .05) and Hip Disability and Osteoarthritis Outcome Score Junior ( P > .05) when compared with EPRA-HHS. Conclusion The integration of electronic Rehabilitation tools is gaining acceptance within the orthopedic community. Our study demonstrated that EPRA alone was clinically noninferior while substantially less costly than EPRA-HHS.
Pranesh Bhargava - One of the best experts on this subject based on the ideXlab platform.
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top down restoration of speech in cochlear implant users
Hearing Research, 2014Co-Authors: Pranesh Bhargava, Etienne Gaudrain, Deniz BaskentAbstract:Abstract In noisy listening conditions, intelligibility of degraded speech can be enhanced by top-down restoration. Cochlear implant (CI) users have difficulty understanding speech in noisy environments. This could partially be due to reduced top-down restoration of speech, which may be related to the changes that the electrical stimulation imposes on the bottom-up cues. We tested this hypothesis using the phonemic restoration (PhR) paradigm in which speech interrupted with periodic silent intervals is perceived illusorily continuous (continuity illusion or CoI) and becomes more intelligible (PhR benefit) when the interruptions are filled with noise bursts. Using meaningful sentences, both CoI and PhR benefit were measured in CI users, and compared with those of normal-hearing (NH) listeners presented with normal speech and 8-channel noise-band vocoded speech, acoustically simulating CIs. CI users showed different patterns in both PhR benefit and CoI, compared to NH results with or without the noise-band vocoding. However, they were able to use top-down restoration under certain test conditions. This observation supports the idea that changes in bottom-up cues can impose changes to the top–down processes needed to enhance intelligibility of degraded speech. The knowledge that CI users seem to be able to do restoration under the right circumstances could be exploited in Patient Rehabilitation and product development.
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Top–down restoration of speech in cochlear-implant users
Hearing Research, 2014Co-Authors: Pranesh Bhargava, Etienne Gaudrain, Deniz BaskentAbstract:In noisy listening conditions, intelligibility of degraded speech can be enhanced by top-down restoration. Cochlear implant (CI) users have difficulty understanding speech in noisy environments. This could partially be due to reduced top-down restoration of speech, which may be related to the changes that the electrical stimulation imposes on the bottom-up cues. We tested this hypothesis using the phonemic restoration (PhR) paradigm in which speech interrupted with periodic silent intervals is perceived illusorily continuous (continuity illusion or CoI) and becomes more intelligible (PhR benefit) when the interruptions are filled with noise bursts. Using meaningful sentences, both CoI and PhR benefit were measured in CI users, and compared with those of normal-hearing (NH) listeners presented with normal speech and 8-channel noise-band vocoded speech, acoustically simulating CIs. CI users showed different patterns in both PhR benefit and CoI, compared to NH results with or without the noise-band vocoding. However, they were able to use top-down restoration under certain test conditions. This observation supports the idea that changes in bottom-up cues can impose changes to the topedown processes needed to enhance intelligibility of degraded speech. The knowledge that CI users seem to be able to do restoration under the right circumstances could be exploited in Patient Rehabilitation and product development.
Deniz Baskent - One of the best experts on this subject based on the ideXlab platform.
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top down restoration of speech in cochlear implant users
Hearing Research, 2014Co-Authors: Pranesh Bhargava, Etienne Gaudrain, Deniz BaskentAbstract:Abstract In noisy listening conditions, intelligibility of degraded speech can be enhanced by top-down restoration. Cochlear implant (CI) users have difficulty understanding speech in noisy environments. This could partially be due to reduced top-down restoration of speech, which may be related to the changes that the electrical stimulation imposes on the bottom-up cues. We tested this hypothesis using the phonemic restoration (PhR) paradigm in which speech interrupted with periodic silent intervals is perceived illusorily continuous (continuity illusion or CoI) and becomes more intelligible (PhR benefit) when the interruptions are filled with noise bursts. Using meaningful sentences, both CoI and PhR benefit were measured in CI users, and compared with those of normal-hearing (NH) listeners presented with normal speech and 8-channel noise-band vocoded speech, acoustically simulating CIs. CI users showed different patterns in both PhR benefit and CoI, compared to NH results with or without the noise-band vocoding. However, they were able to use top-down restoration under certain test conditions. This observation supports the idea that changes in bottom-up cues can impose changes to the top–down processes needed to enhance intelligibility of degraded speech. The knowledge that CI users seem to be able to do restoration under the right circumstances could be exploited in Patient Rehabilitation and product development.
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Top–down restoration of speech in cochlear-implant users
Hearing Research, 2014Co-Authors: Pranesh Bhargava, Etienne Gaudrain, Deniz BaskentAbstract:In noisy listening conditions, intelligibility of degraded speech can be enhanced by top-down restoration. Cochlear implant (CI) users have difficulty understanding speech in noisy environments. This could partially be due to reduced top-down restoration of speech, which may be related to the changes that the electrical stimulation imposes on the bottom-up cues. We tested this hypothesis using the phonemic restoration (PhR) paradigm in which speech interrupted with periodic silent intervals is perceived illusorily continuous (continuity illusion or CoI) and becomes more intelligible (PhR benefit) when the interruptions are filled with noise bursts. Using meaningful sentences, both CoI and PhR benefit were measured in CI users, and compared with those of normal-hearing (NH) listeners presented with normal speech and 8-channel noise-band vocoded speech, acoustically simulating CIs. CI users showed different patterns in both PhR benefit and CoI, compared to NH results with or without the noise-band vocoding. However, they were able to use top-down restoration under certain test conditions. This observation supports the idea that changes in bottom-up cues can impose changes to the topedown processes needed to enhance intelligibility of degraded speech. The knowledge that CI users seem to be able to do restoration under the right circumstances could be exploited in Patient Rehabilitation and product development.
Van Der Lucas Woude - One of the best experts on this subject based on the ideXlab platform.
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upper extremity musculoskeletal pain during and after Rehabilitation in wheelchair using persons with a spinal cord injury
Spinal Cord, 2006Co-Authors: S Van Drongelen, De Sonja Groot, H E J Veeger, E L D Angenot, A J Dallmeijer, Marcel W M Post, Van Der Lucas WoudeAbstract:STUDY DESIGN: Prospective cohort study. OBJECTIVES: To study upper extremity musculoskeletal pain during and after Rehabilitation in wheelchair-using subjects with a spinal cord injury (SCI) and its relation with lesion characteristics, muscle strength and functional outcome. SETTING: Eight Rehabilitation centers with an SCI unit in the Netherlands. METHODS: Using a questionnaire, number, frequency and seriousness of musculoskeletal pain complaints of the upper extremity were measured. A pain score for the wrist, elbow and shoulder joints was calculated by multiplying the seriousness by the frequency of pain complaints. An overall score was obtained by adding the scores of the three joints of both upper extremities. Muscle strength was determined by manual muscle testing. The motor score of the functional independence measure provided a functional outcome. All outcomes were obtained at four test occasions during and 1 year after Rehabilitation. RESULTS: Upper extremity pain and shoulder pain decreased over time (30%) during the latter part of in-Patient Rehabilitation (P<0.001). Subjects with tetraplegia (TP) showed more musculoskeletal pain than subjects with paraplegia (PP) (P<0.001). Upper extremity pain and shoulder pain were significantly inversely related to functional outcome (P<0.001). Muscle strength was significantly inversely related to shoulder pain (P<0.001). Musculoskeletal pain at the beginning of Rehabilitation and BMI were strong predictors for pain 1 year after in-Patient Rehabilitation (P<0.001). CONCLUSIONS: Subjects with TP are at a higher risk for upper extremity musculoskeletal pain and for shoulder pain than subjects with PP. Higher muscle strength and higher functional outcome are related to fewer upper extremity complaints.
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upper extremity musculoskeletal pain during and after Rehabilitation in wheelchair using persons with a spinal cord injury
Spinal Cord, 2006Co-Authors: S Van Drongelen, De Sonja Groot, H E J Veeger, E L D Angenot, A J Dallmeijer, Marcel W M Post, Van Der Lucas WoudeAbstract:Prospective cohort study. To study upper extremity musculoskeletal pain during and after Rehabilitation in wheelchair-using subjects with a spinal cord injury (SCI) and its relation with lesion characteristics, muscle strength and functional outcome. Eight Rehabilitation centers with an SCI unit in the Netherlands. Using a questionnaire, number, frequency and seriousness of musculoskeletal pain complaints of the upper extremity were measured. A pain score for the wrist, elbow and shoulder joints was calculated by multiplying the seriousness by the frequency of pain complaints. An overall score was obtained by adding the scores of the three joints of both upper extremities. Muscle strength was determined by manual muscle testing. The motor score of the functional independence measure provided a functional outcome. All outcomes were obtained at four test occasions during and 1 year after Rehabilitation. Upper extremity pain and shoulder pain decreased over time (30%) during the latter part of in-Patient Rehabilitation (P<0.001). Subjects with tetraplegia (TP) showed more musculoskeletal pain than subjects with paraplegia (PP) (P<0.001). Upper extremity pain and shoulder pain were significantly inversely related to functional outcome (P<0.001). Muscle strength was significantly inversely related to shoulder pain (P<0.001). Musculoskeletal pain at the beginning of Rehabilitation and BMI were strong predictors for pain 1 year after in-Patient Rehabilitation (P<0.001). Subjects with TP are at a higher risk for upper extremity musculoskeletal pain and for shoulder pain than subjects with PP. Higher muscle strength and higher functional outcome are related to fewer upper extremity complaints.
