Sister Kenny Rehabilitation Institute

Dodge Center, MN, United States

Sister Kenny Rehabilitation Institute

Dodge Center, MN, United States
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Melzer I.,Ben - Gurion University of the Negev | Kurz I.,Ben - Gurion University of the Negev | Shahar D.,Ben - Gurion University of the Negev | Oddsson L.I.E.,Sister Kenny Rehabilitation Institute
Aging Clinical and Experimental Research | Year: 2010

Background and aims: Stepping reactions play a critical role in responding to balance perturbations, whether they are a consequence of external perturbation or self-induced in nature. The aim of the present study was to determine prospectively the capacity of voluntary stepping performance in single-and dual-task conditions, to predict future falls among older community-dwelling persons. We also aimed to assess whether dual task conditions have an added value over single tasks for fall prediction. Methods: A total of 100 healthy old volunteers (mean age 78.4±5.7 yrs), from two self-care protected retirement homes for older adults, performed the Voluntary Step Execution Test in single- and dual-task conditions as a reaction time task while standing on a single force platform. Step initiation, preparatory and swing phases, and foot-contact time were extracted from data on center of pressure and ground reaction force. One-year fall incidences were monitored. Results: Ninety-eight subjects completed the one-year follow-up, 49 non-fallers, 32 one-time fallers, and 17 recurrent fallers (two or more falls). Recurrent fallers had significantly slower voluntary step execution times in both single- and dual-task conditions, especially due to a slower preparation phase. Two stepwise (backward) logistic regression models showed that longer step execution times have strong predictive value for falls in both single- and dual-task conditions (odds ratio (OR) 8.7 and 5.4, respectively, p<0.05). Conclusions: Voluntary Step Execution Test in both single- and dual-task conditions is a simple and safe examination which can potentially and effectively predict future falls, with no added value to dual- over single-task condition. ©2010, Editrice Kurtis.

Melzer I.,Ben - Gurion University of the Negev | Liebermann D.G.,Tel Aviv University | Krasovsky T.,McGill University | Oddsson L.I.E.,Sister Kenny Rehabilitation Institute
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2010

Background. Quick step execution may prevent falls when balance is lost; adding a concurrent task delays this function. We investigate whether push-off force-time relations during the execution of rapid voluntary stepping is affected by a secondary task in older and young adults. Methods Nineteen healthy older adults and 12 young adults performed rapid voluntary stepping under single-and dual-task conditions. Peak power, peak force, and time to peak force during preparatory and swing phases of stepping were extracted from center of pressure and ground reaction force data. Results For dual-task condition compared with single-task condition, older adults show a longer time to reach peak force during the preparation and swing phases compared with young adults (∼25% vs ∼10%, respectively). Peak power and peak force were not affected by a concurrent attention-demanding task. Conclusion Older adults have difficulty allocating sufficient attention for fast muscle recruitment when concurrently challenged by an attention-demanding task. © The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

Schaefer P.T.,University of Minnesota | Speier J.,Sister Kenny Rehabilitation Institute
Current Sports Medicine Reports | Year: 2012

The fields of sports medicine and performing arts medicine have begun recent initiatives to collaborate more closely and to share information pertinent to the treatment of athletes and performing artists. This article provides a review of the common musculoskeletal and neurological problems encountered among performing artists who play instruments. Approaches to history, examination, diagnosis, and treatment are offered, based on literature reviews, expert opinion, and the authors' own experiences in a musician's clinic. Treatments focus on conservative management within a multidisciplinary framework, and indications are given for appropriate surgical referral. Providers are encouraged to build an understanding of the unique issues affecting instrumental athletes. Copyright © 2012 by the American College of Sports Medicine.

Sandin K.J.,Sister Kenny Rehabilitation Institute
Minnesota medicine | Year: 2012

Recent advances in neuroscience have led to newer, more scientific approaches to rehabilitation for patients who have had a stroke or sustained a brain or spinal cord injury. Specifically, the pendulum in rehabilitation has swung away from a focus on compensatory techniques and toward impairment-mitigating therapies. In addition, there is a new push to base therapies on scientific evidence. This article explores these changes and the developments that led to them, including discoveries in basic science that have enhanced our understanding of neuroplasticity. It also describes new research directions in neurorehabilitation.

Shorer Z.,Ben - Gurion University of the Negev | Becker B.,Ben - Gurion University of the Negev | Jacobi-Polishook T.,Ben - Gurion University of the Negev | Oddsson L.,Sister Kenny Rehabilitation Institute | Melzer I.,Ben - Gurion University of the Negev
European Journal of Pediatrics | Year: 2012

Given the known deficits in attention in attention deficit hyperactivity disorder (ADHD) and the evidence suggesting that postural control requires attention, this study aimed to investigate the mechanisms of postural control of children with and without ADHD in single-(ST) and dual-task (DT) conditions. Postural sway and stabilogram diffusion analysis (SDA) were performed on the Center of Pressure trajectories on 24 ADHD children and 17 age-gendermatched healthy controls. The subjects were instructed to stand as stable as possible on a force platform in two task conditions: (1) single task (ST) and (2) dual task (DT) -an auditory-memory attention-demanding cognitive task. During ST and DT conditions, the ADHD children showed significantly greater ML-sway, short-and long-term effective diffusion coefficients, and critical displacement of SDA compared with controls. The effects of DT were somewhat unexpected; the control group indicated a significant decrease in ML-sway, AP-sway, sway area, and critical displacement of SDA; the ADHD group showed a significant decrease in ML-sway range and critical displacement. It is concluded that a greater sway displacement before closed-loop mechanisms is called into play in ADHD children. The DT enhanced balance control by reinforcing balance automaticity and minimizing sway in both healthy and ADHD children. © 2011 Springer-Verlag.

Halvarsson A.,Karolinska Institutet | Halvarsson A.,Karolinska University Hospital | Franzen E.,Karolinska Institutet | Franzen E.,Karolinska University Hospital | And 5 more authors.
Clinical Rehabilitation | Year: 2013

Objective: To evaluate the long-term effects of a progressive and specific balance group-based program in healthy elderly individuals with increased risk of falling. Design: Follow-up of a randomized controlled trial at nine and 15 months on a population that has previously been described at three months. Setting: The study was conducted in Stockholm, Sweden. Subjects: 59 community-dwelling elderly (age 67-93 years), recruited by advertisement, were randomly allocated to training or to serve as controls. Intervention: Group balance training three times per week during 12 weeks with a 15 month follow-up time. Main measures: Participants were assessed at baseline, three, nine, and 15 months thereafter for gait function (preferred and fast walking), rapid step execution (single and dual task), fear of falling, and likelihood of depression. Results: Fast gait speed (p = 0.004), dual task step execution (p = 0.006) and fear of falling (p = 0.001) were still improved in the training group at nine months follow-up. Only self-perceived fear of falling remained significantly improved (p = 0.012) at 15 months follow-up. Although fast gait speed had decreased to baseline level in the training group (1.49 m/s) it remained significantly higher than in the control group (1.37 m/s) at the end of the study, a difference between the groups that was not seen at baseline. © The Author(s) 2012.

Schmitz M.,Abbott Laboratories | Finkelstein M.,Sister Kenny Rehabilitation Institute
Topics in Stroke Rehabilitation | Year: 2010

Purpose: To study the perspectives and experiences of stroke survivors and partners of stroke survivors regarding sexual issues and perceived rehabilitation needs.Methods: Using semi-structured interviews, 15 stroke survivors and 14 partners of stroke survivors (median age of 65 years, range 29 to 85) provided information about sexual issues experienced after stroke and their perspectives on how to address sexual concerns in a rehabilitation setting. A qualitative thematic analysis was applied to transcribed interviews to identify and describe common themes within the data relevant to the aim of the study. A quantitative analysis was utilized to elucidate the frequency of themes by demographic characteristics that were not readily apparent using a qualitative method alone.Results: Seven themes were identified. Two related to the effects of stroke on sexual life: physical/functional changes and relationship changes. Five related to addressing sexual issues in the process of rehabilitation: (1) difficulty in patients and providers talking about sexual matters, (2) little to no discussion of poststroke sexuality, (3) need for tailoring education to an individual or couple's unique needs, (4) provider rapport and competence, and (5) timing of poststroke sexual education. Conclusions: Poststroke sexual issues are complex and suggest the need for the development of a biopsychosocial model of education and treatment intervention. Rehabilitation programs need to evaluate the level of training and services provided to address poststroke sexual issues. Development of clinically useful poststroke sexual adjustment assessment tools and interventions is warranted. © 2010 Thomas Land Publishers, Inc.

Melzer I.,Boston University | Melzer I.,Ben - Gurion University of the Negev | Oddsson L.I.E.,Boston University | Oddsson L.I.E.,Sister Kenny Rehabilitation Institute
Clinical Rehabilitation | Year: 2013

Objectives: To evaluate the effect of a group-based functional and specific balance training programme that included dual-task exercises on balance function in healthy older adults. Design: A single-blind randomized controlled trial. Setting: General community. Participants: Sixty-six community-dwelling older adults (age 77.0 ± 6.5 years), without functional balance impairment were recruited and allocated at random to an intervention group (n = 33) or a reference group (n = 33). Intervention: The intervention group received 24 training sessions over three months that included perturbation as well as dual-task exercises. The reference group received no intervention. Outcome measures: The voluntary step execution times during single- and dual-task conditions, stabilogram-diffusion analysis in upright standing, and self-reported physical function; all were measured assessed at baseline and at the end of intervention. The intervention group was retested after six months. Results: Compared with the reference group, participation in group-based functional and specific balance training led to faster voluntary step execution times under single-task (P = 0.02; effect size (ES) = 0.34) and dual-task (P = 0.036; ES = 0.55) conditions; lower transition displacement and shorter transition time of the stabilogram-diffusion analysis under eyes-closed conditions (P = 0.007, ES = 0.30 and P = 0.08, ES = 0.44, respectively); and improved self-reported lower extremity function (P = 0.006, ES = 0.37). Effects were lost at six-month follow-up. Conclusions: Functional and specific balance training can improve voluntary stepping and balance control in healthy older non-fallers, parameters previously found to be related to increased risk of falls and injury in older adults. © 2012 The Author(s).

Gimmon Y.,Ben - Gurion University of the Negev | Riemer R.,Ben - Gurion University of the Negev | Oddsson L.,Sister Kenny Rehabilitation Institute | Melzer I.,Ben - Gurion University of the Negev
Journal of Electromyography and Kinesiology | Year: 2011

Objective: Previous studies have demonstrated that ankle muscle fatigue alters postural sway. Our aim was to better understand postural control mechanisms during upright stance following plantar flexor fatigue. Method: Ten healthy young volunteers, 25.7 ± 2.2. years old, were recruited. Foot center-of-pressure (CoP) displacement data were collected during narrow base upright stance and eyes closed (i.e. blindfolded) conditions. Subjects were instructed to stand upright and as still as possible on a force platform under five test conditions: (1) non-fatigue standing on firm surface; (2) non-fatigue standing on foam; (3) ankle plantar flexor fatigue, standing on firm surface; (4) ankle plantar flexor fatigue, standing on foam; and (5) upper limb fatigue, standing on firm surface. An average of the ten 30-s trials in each of five test conditions was calculated to assess the mean differences between the trials. Traditional measures of postural stability and stabilogram-diffusion analysis (SDA) parameters were analyzed. Results: Traditional center of pressure parameters were affected by plantar flexor fatigue, especially in the AP direction. For the SDA parameters, plantar flexor fatigue caused significantly higher short-term diffusion coefficients, and critical displacement in both mediolateral (ML) and anteroposterior (AP) directions. Long-term postural sway was different only in the AP direction. Conclusions: Localized plantar flexor fatigue caused impairment to postural control mainly in the Sagittal plane. The findings indicate that postural corrections, on average, occurred at a higher threshold of sway during plantar flexor fatigue compared to non-fatigue conditions. © 2011 Elsevier Ltd.

News Article | November 29, 2016

Courage Kenny Rehabilitation Institute researchers recently presented results from two studies at the American Congress of Rehabilitation Medicine. The annual conference is an expansive educational program covering brain injury, spinal cord injury, stroke, neurodegenerative diseases, pain, cancer, pediatric rehabilitation and neuroplasticity. Nancy Flinn, PhD, OTR/L, senior scientific adviser, showed how new gait guidelines have improved the walking speed of stroke patients. Courage Kenny developed more aggressive guidelines based on best practices and began using them during physical therapy sessions in 2015. On average, patients doubled their improvement in speed during therapy after the implementation of the guidelines. "Gait speed has a big impact of how people do in the community. The gains patients made in gait speed meant that, on average, patients were now walking at community walking speeds. If they went to the mall or the grocery store, they would be able to move at the speed of others, so they are safer, because they are less likely to get bumped by others who are passing them," said Flinn. Mary Vining Radomski, PhD, OTR/L, senior scientific adviser, presented the results of study on cancer-related cognitive dysfunction, also known as chemobrain that involved 28 patients treated for breast cancer. "Patients describe feeling as if in a cognitive fog - difficulty concentrating, forgetfulness, inability to multitask - all of which interferes with performing the tasks and roles that they value. For some, these are short term problems; for others, the problem lingers for months, even years," said Radomski. The study, which was funded by the Courage Kenny Foundation, concluded that occupational therapy can improve everyday functioning and a patient's ability to manage issues with mood, stress, and fatigue, even though brain-related factors do not change. "While the cause of cancer-related cognitive dysfunction is unclear, it seems that multiple factors associated with the cancer experience - stress, fatigue, disruption of daily routines - are at least in part to blame," Radomski said. Radomski reported that cancer survivors may be able to lift the cognitive fog by learning strategies to manage some of these factors. Robin Newman, OTD, OTR of Boston University, co-presented with Radomski. Courage Kenny Rehabilitation Institute, part of Allina Health, was created in 2013 by the merger of Courage Center and Sister Kenny Rehabilitation Institute. The Institute provides a continuum of rehabilitation services for people with short- and long-term conditions, injuries and disabilities in communities throughout Minnesota and western Wisconsin. Courage Kenny Rehabilitation Institute has multiple locations, and numerous programs and services. For more information visit Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 13 hospitals, 14 retail pharmacies, specialty care centers and specialty medical services, home care, senior transitions, hospice care, home oxygen and medical equipment and emergency medical transportation services. For more information, visit us at, Facebook, Twitter, YouTube or Healthy Set Go.

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