Browsing by Subject " rehabilitation"

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  • Petersen, Bjorn; Weed, Ethan; Sandmann, Pascale; Brattico, Elvira; Hansen, Mads; Sorensen, Stine Derdau; Vuust, Peter (2015)
    Cochlear implants (CIs) are primarily designed to assist deaf individuals in perception of speech, although possibilities for music fruition have also been documented. Previous studies have indicated the existence of neural correlates of residual music skills in postlingually deaf adults and children. However, little is known about the behavioral and neural correlates of music perception in the new generation of prelingually deaf adolescents who grew up with CIs. With electroencephalography (EEG), we recorded the mismatch negativity (MMN) of the auditory event-related potential to changes in musical features in adolescent CI users and in normal-hearing (NH) age mates. EEG recordings and behavioral testing were carried out before (T1) and after (T2) a 2-week music training program for the CI users and in two sessions equally separated in time for NH controls. We found significant MMNs in adolescent CI users for deviations in timbre, intensity, and rhythm, indicating residual neural prerequisites for musical feature processing. By contrast, only one of the two pitch deviants elicited an MMN in CI users. This pitch discrimination deficit was supported by behavioral measures, in which CI users scored significantly below the NH level. Overall, MMN amplitudes were significantly smaller in CI users than in NH controls, suggesting poorer music discrimination ability. Despite compliance from the CI participants, we found no effect of the music training, likely resulting from the brevity of the program. This is the first study showing significant brain responses to musical feature changes in prelingually deaf adolescent CI users and their associations with behavioral measures, implying neural predispositions for at least some aspects of music processing. Future studies should test any beneficial effects of a longer lasting music intervention in adolescent CI users.
  • Wallin, M (Kela, 2009)
    Sosiaali- ja terveysturvan tutkimuksia 103
    Tutkimuksen tarkoitus oli selvittää kotona asuvien vanhusten laitoskuntoutuksen liikunnallisen osuuden toteutumista fysioterapeuttien ja vanhusten näkökulmasta. Tutkimuksen aineisto kerättiin vuosina 2002 ja 2003 Kelan IKÄ-hankkeen kuntoutusryhmistä. Tutkimukseen haastateltiin 31 iältään 66–93-vuotiasta kuntoutujaa ja 11 fysioterapeuttia. Lisäksi videoitiin seitsemän ryhmäliikuntatilannetta, joihin osallistui yhteensä 52 vanhusta ja 9 ammattilaista. Vanhukset kuvailivat kuntoutuskokemustaan joko arjessa selviytymisen välineeksi tai lomaksi arjesta. Osa oli pettynyt saamaansa kuntoutukseen. Fysioterapeutit pitivät vanhuksia joko kuntoutuksen vastaanottajina, jolloin keskityttiin vanhuksen fyysisen toimintakyvyn ongelmiin tai sosiaalisiin tarpeisiin, tai kumppaneina harjoitteluinterventiossa kotona selviytymisen edistämiseksi. Ryhmäliikuntatilanteet etenivät fysioterapeuttijohtoisesti, joko strukturoidusti ilman kuntoutujille annettua yksilöllistä palautetta tai yksilöllisen ohjauksen ja palautteen mahdollistaen. Ns. kiertoharjoittelussa vanhuksilla oli mahdollisuus osallistua aktiivisesti liikuntaryhmän toteuttamiseen. Vanhukset osallistuivat hiljaisesti harjoittelemalla, vastentahtoisesti suostumalla, sitkeästi yrittämällä tai kaveria auttamalla. Heterogeeninen vanhusryhmä haastaa nykyisiä kuntoutuskäytäntöjä, joissa on sekä toimivia että kehitettäviä alueita. Vanhusten kotona asumista heidän yksilölliset tarpeensa huomioon ottaen voidaan tukea, kun vanhukset saavat osallistua muiden ryhmäläisten kanssa yhteiseen ongelmanratkaisuun ja heille mielekkäiden, arjen askareita tukevien harjoitusten tekemiseen. – Suomenkielinen yhteenveto s. 52–56.
  • Sipilä, Raija; Mikkelsson, Marja; Honkanen, Mari; Malmivaara, Antti; Komulainen, Jorma (2019)
    Objective: To describe a project to develop guideline implementation tools (GItools) for rehabilitation guidelines, and a collaboration between a guideline producer and a healthcare organization to implement guidelines into care pathways. Design: Descriptive case study. Methods: A national guideline organization in Finland launched a 3-year project in 2015 to implement rehabilitation recommendations. Usability of the GItools was evaluated and improved, based on literature, workshops and surveys. An implementation plan guided the production of the GItools. An implementation plan was developed to integrate the shoulder disorders guideline into a care pathway at Paijat-Hame district rehabilitation unit. The implementation plan was produced in 3 facilitated workshops, which included brainstorming, snowballing, prioritizing and short lectures. Results: Twenty implementation plans and 119 different GItools for 22 guidelines were developed. The GItools, in particular patient material, were perceived as useful for the facilitation of guideline implementation. Four seminars and 14 sessions of continuous medical education were arranged. A plan was developed and executed for the implementation of the shoulder disorders guideline. Conclusion: It is feasible for a guideline producer to systematically include GItools into rehabilitation guidelines. This implementation project was an example of a successful collaboration between a guideline producer and a healthcare organization.
  • Särkamö, Teppo; Altenmueller, Eckart; Rodriguez-Fornells, Antoni; Peretz, Isabelle (2016)
  • O’Shea, Mia (Helsingin yliopisto, 2021)
    Objectives. This study sought to investigate factors related to the elicitation of music-evoked autobiographical memories (MEAMs) in healthy aging to improve overall understanding of the phenomenon and to enhance the selection of optimal musical stimuli to be used for the neurological rehabilitation and care of elderly individuals. The characteristic contents of MEAMs of healthy older individuals were also explored. Methods. 113 healthy senior subjects (aged 60 – 86 years) listened to 70 preselected song excerpts and rated each on a 5-point Likert scale in five domains: valence, emotional intensity, arousal, familiarity and autobiographical salience. Correlational and linear mixed model analyses were conducted to discover the relationship between the rated variables. Eighty-one participants additionally chose to verbally describe their MEAMs in further detail. These submitted inserts (n = 2790) were manually categorized and labelled into non-mutually exclusive groups and sub-groups. Results and conclusions. The analyses revealed that all rating variables had statistically significant positive relationships with one another. Valence, emotional intensity, arousal and familiarity all had significant positive effects on the dependent variable autobiographical salience. Thus, in order to maximally evoke MEAMs in healthy elderly individuals, the chosen musical stimuli should be regarded by the listener as being pleasant, emotionally intense, physiologically arousing and familiar. The contents of elderly individuals’ MEAMs often involved music-related activity, such as singing, dancing or listening to music. They also frequently contained details of specific people or locations. Lastly, they often weren’t very temporally specific and memories from adolescence were more common than other life periods.
  • Honkanen, Mari; Arokoski, Jari; Sipilä, Raija; Kukkonen-Harjula, Katriina; Malmivaara, Antti; Komulainen, Jorma (2019)
    Objective: Rehabilitation is often neglected in clinical practice guidelines, even when there is evidence for its effectiveness. The Current Rehabilitation development project, documented in this article, aimed to develop processes and structures to incorporate evidence and good practice on rehabilitation and functional capacity into the Finnish national Current Care Guidelines. Design: Descriptive assessment. Methods: The 3-year Current Rehabilitation development project was launched in 2012. It began with an assessment of existing rehabilitation evidence on the Current Care Guideline database and a query to Finnish rehabilitation experts. The project group developed and compiled tools for Current Care editors and guideline panels. The editorial team continued to monitor changes in rehabilitation evidence in the guidelines. Results: During the years 2012-2014, a total of 54 guidelines were published, and rehabilitation was incorporated into 31 of them. The number of rehabilitation-related evidence summaries increased from 49 to 164. During the next 3 years an additional 41 guidelines were published. Rehabilitation was incorporated to 24 of them, and the number of rehabilitation-related evidence summaries increased from 78 to 136. Conclusion: The level of evidence criteria used for rehabilitative interventions were the same as for symptomatic or curative interventions. Evidence showing the effectiveness of rehabilitation increased substantially during the project.
  • Valkeapää, Taina Jenni Marika; Tanaka, Kimiko; Lindholm, Camilla Christina; Weiste, Elina Hannele; Stevanovic, Tuire Melisa (2019)
    This paper investigates how two ideologies of mental health rehabilitation—recovery ideology and communal approach—are realized in interactional practices associated with psychosocial rehabilitation. More spesifically, the paper discusses employee selection in the context of the Clubhouse-created Transitional Employment (TE) programme, which offers employment opportunities for rehabilitants. The paper describes how joint decisions are established during the moment-by-moment interactional processes at the Clubhouse. Drawing from the data set of 29 video-recorded rehabilitation group meetings, and Conversation Analysis as a method, the paper analyzes two questions: (1) How do the participants talk about the decision-making process associated with the TE on a “meta” level? And (2) how are the TE employees actually selected in the turn-by-turn sequential unfolding of interaction? When discussing the TE employee selection procedure on a “meta” level, the values of recovery ideology focusing on client empowerment and self-determination are prevalent. Also, the central ideals of the communal approach—openness and collaboration—are defended as decision-making guidelines. However, in the meetings where decisions on the TE employees are concretely made, there is a mismatch between the two ideological approaches to rehabilitation and the actual practices observable in the relevant interactional encounters.
  • Kela (Kela, 2019)
  • Kela (Kela, 2020)
    Suomen virallinen tilasto
  • Kela (Kela, 2021)
    Suomen virallinen tilasto
  • Sillantaka, Jenni; Rajavaara, Marketta; Töytäri, Aija; Salminen, Anna-Liisa; Vuoskoski, Pirjo (2022)
  • Turunen, Kati (Helsingfors universitet, 2012)
    Objective. Hearing loss is one of the most common chronic health problems, and the number is increasing as a result of population aging. Hearing aids are regarded as the main rehabilitation method for hearing loss. The goal of this follow-up study was to review the experiences of working aged new hearing aid adopters. The focus was to map out the expectations and satisfaction towards the hearing aid, and the disability experiences caused by hearing loss. This thesis is a part of Minna Laakso, Eila Lonka, Johanna Ruusuvuori and Tarja Aaltonen's research project "Communication with Hearing Aid". Also the data was collected as a part of the project. Methods. The population consisted of 42 working age hearing aid first time users (37 64 years). 16 of them were women. Before the hearing aid fitting the participants filled up two self-assessment questionnaires: Denver Scale and Expectations towards hearing aids. Two to three weeks after implementation of the hearing aid the participants filled up the second Denver Scale questionnaire and also IOI-HA questionnaire. Thus it was possible to compare the expectations, disability experiences and satisfaction. The research also studied the construct of Denver scale by using statistical principal component analysis. The model was then utilized in the other statistical analyses. Three participants were also interviewed. Half-structured interviews provided more detailed information about the experiences towards the hearing aid and the hearing loss. The contents of the interviews were then compared to the questionnaire data. Results and conclusions. The expectations towards the hearing aid were high in the study population, although there wasn t any correlation between expectations and short-range satisfaction. Changes in the disability as the result of hearing aid intervention weren t statistically significant. Principal components of the Denver Scale didn't follow the model introduced in previous studies. The contents of the interviews were moderately consistent with the questionnaire data. In this research it was noticed, that the high disabilities due to hearing loss can also be seen after the hearing aid intervention.
  • Lahti, Anna-Maija; Nätynki, Mirva; Huhtakangas, Juha; Bode, Michaela; Juvela, Seppo; Ohtonen, Pasi; Tetri, Sami (2021)
    Background and purpose The aim of this study was to determine the differences in life expectancy and causes of death after primary intracerebral hemorrhage (ICH) relative to general population controls. Methods In a population-based setting, 963 patients from Northern Ostrobothnia who had their first-ever ICH between 1993 and 2008 were compared with a cohort of 2884 sex- and age-matched controls in terms of dates and causes of death as extracted from the Causes of Death Register kept by Statistics Finland and valid up to the end of 2017. Results Of our 963 patients, 781 died during the follow-up time (mortality 81.1%). Cerebrovascular disease was the most common cause of death for these patients, 37.3% compared with 8.2% amongst the controls. The most common reasons for cerebrovascular mortality in the ICH patients were late sequelae of ICH in 12.8% (controls 0%) and new bleeding in 10.6% (controls 1.0%). The long-term survivors had a smaller ICH volume (median 12 ml) than those patients who died within 3 months (median 39 ml). The mortality rate of ICH patients during a follow-up between 12 and 24 years was still higher than that of their controls (hazard ratio 2.08, 95% confidence interval 1.58-2.74, p < 0.001). Conclusions Very long-term ICH survivors have a constant excess mortality relative to controls even 10 years after the index event. A significantly larger proportion of patients died of cerebrovascular causes and fewer because of cancer relative to the controls.
  • Mattila-Holappa, Pauliina (Kela, 2018)
    Studies in social security and health 152
    Mental disorders are the leading cause of work disability among young adults. This study examined the background of young adults who were granted temporary work disability pension due to mental disorders in Finland, their clinical profile, the interventions targeted at them, and employment outcomes over five years. The data comprised people aged 18–34 (n = 1,163) who were granted a fixed-term work disability pension in 2008 due to a mental disorder (ICD-10 codes F10–69, F80–99) by an occupational pension institute. The data included patients’ pension applications and attached medical certifications, which were linked to employment data from the Finnish Centre for Pensions. The most common diagnoses were depressive mood disorders (39%), schizophrenia, schizotypal and delusional disorders (34%), and mania or bipolar disorder (14%). Half of the young adults were attached to the labour market or education prior to the granted pension. Three clinical profiles were identified: ‘Childhood (including adolescence) adversity’, associated with depressive disorders; ‘Comorbidity’, associated with bipolar disorder; and ‘Undefined’, associated with psychotic disorders. Half of the non-student young adults had received work-oriented interventions or had them in their treatment and rehabilitation plan. Forty per cent had received psychotherapy or had a plan for it. A total of 22% of the sample were employed at the end of the 5.6-year follow-up, whereas 48% had been employed at some time during this period. Having planned psychotherapeutic intervention or rehabilitative courses and training at baseline was associated with quicker entry into the labour market. Having both planned psychotherapeutic and work-oriented interventions was associated with being employed at the end of the follow-up. Both psychotherapy and work-oriented interventions are likely to be beneficial for the future employment of young adults on disability pension.
  • Marques, Maria Jose; Schwilch, Gudrun; Lauterburg, Nina; Crittenden, Stephen; Tesfai, Mehreteab; Stolte, Jannes; Zdruli, Pandi; Zucca, Claudio; Petursdottir, Thorunn; Evelpidou, Niki; Karkani, Anna; AsliYilmazgil, Yasemen; Panagopoulos, Thomas; Yirdaw, Eshetu; Kanninen, Markku; Luis Rubio, Jose; Schmiedel, Ute; Doko, Adrian (2016)
  • Sarkamo, Teppo (2018)
    Music engages an extensive network of auditory, cognitive, motor, and emotional processing regions in the brain. Coupled with the fact that the emotional and cognitive impact of music is often well preserved in ageing and dementia, music is a powerful tool in the care and rehabilitation of many ageing-related neurological diseases. In addition to formal music therapy, there has been a growing interest in self- or caregiver-implemented musical leisure activities or hobbies as a widely applicable means to support psychological wellbeing in ageing and in neurological rehabilitation. This article reviews the currently existing evidence on the cognitive, emotional, and neural benefits of musical leisure activities in normal ageing as well as in the rehabilitation and care of two of the most common and ageing-related neurological diseases: stroke and dementia.
  • Grau-Sanchez, Jennifer; Ramos-Escobar, Neus; Sierpowska, Joanna; Rueda, Nohora; Susana, Redón; Rifà, Xavi; Veciana de las Heras, Misericordia; Pedro, Jordi; Särkämö, Teppo Tapio; Duarte, Esther; Rodríguez-Fornells, Antoni (2018)
    The effect of music-supported therapy (MST) as a tool to restore hemiparesis of the upper extremity after a stroke has not been appropriately contrasted with conventional therapy. The aim of this trial was to test the effectiveness of adding MST to a standard rehabilitation program in subacute stroke patients. A randomized controlled trial was conducted in which patients were randomized to MST or conventional therapy in addition to the rehabilitation program. The intensity and duration of the interventions were equated in both groups. Before and after 4 weeks of treatment, motor and cognitive functions, mood, and quality of life (QoL) of participants were evaluated. A follow-up at 3 months was conducted to examine the retention of motor gains. Both groups significantly improved their motor function, and no differences between groups were found. The only difference between groups was observed in the language domain for QoL. Importantly, an association was encountered between the capacity to experience pleasure from music activities and the motor improvement in the MST group. MST as an add-on treatment showed no superiority to conventional therapies for motor recovery. Importantly, patient's intrinsic motivation to engage in musical activities was associated with better motor improvement.
  • Räty, Silja; Borrmann, Carolin; Granata, Giuseppe; Cardenas-Morales, Lizbeth; Schoenfeld, Ariel; Sailer, Michael; Silvennoinen, Katri; Holopainen, Juha; De Rossi, Francesca; Antal, Andrea; Rossini, Paolo M.; Tatlisumak, Turgut; Sabel, Bernhard A. (2021)
    Background: Occipital strokes often cause permanent homonymous hemianopia leading to significant disability. In previous studies, non-invasive electrical brain stimulation (NIBS) has improved vision after optic nerve damage and in combination with training after stroke. Objective: We explored different NIBS modalities for rehabilitation of hemianopia after chronic stroke. Methods: In a randomized, double-blinded, sham-controlled, three-armed trial, altogether 56 patients with homonymous hemianopia were recruited. The three experiments were: i) repetitive transorbital alternating current stimulation (rtACS, n=8) vs. rtACS with prior cathodal transcranial direct current stimulation over the intact visual cortex (tDCS/rtACS, n=8) vs. sham (n = 8); ii) rtACS (n = 9) vs. sham (n = 9); and iii) tDCS of the visual cortex (n = 7) vs. sham (n = 7). Visual functions were evaluated before and after the intervention, and after eight weeks follow-up. The primary outcome was change in visual field assessed by high-resolution and standard perimetries. The individual modalities were compared within each experimental arm. Results: Primary outcomes in Experiments 1 and 2 were negative. Only significant between-group change was observed in Experiment 3, where tDCS increased visual field of the contralesional eye compared to sham. tDCS/rtACS improved dynamic vision, reading, and visual field of the contralesional eye, but was not superior to other groups. rtACS alone increased foveal sensitivity, but was otherwise ineffective. All trial-related procedures were tolerated well. Conclusions: This exploratory trial showed safety but no main effect of NIBS on vision restoration after stroke. However, tDCS and combined tDCS/rtACS induced improvements in visually guided performance that need to be confirmed in larger-sample trials.
  • Askola, Riitta; Soininen, Päivi; Seppänen, Allan (2020)
    Characteristics unique to forensic psychiatric treatment include coming to terms with the offenses committed, the long duration of treatment and the assessment of the risk of repeat offending. This study describes the views of both patients and staff on the significance of the patient’s offense as a part of forensic psychiatric rehabilitation. Eight forensic psychiatric patients and eight forensic psychiatric nurses from two forensic psychiatric hospitals in Finland participated in this study. Data were gathered by means of thematic interview and analyzed by means of thematic analysis. The findings suggest that patients and professionals alike concur that ascertaining the factors with a bearing on the offense, and working through the offense and the factors leading up to it, constitute an essential aspect of forensic treatment. This, in turn, has a bearing on the planning and administration of a treatment plan consisting of both medical and psychosocial support and interventions intended to enable patients to live independent, fulfilling lives, thus reducing the likelihood of reoffending. The findings of this study can be used as part of the development of international, standardized treatment models for clinical forensic psychiatric practices.
  • Turkia, Mirva (Helsingin yliopisto, 2020)
    Objectives. Reform schools (RS) in Finland are foster care institutions where children and adolescents are placed when other child welfare services fail to provide adequate education and care. Former research has shown that the mental health problems of these adolescents are multiple and severe, and they often continue to adulthood. The aim of this study was to investigate how much those placed in RS participate in rehabilitation services provided by the Social Insurance Institution of Finland (Kela) and purchase psychopharmacons after RS placement, compared to their peers. Methods. This study was a part of After reform school study (ARSS), study project by the Finnish Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos, THL), the aim of which is to research adolescent’s life after RS placement. The data for the study project was acquired in the end of 2014, and included all the adolescents residing in RS in 1991, 1996, 2001, 2006, and 2011 and their matched peers. Data analyses were conducted using logistic regression, with RS placement, cohort year, and gender as independent variables. In the final analyses, dependent variables were psychotherapy and the purchases of antipsychotics, anxiolytics, drugs used for sleep disorders, antidepressants, psychostimulants used for ADHD and drugs used in alcohol dependence. Results and conclusions. First, even though the psychiatric morbidity among the persons with RS background is high, the results of this study showed that they do not participate in the Kela´s psychotherapy services more than their peers. Second, those with RS background purchase psychopharmacons remarkably more compared to their peers. In addition, women participate in Kela´s psychotherapy, and purchase psychopharmacons more than men, except stimulants used for ADHD. Also, the youngest cohorts participate in psychotherapy and purchase psychopharmacons less than the oldest cohort. In conclusion, the psychotherapy services currently available do not meet the needs of the persons placed in RS. There should be wider range of mental health services available, and it should be made as easy as possible to access them.