• Improving Access to Specialist Rehabilitation Services in Ireland

      Twomey, Valerie; O’Driscoll, Edina (2014-03)
    • Intrathecal baclofen therapy

      Khan, A (Irish Medical Journal, 2014)
      Intrathecal baclofen therapy has been used in the treatment of severe, intractable spasticity resistant to oral agents in brain and spinal cord injury since 1992. A successful trial of intrathecal baclofen infusion administered with a test dose of baclofen injection via a lumbar puncture precedes the therapy and those who respond favorably in the standard screening test go on to receive intrathecal baclofen pump therapy long-term. 1,2
    • An investigation into the functional outcomes of individuals with paraplegia, resulting from spinal cord injury, following discharge from a rehabilitation setting

      McNamara, Angela Dr.; Held, Lisa (2005)
      The purpose of this study was to investigate if changes occurred in the functional independence of spinal cord injured (SCI) patients, following discharge from a rehabilitation setting. The research was carried out on patients with a paraplegic injury, who underwent rehabilitation in the spinal injury unit of a Dublin based rehabilitation hospital. Eight male subjects residing in the Republic of Ireland were recruited to the study between October 2004 and May 2005. Two measures of functional independence, a mood outcome measure and semi-structured interviews were carried out at two separate stages. The first, in the hospital one to five days prior to discharge. The second in the home of the subject six to eight weeks following discharge. Studies investigating the experience of spinal injured patients soon after discharge are very limited. Research to date indicates that the functional independence of those with spinal cord injury improves after a period of one year and longer at home. Results in this study showed that functional independence as measured using the Functional Independence Measure (FIM), decreased following discharge and the change was statistically significant (p=0.041). A decrease was also noted on the Spinal Cord Independence Measure (SCIM), but this was not shown to be statistically significant (p=0.075). Mood was measured using the Centre for Epidemiological Studies Depression Scale (CES-D) and an overall improvement in mood following discharge was observed. The qualitative data obtained through the semi-structured interviews, yielded rich information on the subjects views of the pre and post discharge phase. Six factors which could be associated with changes in functional independence were identified; environmental, lack of appropriate equipment, social support, lack of services, pre-discharge preparation and pain. Exploring the experiences and functional changes of individuals with spinal cord injury following discharge has implications for pre discharge rehabilitation and follow-up. Changes in line with other models of rehabilitation in Australia and America may provide a more transitional period to allow persons with SCI to be well prepared for the physical and emotional challenges presented to them in the community.
    • An investigation into the occupational status of persons with incomplete spinal cord injury

      McNamara, Angela Dr.; Logan, Catherine; National Rehabilitation Hospital (2005)
    • Irish occupational therapists' views of electronic assistive technology

      Verdonck, Michele; McCormack, Cathy; Chard, Gill (2012-04-30)
    • Lower segment cesarean scar rupture: does it always occur in the next labour

      Corrigan, L; O' Herlihy, C; McGoldrick, A (American Journal of Obstetrics and Gynaecology, 2012-01)
      32nd Annual Meeting - Society for Maternal-Fetal Medicine. The Pregnancy Meeting 6-11 February 2012 Dallas, Texas USA
    • Music therapists’ strategies in implementing new posts within health care settings

      Monaghan, Dr Hugh; Edwards, Professor Jane (2009)
      The National Rehabilitation Hospital was one of a number of sites that contributed to a research study in the area of music therapy service development. This research aimed to examine the experiences of expert music therapists in developing new work and to identify strategies for introducing a new role to an existing healthcare team. Service development strategies that were identified included: Providing education about music therapy Conjoint working with other staff Remaining flexible Generating evidence Investing time and energy Results from the research will be disseminated to music therapy students, qualified music therapists and health care managers, to assist in the creation of further music therapy posts nationally and internationally. Final Report presented to the NRH Ethics Committee - October 2009
    • National Rehabilitation Hospital annual general meeting year ended 31st December 1996

      National Rehabilitation Hospital (National Rehabilitation Hospital, 1997)
    • NRH National Rehabiliation Hospital 31st Annual Report

      National Rehabiliation Hospital (NRH) (National Rehabiliation Hospital (NRH), 2012-05)
    • Optimising the prescription of prosthetic technologies (opptec): Outcome measures for evidence based prosthetic practice and use

      Ryall, Dr Nicola; Gallagher, Dr Pamela; Ni Mhurchadha, Sinead (2010)
      This study provided a forum for patients and service providers to voice their opinions in what they believe to be the important predictors and outcomes involved in successful rehabilitation following limb loss. To develop a consensus on the most important outcomes and factors to address for both the lower limb and upper limb prosthetic prescription process, the above data relating to lower limb and upper prosthetics were subsequently used in the next phase of the research involving two Delphi surveys of 23 and 53 experts within the lower limb and upper limb amputation and prosthetic field respectively, including users, service providers and researchers. This is the first time consensus has been sought on the most important outcomes, predictors and factors which optimise prosthetic prescription and use. By identifying the important outcomes of prosthetic prescription to both prosthetic users and service providers, we are not only better served to inform outcome measurement, to compare and evaluate research in the field, different interventions or prosthetic components, but also to understand why and when prosthetic technology should be provided. This research is also helpful in pinpointing factors that could potentially be used as predictors of prosthetic use to optimise use after prescription.
    • A pilot study of the safety and effectiveness of the traxon spinal cord repair stimulator for the treatment of complete spinal cord injury in humans

      Murray, Patrick C.; Bolger, Ciaran; McEvoy, Linda; National Rehabilitation Hospital & Beaumont Hospital (2004)
    • Post Stroke Fatigue; Point Prevalence, Characterization, Associations and Radiological Correlation in a Rehabilitation Hospital

      Khan, A; Delargy, M (Irish Medical Journal, 2017-11)
      Post stroke fatigue (PSF) is a frequently reported symptom by stroke survivors undergoing rehabilitation. This cross sectional observational study was undertaken in a rehabilitation facility to look at its prevalence and relationship with various variables like personal factors, type of stroke, social context, hemispheric involvement on CT scan and mobility status. The results showed that PSF was present in 83% (25 out of 30) of the patients included in the study. No clear association could be established between PSF, social, radiological and functional characteristics.
    • The prevalence of osteoporosis in the disabled population at the national rehabilitation hospital

      Carroll, Dr Aine; Smith, Dr Eimear (2009)
      OBJECTIVES: To examine prevalence of low bone mineral density (BMD) among adults with disability, using World Health Organization diagnostic categories. DESIGN: Cross-sectional study. SETTING: National Rehabilitation Hospital, Dublin, Ireland. PARTICIPANTS: Patients (N=255; 178 men, 77 women) who were disabled for at least 3 months because of acquired brain injury, spinal cord injury, other neurologic condition, or lower-limb amputation. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Laboratory investigations including intact parathyroid hormone, 25-hydroxyvitamin D (25-OHD), and sex hormones; and BMD of lumbar spine and at least 1 hip, measured by dual-energy x-ray absorptiometry and expressed as T scores and z scores. RESULTS: Mean age +/- SD of participants was 48.7+/-15.6 years. Vitamin D deficiency, 25-OHD level 50 nmol/L or less, occurred in 154 (62.9%); insufficiency, a level between 51 and 72 nmol/L, occurred in 36 (14.7%). Based on T scores, 108 participants (42.4%) had osteopenia, and 60 (23.5%) had osteoporosis. A z score of -1 or less but more than -2 occurred in 76 (29.8%); a further 52 (20.4%) had a z score of -2 or less. On multiple linear regression analysis, ambulatory status and duration of disability were independent predictors of BMD at neck of femur (beta=.152, P=.007; beta=-.191, P=.001, respectively) and total proximal femur (beta=.170, P=.001; beta=-.216, P<.001, respectively). CONCLUSIONS: Osteopenia and osteoporosis are very common in adults with disability participating in rehabilitation, compared with the general young adult population. Duration since onset of disability and mobility status are independent predictors of BMD at the hip. Bone health monitoring should form part of the long-term follow-up in adults with newly acquired disabilities. Final Report presented to the NRH Ethics Committee - October 2009
    • A Prospective Audit of Inappropriately Occupied Hospital Beds in Patients with Newly Acquired Traumatic Spinal Cord Injury

      Smith, E.; Synnott, K. (Irish Medical Journal, 2019-07)
      Aim To quantify the inappropriate bed occupancy amongst patients with traumatic spinal cord injury (TSCI) awaiting transfer of care from the acute to community. Methods A prospective audit was carried out, of all newly acquired cases of TSCI in 2017, who progressed through acute care and specialist rehabilitation. Results Forty-four patients who were audited spent a total of 3915 days occupying a hospital bed, inappropriate for their phase of care, 78 awaiting admission to specialist acute care, 3126 awaiting admission to rehabilitation and 711 awaiting discharge from rehabilitation. Conclusion Valuable health-care resources are being wasted because TSCI patients cannot move seamlessly from one phase of care to the next. This impacts negatively on the quality of care being delivered to this patient cohort.
    • Psychological aspects of amputation: A cross-sectional study

      Ryall, Nicola Dr.; MacLachlan, Malcolm Prof.; Horgan, Olga (2004)