Rehabilitation

Supporting Quality Improvement within the Stroke and Rehab Therapy Team (2022)

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Type of publication:
Service improvement case study

Author(s):
*Erin Tsang (Therapy Quality Improvement Lead)

Citation:
SaTH Improvement Hub, 2022

Abstract:
NHS Staff Survey results, staff listening events and informal feedback indicated reduced levels of staff engagement and opportunities for Quality Improvement within the inpatient therapy teams at PRH and RSH. Despite embedding national job planning initiatives within the Therapy Centre, staff reported feeling unable to take their allocated Supporting Professional Activities (SPA) time and felt unable to meet the conflicting demands of their job. A model of monthly Quality Improvement Half Day (QIHD) was trialed in October and November 2022 in the Stroke and Rehab Therapy team to offer therapy staff an opportunity for regular, protected SPA time as a whole team. As a result 90% of the team felt that the sessions allowed them to develop and demonstrate their leadership skills and the team were able to implement a number of service improvement projects.

Link to PDF poster [no password required]

Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair. (2018)

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Type of publication:
Journal article

Author(s):
Braunstein M, Baumbach SF, Boecker W, *Carmont MR, Polzer H.

Citation:
Knee Surgery, Sports Traumatology, Arthroscopy. 2018 Mar;26(3):846-853

Abstract:
Surgical repair after acute Achilles tendon rupture leads to lower re-rupture rates than non-surgical treatment. After open repair, early functional rehabilitation improves outcome, but there are risks of infection and poor wound healing. Minimal invasive surgery reduces these risks; however, there are concerns about its stability. Consequently, physicians may have reservations about adopting functional rehabilitation. There is still no consensus about the post-operative treatment after minimal invasive repair. The aim of this study was to define the most effective and safe post-operative rehabilitation protocol following minimal invasive repair.
METHODS: A systematic literature search in Embase, MEDLINE and Cochrane Library for prospective trials reporting on early functional rehabilitation after minimal invasive repair was performed. Seven studies were included.
RESULTS: One randomized controlled trail, one prospective comparative and five prospective non-comparative studies were identified. Four studies performed full weight bearing, all demonstrating good functional results, an early return to work/sports and high satisfaction. One study allowed early mobilization leading to excellent subjective and objective results. The only randomized controlled trial performed the most accelerated protocol demonstrating a superior functional outcome and fewer complications after immediate full weight bearing combined with free ankle mobilization. The non-comparative study reported high satisfaction, good functional results and an early return to work/sports following combined treatment.
CONCLUSION: Immediate weight bearing in a functional brace, together with early mobilization, is safe and has superior outcome following minimally invasive repair of Achilles tendon rupture. Our recommended treatment protocol provides quality assurance for the patient and reliability for the attending physician.
LEVEL OF EVIDENCE: II.