Hand injuries, particularly fractures involving the phalanges and metacarpals, are common occurrences in various settings, including industrial environments. Prompt and effective management of these injuries is crucial to minimize long-term disability and facilitate return to work. This case report focuses on the rehabilitation of a middle phalangeal fracture in an industrial worker following Kirschner wire (K-wire) fixation. The patient, a 24-year-old male, sustained the injury while operating an electric stamping machine. Emergency surgery was performed to stabilize the fracture, and subsequent physiotherapy was initiated due to persistent difficulties in hand function. The rehabilitation protocol aimed to address pain, improve range of motion, and enhance grip strength through passive range of motion exercises, movement with mobilization techniques, blocking exercises, and grip strengthening exercises. Mulligan\'s mobilization with movement (MWM) concept was incorporated to facilitate rapid pain relief and movement restoration. Follow-up assessments after four weeks of rehabilitation revealed significant improvements in pain levels, range of motion, strength, and overall quality of life. The case underscores the importance of timely intervention and comprehensive rehabilitation strategies in managing traumatic hand injuries in industrial settings, aiming to optimize treatment outcomes and promote successful return to work.

Interdisciplinary treatment is a widely implemented strategy for the rehabilitation of patients with chronic pain. A primary treatment objective is to decrease the load on the social insurance system; however, it is questionable whether interdisciplinary treatment reduces sickness absence and disability pension (SA/DP). This register-based observational study compared SA and DP between patients in interdisciplinary treatment and unspecified interventions. With data from 7,752 Swedish specialist health care patients in their prime working age, we analyzed total net SA/DP days over 3 years from the first visit to a pain rehabilitation center. A zero-one-inflated beta model, adjusted for theoretically substantiated confounders, was used to estimate the mean differences in total days and the proportions of patients with both zero and maximum days. Compared with unspecified interventions, interdisciplinary treatment resulted in a mean (95% confidence interval) absolute increase of 50 (37, 62) total days, a 13.0% (11.3%, 14.6%) decrease in patients with zero days, and a 1.5% (.2%, 2.8%) decrease in patients with the maximum days. These findings support that interdisciplinary treatment increases SA/DP compared to less intensive interventions but reduces the risk of maximum days, implying that it is advantageous for patients with the highest absence. This highlights the need for improved patient selection procedures and the adaptation of interdisciplinary treatment programs to more adequately target SA/DP reduction. PERSPECTIVES: This study provides an accessible overview of SA/DP among working-age patients with chronic pain in Swedish specialist health care. It also shows that interdisciplinary treatment does not decrease SA/DP more than alternative treatments in most patients but is advantageous for the patients with the longest absence.

Orofacial pain in patients taking part in a multimodal rehabilitation programme (MMRP) due to chronic bodily pain is common but it is not known whether such a rehabilitation programme can also have an effect on the presence of orofacial pain. The first aim of this study was to evaluate the effect of an MMRP on orofacial pain frequency. The second aim was to evaluate differences in the effect on quality of life and on psychosocial factors related to chronic pain.
MMRP was evaluated through validated questionnaires from the Swedish Quality Registry for Pain Rehabilitation (SQRP). Fifty-nine patients participating in MMRP filled out the two screening questions for orofacial pain in addition to the SQRP questionnaires before and after participation in MMRP during the period August 2016 to March 2018.
Pain intensity decreased significantly after the MMRP (p=0.005). Fifty patients (69.4 %) reported orofacial pain before MMRP and no significant decrease after the programme (p=0.228). Among individuals with orofacial pain, the self-reported level of depression decreased after participation in the programme (p=0.004).
Even though orofacial pain is common among patients with chronic bodily pain, participation in a multimodal pain programme was not enough to reduce frequent orofacial pain. This finding implies that specific orofacial pain management including information about jaw physiology could be a justified component of patient assessment prior to a multimodal rehabilitation programme for chronic bodily pain.

Spinal cord injury results in multiple, simultaneous sensorimotor deficits. These include, but are not limited to, full or partial paralysis of muscles below the lesion, muscle spasms, spasticity, and neuropathic pain. Bowel, bladder, and sexual dysfunction are also prevalent. Yet, the majority of emerging spinal stimulation-based therapies focus on a single issue: locomotor rehabilitation. Despite the enormous potential of these translational advances to transform the lives of people living with spinal cord injury, meaningful recovery in other domains deemed critical priorities remains lacking. Here, we highlight the importance of considering the diverse patterns of neural transmission that underlie clinically similar presentations when developing spinal stimulation-based therapies. We also motivate advancement of multi-modal rehabilitation paradigms, which leverage the dense interconnectivity of sensorimotor spinal networks and the unique ability of electrical stimulation to modulate these networks to facilitate and guide simultaneous rehabilitation across domains.

UNASSIGNED: To evaluate patient-reported outcome measures in patients with chronic musculoskeletal pain 1 year after participation in a case manager-led multimodal rehabilitation intervention in a Finnish primary care centre. Changes in healthcare utilization (HCU) were also explored.
UNASSIGNED: A prospective pilot study with 36 participants. The intervention consisted of screening, multidisciplinary team assessment, a rehabilitation plan and case manager follow-up. Data were collected through questionnaires filled in after the team assessment and 1 year later. HCU data 1 year before and 1 year after team assessment were compared.
UNASSIGNED: At follow-up, satisfaction with vocational situation, self-reported work ability and health-related quality of life (HRQoL) had improved and pain intensity had diminished significantly for all participants. The participants who reduced their HCU improved their activity level and HRQoL. Early intervention by a psychologist and mental health nurse was distinctive for the participants who reduced HCU at follow-up.
UNASSIGNED: The findings demonstrate the importance of early biopsychosocial management of patients with chronic pain in primary care. Identification of psychological risk factors at an early stage may lead to better psychosocial wellbeing, improve coping strategy and reduce HCU. A case manager may free up other resources and thereby contribute to cost savings.

BACKGROUND: To address the increase in sick leave for nonspecific chronic pain and mental illness, the Swedish government and the Swedish Association of Local Authorities and Regions entered into an agreement on a \"Rehabilitation Guarantee\" to carry out multimodal rehabilitation (MMR).
OBJECTIVE: To investigate whether components of primary care MMR are associated with changes in sick leave.
METHODS: A web-based survey was conducted in conjunction with a retrospective cross-sectional observational study of 53 MMR units. Sick leave data for the years before and after MMR completion was collected for 846 individuals.
RESULTS: There was great disparity in how MMR was delivered. The average duration of rehabilitation was 4-8 weeks, and 74% of the MMR teams reported having fewer patients than recommended (≥20/year). Only 58% of the teams met the competence requirements. In-depth competence in pain relief and rehabilitation was reported by 45% of the teams and was significantly associated with fewer sick leave days after MMR (26.53, 95% CI: 3.65; 49.42), as were pain duration (17.83, 95% CI: -9.20; 44.87) and geographic proximity (23.75, 95% CI: -5.25; 52.75) of the health care professionals included in the MMR unit.
CONCLUSIONS: In-depth competence and knowledge about the complex health care needs of patients seem essential to MMR teams\' success in reducing sickness benefits for patients with nonspecific chronic pain and mental illness. Further research is needed to elucidate the optimal combination of primary care MMR components for increasing the return-to work rate and to determine whether involvement of the Social Insurance Agency or employers could support and further contribute to recuperation and help patients regain their previous work capacity.

Stroke is one of the most common causes of disability in the world. It has sensory, motor, and cognitive symptoms. Many cognitive domains might get involved in a stroke. This systematic review focuses on working memory domain deficits after stroke and their various rehabilitation methods. This review is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines. For this review, we have searched PubMed, Google Scholar, and Science Direct databases and screened thoroughly with the inclusion criteria of free full-text English papers in the last 10 years that have exclusively studied humans. The articles included in the search are randomized control trials (RCTs), observational studies, meta-analysis studies, systematic reviews, and traditional reviews. Consequent quality assessment was done using the most commonly used tools for each type of study and eight papers were selected. From these papers, full-text articles were studied, analyzed, and tabulated. We found five different rehabilitation methods: transcranial direct-current stimulation, computer-assisted cognitive rehabilitation, physical activity, goal setting, and multimodal rehabilitation. We found that goal setting, computer-assisted cognitive rehabilitation, and multimodal rehabilitation can improve working memory deficits. While transcranial direct current stimulation and physical activity were inconsistent, further studies are needed. The small sample size, no follow-up, the inclusion of only a few studies, the size of the stroke, and comorbid conditions like mild cognitive impairment, dementia, and depression were the main limitations of this study. Future reviews must include a larger number of studies with large sample sizes, including follow-up as an inclusion criterion. We need more clinical trials on these methods for better knowledge.

Background: Parkinson’s disease reduces patients’ function, activities of daily living, and quality of life, and increases their guardians’ burden of care. This study verified the effectiveness of a multimodal rehabilitation programme for patients with Parkinson’s disease. Trial design: This study was a multicentre parallel randomised controlled, single-blind, trial conducted in three hospitals in Korea. Methods: A central randomisation centre used computer generated tables to randomly allocate 60 of 75 patients with Parkinson’s disease who fulfilled the study requirements into experimental (n = 30; multimodal rehabilitation; consisting of daily living training, guardian education, home environment modification, fine muscle exercise, balance training, and training using auxiliary tools performed 50 min per session, twice a week, in 10 sessions) and control (n = 30; traditional rehabilitation; consisting of task-oriented training, joint exercise, and daily living training performed 50 min per session, twice a week, in 10 sessions) groups. Results: Multimodal rehabilitation for Parkinson’s disease significantly improved the activities of daily living (p < 0.01) and quality of life of patients (p < 0.001) and eased the guardians’ burden of care (p < 0.001). Conclusions: Multimodal rehabilitation is suggested to improve activities of daily living, quality of life of patients with Parkinson’s disease, and reduce the burden of care of their guardians.

UNASSIGNED: There is considerable diversity of outcome selections and methodologies for handling the multiple outcomes across all systematic reviews (SRs) of Interdisciplinary Pain Treatment (IPT) due to the complexity. This diversity presents difficulties for healthcare decision makers. Better recommendations about how to select outcomes in SRs (with or without meta-analysis) are needed to explicitly demonstrate the effectiveness of IPT.
UNASSIGNED: This overview systematically collates the reported outcomes and measurements of IPT across published SRs and identifies the methodological characteristics. Additionally, we provide some suggestions on framing the selection of outcomes and on conducting SRs of IPT.
UNASSIGNED: Three electronic databases (PubMed, Cochrane Library, and Epistemonikos) and the PROSPERO registry for ongoing SR were supplemented with hand-searching ending on 30 September 2021.
UNASSIGNED: We included 18 SRs with data on 49007 people from 356 primary randomised controlled trials (RCTs); eight were followed by meta-analysis and ten used narrative syntheses of data. For all the SRs, pain was the most common reported outcome (72%), followed by disability/functional status (61%) and working status (61%). Psychological well-being and quality of life were also reported in half of the included SR (50%). The core outcome domains according to VAPAIN, IMMPACT, and PROMIS were seldom met. The methodological quality varied from critically low to moderate according to AMSTAR2. The AMSTAR2 rating was negatively correlated to the number of outcome domains in PROMIS, and VAPAIN was positively correlated with IMMPACT and PROMIS, indicating the intercorrelations between the reported outcomes.
UNASSIGNED: This systematic overview showed wide-ranging disparity in reported outcomes and applied outcome domains in SRs evaluating IPT interventions for chronic pain conditions. The intercorrelations between the reported outcomes should be appropriately handled in future research. Some approaches are discussed as well.

In recent years, multidisciplinary programs have been implemented that include different actions during the pre, intra and postoperative period, aimed at reducing perioperative stress and therefore improving the results of patients undergoing surgical interventions. Initially, these programs were developed for colorectal surgery and from there they have been extended to other surgeries. Thoracic surgery, considered highly complex, like other surgeries with a high postoperative morbidity and mortality rate, may be one of the specialties that most benefit from the implementation of these programs. This review presents the recommendations made by different specialties involved in the perioperative care of patients who require resection of a lung tumor. Meta-analyzes, systematic reviews, randomized and non-randomized controlled studies, and retrospective studies conducted in patients undergoing this type of intervention have been taken into account in preparing the recommendations presented in this guide. The GRADE scale has been used to classify the recommendations, assessing on the one hand the level of evidence published on each specific aspect and, on the other hand, the strength of the recommendation with which the authors propose its application. The recommendations considered most important for this type of surgery are those that refer to pre-habilitation, minimization of surgical aggression, excellence in the management of perioperative pain and postoperative care aimed at providing rapid postoperative rehabilitation.