EL-2-10-01
LESSONS FROM THE UDSMRSM DATABASE: THE SEARCH FOR BEST PRACTICES IN STROKE REHABILITATION
Carl V. Granger, M.D. (Center for Functional Assessment Research, SUNY at Buffalo, Buffalo NY, USA)
Abstract: The purpose is to demonstrate the utility of a large active database for medical rehabilitation in detecting major trends in clinical practice. The method of investigation involved establishment of the Penn Ability System (PAS-TM) FIM-FRG system as a basis for adjusting for case-mix severity upon admission to rehabilitation. For 14 geographic regions of the U.S., records from stroke patients were case-mix adjusted and outcomes across a 3-year span were compared. The results were that despite declining length of stay and shorter time between acute onset of stroke and admission to rehabilitation, rehabilitation outcomes had remained preserved. One of the 14 regions had remarkable efficiency, or gain in FlM-TM points per day, of 1.71 in 1993 and 1.86 in 1995.
EL-2-11-01
"Challenge to Promote Higher Prosthetic and Orthotic Service in the World"
Seishi SAWAMURA M.D. (President of ISPO, Kobe, Japan)
People with disabilities in need of orthoses and prostheses make up 0.5% of the general population and, as the total population of Africa, Asia and Latin America will reach approximately four billion in the year 2000, this means that 20 million people will require prostheses and orthoses.
In particular, there are 12 million suffering from leprosy in the world and 1.2 million of those, roughly 10%, require orthopaedic shoes. There are also five million amputees in the world today, of whom 3.5 million live in Asia. Replacement of their prostheses is necessary every three to four years and this implies a yearly demand for 1.2 million upper and lower limb prostheses.
In order to challenge to promote higher prosthetic and orthotic service in the world, the International Society for Prosthetics and Orthotics has tried to further advances in prosthetics and orthotics and to focus on the problems in developing countries as well as those in areas with more developed technology. The education and training, standard for Category I and II, appropriate technology in developing countries, prosthetic orthotic supply system, needs of International collaboration will be main subject.
