All Rehabilitation is NOT EQUAL...

I've been tip-toeing around this topic, but I realized that I should just come out and say what I think. All Rehabilitation is NOT EQUAL!. There, I said it. In fact, there are worlds of difference between facilities. The reason that I'm concentrating on this is that Sophie's 'progress' may not reflect her abilities or inabilities, but may be affected by the system that is qualifying her and its limitations.

Having worked in several rehab facilities years ago, it became clear to me that a person's recovery was dependent on the rehab's capacity to deliver the best quality of care. There were then, and still are I am sure, such a wide range of quality-- from those facilities which basically just 'did a job' and settled for minimal progress, to those that were dedicated to delivering the most up-to-date treatment possible. Even if the facility was run by people who were very caring, if the administration's focus was not forward-looking or if the general attitude of the staff was not enthusiastic and devoted to advancing the care they provided, then their quality of care reflected that.

Rehabilitation medicine used to be the dinosaur of the medical areas. But that has really changed. Today, so many advances are being made that it has become one of the most dynamic areas of medicine. For this reason, I encourage you to NOT necessarily take your doctor's conclusions as gospel.

Although the information below is six years old, it reflects the truth of what I'm saying. These are ranked hospitals in this specialty, named by at least 3 percent of board-certified physicians responding to U.S.News surveys in 2001, 2002, and 2003. (A link to the latest US News ranking is just below)

Rank Hospital Reputational score

1 Rehabilitation Institute of Chicago 72.2
2 TIRR- Inst for Rehab & Research, Houston 42.3
3 University of Washington Medical Center, Seattle 37.7
4 Mayo Clinic, Rochester, Minn. 30.7
5 Craig Hospital, Englewood, Colo. 26.7
6 Kessler Institute for Rehabilitation, West Orange, N.J. 26.1
7 Rusk Institute, NYU Medical Center, New York 15.1
8 Thomas Jefferson University Hospital, Philadelphia 15.0
9 Spaulding Rehabilitation Hospital, Boston 14.7
10 Ohio State University Medical Center, Columbus 14.2
11 Rancho Los Amigos National Rehab Center, Downey, CA. 13.5
12 Johns Hopkins Hospital, Baltimore 12.7
13 National Rehabilitation Hospital, Washington, D.C. 11.2
14 University of Michigan Medical Center, Ann Arbor 9.5
15 Moss Rehab Hospital, Albert Einstein Med Ctr, Philadelphia 8.1
16 Shepherd Center, Atlanta 6.6
17 Mount Sinai Medical Center, New York 5.3
18 Stanford Hospital and Clinics, Stanford, Calif. 4.4
19 Temple University Hospital, Philadelphia 4.0
20 UCLA Medical Center, Los Angeles 3.8
21 New York-Presbyterian Hospital 3.8
22 Cleveland Clinic 3.7
23 University of Alabama Hospital at Birmingham 3.3


In 13 of the 17 specialties, ranked hospitals initially had to meet any of three entry standards: membership in the Council of Teaching Hospitals, affiliation with a medical school, or availability of at least nine of 17 specified items of medical technology: magnetic resonance imaging, for example. Those criteria screened out all but 2,072 of the 6,003 hospitals.

Note the difference in the percentage points between the #1 ranked hospital, RIC, and the others!

Rehabilitation Institute of Chicago
345 East Superior Street
Chicago, IL 60611
Web site

U.S. News Ranking: 1 in Rehabilitation This is the latest US News rankings. The #'s are little different, but the line-up is essentially the same.

Stroke Services at Rehabililtation Institute of Chicago

The effects of a stroke on mobility, memory and communication can vary greatly from one person to another and the pace and progress of rehabilitation can vary too. What’s important to know is that the rehabilitation care provider you choose has the depth of experience and breadth of services to help you achieve the best life possible. At the Rehabilitation Institute of Chicago (RIC), we do.

A National Leader in Stroke Rehabilitation

• The Rehabilitation Institute of Chicago has been ranked the “Best Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991.
• RIC helps more people with stroke than almost any other hospital in the country. Hundreds of stroke patients come to RIC each year, including people from across the country and around the world, for expert physical medicine and rehabilitation, and nearly half of them are younger than 55 years of age.
• New developments in stroke rehabilitation discovered in RIC laboratories are brought immediately to our patients, placing them at the forefront of scientific advancement through participation in the newest therapies and clinical trials.
• RIC is the only federally-designated Rehabilitation Research and Training Center for Stroke by the National Institute on Disability and Rehabilitation Research.
• RIC is the first rehabilitation hospital to be recognized with Magnet status, the prestigious award given to fewer than 3% of the nation’s hospitals for the very best nursing care.
• 95% of Prime of Life Stroke patients and their families would recommend RIC to family and friends.
• 99% of Prime of Life Stroke patients and their families rated their care as “excellent” or “good.”

For an appointment or information please call: 1-800-354-REHAB (7342), find a location or request an appointment .

You can Google any of the other hospitals listed above, to get a comparison, as well. I encourage you to do this, and, if you would like, I can help you with it.

Best,

Stephanie

Virtual reality improves stroke rehabilitation

Israeli hospitals have recently started to use virtual reality therapy for stroke patients. One commonly used program has the patient watch his virtual image on a screen. For example, tennis balls are virtually thrown at the patient from all directions and the patients' actual hand motions are recorded on screen. In the first stage of development of this new program, computer scientists Dr. Larry Manevitz of the University of Haifa, together with Dr. Uri Feintuch, a neuroscientist from Hebrew University and a research fellow at the Haifa's Caesarea Rothschild Institute for Interdisciplinary Applications of Computer Science, and Eugene Mednikov, a computer science graduate student, fed video sessions of this virtual reality therapy into their newly developed program. With the new program, the computer "learned" to differentiate between different types of brain injuries: cerebrovascular accident (CVA) and traumatic brain injury (TBI). During further testing, the computer was able to accurately diagnose, between 90%-98% of the time, whether the patient was healthy, or had suffered a traumatic brain injury or a stroke.

Diagnosis, says Dr. Manevitz, is the most basic part of treatment – any doctor and many healthcare workers can correctly diagnose severe brain injuries. While this study is an important advance in the field of computer science, it will not directly help society. What is important, however, is the next phase of development, in which the computer is able to do things that doctors cannot. "As soon as the computer identified the injury, we have a model that we can use for further testing and analysis – something that cannot be done on live patients. Using a computer model, we can experiment with different treatment options and decide which will be the most effective. The computer can also define how much the patient will be able to rehabilitate. These are things that would take a long time for medicine to accomplish, and some of them cannot be done at all," explained Dr. Manevitz.

For example, the computer can simulate how the patient will respond if the virtual reality therapy throws more balls to the patient's left side than to the right or if any other change would be beneficial for rehabilitation. The computer can quickly examine tens of different possibilities in a very short time. Using the computer will help avoid spending time on treatments that will not benefit the patient, or worse, cause harm.

"Our next step is to find similarities in the behavior of people in sub-groups of brain injuries. The human eye may not be able to see such similarities, but a computer would easily be able to pick them up. As soon as we are able to identify similarities in different sub-groups, new avenues of effective treatment will open up for doctors," summarized Dr. Manevitz.

Contact: Amir Gilat
agilat@univ.haifa.ac.il
972-482-40092
University of Haifa

So, What the Heck is Virtual Reality?

Virtual reality is used today in many ways from training simulations like driving a car or flying an airplane, to more advanced training exercises by the military, to video games. It's also being used in surgery, bomb diffusion, archeology, geology--just about any place where a three-dimensional rendering of the environment is helpful and where the users can simulate the reality of being in that 3-D place and interacting with it.

The next generation in the technology of virtual reality is called augmented reality where things in a real environment are mixed with 'virtual' things. Imagine giving firemen the ability to see through the smoke to search burning buildings for survivors? That's just one application--imagine all the others!

Although this video is about phantom limb pain, it demonstrates how virtual reality is being used in rehabilitation.