COVID-19 pandemic challenged the health-care system globally. It intensified the existing burden of rehabilitation of neurological patients. That adverse impact has been more profound in developing countries. This is an exploratory narrative review conducted during May 1 to July 31, 2020 to reflect on the COVID-19 impacts and how to address the challenges of rehabilitation services in Bangladesh. Nonsystematic review methods were used, and to some-extent, the Preferred reporting items for systematic review and meta-analysis statements were followed for this review. Bangladesh is a Lower–Middle-Income Country currently facing multiple challenges with more than 16 million people with disability. The country has world's sixth highest density of population and currently further burdened with the largest refugee camp of the world. It has serious shortage of health-care workers at different levels making COVID-19 preparedness and mitigation difficult. The neurorehabilitation services faced serious challenges. There is no database or registry for stroke, spinal cord injury, or traumatic brain injury. The rehabilitation teamwork is facing daunting challenge at the height of COVID-19. Despite shortage of work force, funding, infrastructures, poor awareness, and difficult professional relationship within the rehabilitation team, neurorehabilitation services are gradually developing in Bangladesh.

Introduction: Coronavirus disease 2019 (COVID-19) pandemic has affected the physical and rehabilitation medicine (PRM) specialty globally. The effects of this pandemic on PRM residents in 14 countries of the Americas are described in this study. Materials and Methods: This study is based on the international survey done by the World Youth Forum of the International Society of Physical and Rehabilitation Medicine. The cross-sectional data obtained were analyzed for a point-of-view study (August 2020). Results: PRM residents reported multiple challenges in their training program including mental health issues during the pandemic. In all the countries, there was either complete or partial closure of services provided by PRM specialists at the height of the crisis. In some areas, there was a necessity to temporarily transform the rehabilitation service into a COVID-19 unit and to assign residents to medical and intensive care units. Residency programs in 13 countries introduced virtual lectures and examinations. The duration of residency will probably increase in three countries, may not be affected in another six, and is still undetermined in five. The specialty licensing examination was temporally suspended/postponed in four countries, administered in a modified way in one, and has not been affected yet in four. Conclusion: COVID-19 pandemic adversely affected the training of PRM residents in the Americas. Despite the efforts to overcome this, the residents need more support including well-being programs. Every country and training program should continue to evolve to adapt to the crisis and anticipate additional challenges in the near future.

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has adversely impacted the Physical and Rehabilitation Medicine (PRM) residency training program in many countries. Aims and Objectives: To describe and analyse the issues and challenges faced by PRM trainees in Asia, Eastern Mediterranean and Oceania, and to discuss strategies to encounter the training and educational challenges amidst the pandemic. Materials and Methods: A cross-sectional survey was completed by Country Ambassadors of the International Society of Physical and Rehabilitation Medicine (ISPRM) World Youth Forum Task Force, to assess the COVID-19 impact on PRM trainees across Asia, Eastern Mediterranean, and Oceania. Results: Participants reported issues including training program disruption, limited practical skills training, examination postponement, negative psychological consequences, PRM service delivery restructuring, and deployment to acute services. Conclusion: The COVID-19 pandemic has variably impacted PRM residency training programs in the countries. The role of National Societies, training programs, and ISPRM is crucial to support trainees during the pandemic.

Context: Although quantitative analyses of human behavior data collected through wearable sensors have uncovered principles of complex human behaviors and organization performances, quantitative assessment has not been conducted on communication among the medical team, despite its importance. Aims: The aim of the study is to quantify face-to-face communication in a multiprofessional medical team using a sociophysical method and wearable sensors. Settings and Design: The study was conducted at a rehabilitation ward in Japan; this was a pilot study. Subjects and Methods: The amount of time spent on face-to-face communication among 36 multidisciplinary medical professional in a rehabilitation ward was recorded using name tag-type sensors for 2 weeks. The average communication time per week for each pair of participants was calculated; the network diagrams were drawn by using Cytoscape software. The unpaired t-test and Welch's F-test used together with the Games–Howell post hoc test were performed to compare the communication times between two groups and among three groups, respectively. Results: The following three groups emerged: ward staff (nurses and care workers), rehabilitation therapists, and physicians/medical social workers. The communication time between physicians and ward staff (mean, 8.0 min/week) did not differ from that between the physicians and rehabilitation therapists (5.5). The communication time was longer among rehabilitation therapists (61.7) than among the ward staff (45.7), both of which were longer than that between the ward staff and rehabilitation therapists (4.8). Conclusions: Quantitative measurement of face-to-face communication time using wearable sensors characterized the staff behavior in a multiprofessional medical practice in a rehabilitation ward, which may affect medical team performance, such as patient outcomes.

Objective: There is heterogeneity in the management of spinal cord injury (SCI) patients requiring mechanical ventilation (MV). This survey's objective was to study the current practices of ventilator management and weaning in adults with SCI. Methods: We conducted a cross-sectional, self-administered global electronic survey of providers caring for adults with SCI on MV. Recruitment was accomplished through direct E-mailing, social media posting and sharing amongst qualifying providers. Respondents were divided into acute care (AC) and rehabilitation (rehab) groups based on their work setting and specialty. Results: Overall, 137 respondents with a majority from North America (50%) were included. Assist Control mode was the most frequently reported mode (33%) in AC and the rehabilitation setting (RS). Most (72%) in AC use predicted body weight (PBW) to determine the tidal volume (VT); it varies widely in the RS. The highest VT (median [interquartile range]) reported by AC was 10 (8–10) cc/kg pbw compared to 13 (10–15) cc/kg pbw (P = 0.001) in the RS. Application of positive end-expiratory pressure and keeping the tracheostomy cuff inflated are commonly reported practices in AC, whereas there is inconsistency with these practices in the RS. Regarding factors to initiate weaning, physicians in the AC mostly relied on arterial blood gas (70%) findings, whereas in the RS, physicians relied on vital capacity (73%). Conclusion: We found significant differences in practices between “AC and RS” and “within RS,” which warrants further investigation of optimal ventilator settings and weaning practices for people with SCI.

Context: Neck pain is common in the general population. Active cervical spine range of motion (ACROM) is often measured in the diagnosis, evaluation, and treatment of neck pain. However, commonly used measurement tools have been deemed inaccurate or impractical. The Cervical Range of Motion (CROM) Instrument, which uses inclinometers and a magnetic reference, has demonstrated high reproducibility and validity in the measurement of ACROM, however, its practicable use is suboptimal due to its large dimensions. The JINS MEME eyeglass is a lightweight and compact wearable device that contains gyroscope and accelerometer electrodes capable of detecting body motion offering an alternative means of measuring ACROM. Aims: The primary aim of this study is to validate ACROM measurements using the JINS MEME eyeglasses in comparison to the CROM Instrument. The secondary aim is to investigate the variable range of motion patterns between individuals with neck pain (NP group) versus asymptomatic individuals (AS group). Settings and Design: This was a cross-sectional, clinical measurement, and reliability study. Subjects and Methods: Seven neck pain and 14 asymptomatic individuals underwent ACROM measurements with the JINS MEME and CROM Instrument concurrently. Statistical Analysis Used: Intraclass correlation coefficient was used to determine inter- and intra-rater reliability of the JINS MEME and CROM Instrument. Mann–Whitney's U-test was used to assess differences between the two groups (NP group vs. AS group) in ACROM. Results: Using the JINS MEME eyeglasses, we observed excellent intra- and inter-rater reliability for nearly all ACROM directions (cervical spine flexion, extension, and lateral bending) except for rotation which was considered poor. ACROM was decreased in all directions for neck pain patients when measured by both devices. Conclusions: The JINS MEME eyeglasses showed excellent intra- and inter-rater reliability for all ACROM movements except for cervical rotation. Comparing the AS group and NP group, the ACROM of the NP group was significantly decreased compared to that of the AS group in all cervical spine directions, similar to findings in previous studies. With the exception of the measurement of cervical rotation, the JINS MEME eyeglasses demonstrated similar accuracy to the CROM Instrument in the assessment of ACROM in both the NP and AS groups.

Objective: Despite increasing evidence of the benefits of cancer rehabilitation worldwide, the nature of cancer rehabilitation programs is not well described in Australia and New Zealand. We report findings of a pilot survey highlighting the current service delivery of cancer rehabilitation programs and health professionals' perspectives on barriers and facilitators to implementation of cancer rehabilitation programs. Methods: A cross-sectional pilot survey of rehabilitation health professionals in hospital and ambulatory care settings in Australia and New Zealand, evaluating current availability of cancer rehabilitation programs, health professional workforce, core components delivered, and barriers and facilitators to provision and delivery of cancer rehabilitation programs. Results: Respondents (n = 60) included rehabilitation physicians and advanced trainees, with a majority of respondents working in non-dedicated cancer rehabilitation programs in Australia and New Zealand. Most rehabilitation programs being provided to cancer patients are led by rehabilitation physicians, followed by allied health. The most common tumor streams referred include central nervous system, hematological, and breast cancers. Patients are most frequently referred during posttreatment phase. The core components of rehabilitation programs include management of complications and provision of education (mood, exercise, and fatigue management), with exercise prescription comprising mainly strengthening exercises, mobilization, and gait training. Common barriers for adequate service delivery included inadequate funding and lack of appropriate staffing with expertise, while most common facilitators identified were encouraging better collaboration and integration of rehabilitation within acute cancer care services and specialty teams and increased enthusiasm and engagement of staff with leadership skills. Conclusion: The pilot survey identified current service provision among rehabilitation programs providing care to cancer patients and highlighted preliminary gaps and facilitators to the implementation of formal cancer rehabilitation programs. These findings need further confirmation in a larger study to assess further outcome measures and the impact of barriers and facilitators for care quality. Collaborative efforts between physicians, patients, policy makers, and related parties may assist in overcoming the barriers identified.

This case describes success using high-dose submotor threshold electrical stimulation (EStim) therapy for the management of dystonia in a chronic stroke patient. The authors find this novel EStim treatment is safe and offers the potential to manage poststroke dystonic movements.