Biofeedback training in rehabilitation of patients with neurological disorders in post-COVID syndrome: a randomized controlled trial

Aim: The objectives of our study were to evaluate a range of circulating biomarkers in COVID-19-related long-term neurological dysfunction. Methods: The study involved 30 patients with post-COVID syndrome (PCS) and 28 patients after COVID-19 without PCS. The third cohort consisted of 29 patients with acute COVID-19 of varying severity. The severity of COVID-19 was classified as mild and moderate to severe. The Montreal Cognitive Assessment (MOCA) and the SAGE test were used to study cognitive functions. The Hospital Anxiety and Depression Scale (HADS), the Sheehan Anxiety Scale, and the Beck Depression Inventory were used to study affective functions. The levels of serum cytokines and IgM, IgG, IgA to the SARS-CoV-2 coronavirus were determined using the Vector-Best test systems (Novosibirsk, Russia). We also studied the IgG subclasses to the spike protein of the SARS-CoV-2. Results: А mild to moderate COVID-19 infection primarily increases the risk of affective disorders and asthenia and, to a lesser extent, the development of cognitive impairment. The levels of IFN-α, IL-6, as well as serum antibodies to the SARS-CoV-2 among patients with PCS were significantly higher compared to convalescents without PCS. IgM to the SARS-CoV-2 was detected in the blood of patients with PCS during 2–7 months after the disease. After moderate and severe COVID-19, IgG2 and IgG4 were predominant in the blood of patients with PCS and neurological symptoms. The levels of IL-1, IL-4, IL-6, IL-8 in the blood serum of patients with PCS were higher after moderate and severe COVID-19 compared to patients who had mild COVID-19. Conclusions: The obtained data on an elevated level of cytokines and IFN-α in the blood of PCS patients can suggest the hypothesis about the participation of chronic inflammation in neurological disorders. The main limitation of the study is the relatively small sample size, which limits the statistical analyses.

To explore the rehabilitation effect and compliance of lumbar and abdominal muscle rehabilitation training in patients with osteoporotic vertebral compression fracture (OVCF) after percutaneous balloon vertebroplasty (PKP). A total 177 elderly patients with OVCF were divided into rehabilitation group (n = 104) and control group (n = 73) according to whether they received psoas and abdominal muscle rehabilitation training for 3 months after PKP. The differences of general data, orthopaedic rehabilitation, prognosis and bone metabolism were compared between the two groups. All the patients were divided into compliance group (68 cases) and non-compliance group (36 cases) according to compliance. Orthopaedic rehabilitation indicators, prognostic indicators of PKP, and bone metabolism-related parameters were collected for analysis of Chi-square test and Logistic regression. ROC curve was used to analyze the predictive value of bone metabolism related indicators in the compliance of lumbar and abdominal muscle rehabilitation training. There was no significant difference in the general data between the rehabilitation training group and the control group (All p > 0.05). Compared with the control group, the Berg balance scale score was significantly increased, while the Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) score and the proportion of new fractures were significantly decreased in the rehabilitation training group (All p < 0.05). Compared with the control group, the bone mineral density (BMD) T value, osteocalcin (OCN) and 25-hydroxyvitamin D (25 (OH) D) levels were significantly increased and the levels of type I N-propeptide (P1NP) and β-isomerized C-terminal telopeptides (β-CTX) were significantly decreased in the rehabilitation training group compared with the control group (All p < 0.05). Chi-square test and Logistic regression analysis showed that age > 75 years, severe anxiety, severe pain and postoperative complications were significantly associated with the compliance of psoas and abdominal muscle rehabilitation training in patients with OVCF after PKP. ROC curve analysis showed that BMD T value, OCN, P1NP, β-CTX, or 25-OH-D levels predicted the AUC of rehabilitation training compliance in patients with OVCF after PKP were 0.821, 0.835, 0.736, 0.715, and 0.748, respectively. Rehabilitation training of lumbar and abdominal muscles can significantly improve the efficacy of PKP, reduce the degree of osteoporosis and improve the prognosis of patients with OVCF. Age, anxiety, pain and postoperative complications were independent risk factors affecting the compliance of psoas and abdominal rehabilitation training in patients with OVCF after PKP.

BackgroundAltered immune response and cognitive difficulties have been demonstrated in studies of post-COVID syndrome, including differences in immune status and cognitive functioning in the months following infection. This review aimed to examine immune status and cognitive differences in post-COVID syndrome 12 or more weeks after COVID-19 infection. A further aim of this review was to explore a link between immune response and the cognitive deficits observed in this group. MethodsA systematic review was carried out using PubMed, PsychInfo, EMBASE, and Web of Science electronic databases of observational studies 12+ weeks after COVID-19 infection, with assessment of immune status and cognitive function in post-COVID syndrome samples. This review protocol was recorded on PROSPERO with registration number CRD42022366920. ResultsFollowing eligibility screening, 11 studies met inclusion criteria and were selected for our review. Six of eight studies that examined between-group differences in specific domains suggested impaired cognition in the post-COVID syndrome population, with the domain of executive function particularly affected. Of 11 studies with immune data, 7 studies reported increased markers of inflammation in the post-COVID syndrome group, when compared with an age- and sex-matched “healthy control” sample, or population norms. Finally, when immune function and cognition are examined together, 6 studies presented results indicating a significant association between elevated immune response and cognitive function in post-COVID syndrome. ConclusionThis review highlights the frequency of cognitive difficulties months after COVID-19 infection and explores heightened immune response as a predictor of this change. Six studies suggest that immune status is a predictor of cognitive function, examining a marker of immune function and objective cognitive performance at 12 or more weeks following infection. Future studies of cognitive function in post-COVID syndrome are needed to explore this relationship and underlying mechanisms leading to changes in cognitive performance.

PurposeTo evaluate the efficacy of stroke walking wearable devices based on artificial intelligence Internet of Things (AIoT) technology in the rehabilitation training of patients with ischemic stroke (IS).Patients and MethodsA total of 777 patients with IS were recruited and followed up for 6 months. The participants were divided into control (671 cases) and AIoT group (106 cases) according to whether they received AIoT treatment or not. The primary outcomes were Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between two groups of patients within 3 days before treatment and 1 month after treatment. Propensity score matching (PSM) analysis was performed based on various factors such as gender, age, and course of illness at admission.ResultsThere was no significant difference (P>0.05) in Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between the two groups before treatment. After one month of treatment, Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between the two groups improved compared to before treatment, and the AIoT group was better than the control group, with significance (P<0.05). Moreover, logistic regression analysis showed that AIoT based walking wearable devices was independent risk factor for the development of 90-day readmission in patients with IS after rehabilitation training.ConclusionAIoT based walking wearable devices for stroke rehabilitation training is feasible and safe with satisfactory therapeutic effects. Moreover, further prospective multicenter trials are warranted before incorporating AIoT into routine rehabilitation training.

Introduction. Postcovid syndrome is an urgent problem, due to its high frequency regardless of the severity of the infection and the age of the patient.Aim. To evaluate the efficacy and safety of the use of a dietary supplement Metabovit® Healthy Sleep with Glycine and Zinc in patients with postcovid syndrome.Materials and methods. 50 patients with postcovid syndrome were included in the study, after randomization, Metabovit® Healthy Sleep was added to therapy in group 1 (2 tablets 3 times a day), in group 2 patients received basic therapy for chronic diseases. The duration of observation was 21 days. Before and after the end of the study all patients underwent clinical and neuropsychological examination, which included: complaint analysis, the “Schulte tables” test, a verbal association test, a Trail Making Test, an MFI-20 self-questionnaire, a Reader test, a questionnaire on the level of life exhaustion, a hospital scale of anxiety and depression (HADS).Results. In the group of patients receiving Metabovit® Healthy Sleep 2 tablets 3 times a day, in comparison with the control group, the overall MFI-20 self-questionnaire score sugnificantly (p &lt; 0.001) decreased by 16 [-19, -8] to 59 [52; 63] points performance time of "Schulte tables" test decreased by more than 13 seconds; performance time of the Trail Making Test was 26 seconds faster in part A and 40 seconds faster in part B, in the verbal association test, the results reached normative values for most participants; stress levels decreased by almost 25% in men and 11% in women; the indicator of life exhaustion decreased by 22%; the level of anxiety (HADS score) decreased by 5 [-7; -3] points which led to the normalization of this indicator in almost all participants of the group. By the end of the study, no significant changes in the studied parameters were detected in patients of the control group.Conclusion. In the group of patients who received the Metabovit® Healthy Sleep dietary supplement, there was a significant positive dynamics and regression of most of the symptoms of postcovid syndrome, in comparison with the control group.

Background: We aimed to evaluate personality traits in patients with post-COVID syndrome, as well as the association with neuropsychiatric symptoms present in this disorder. Methods: The Big Five Structure Inventory was administered to 93 consecutive patients with a diagnosis of post-COVID syndrome as defined by the WHO and to demographically matched controls. We also performed a comprehensive evaluation of depression, anxiety, fatigue, sleep quality, cognitive function, and olfactory function. Results: Patients with post-COVID syndrome scored lower for emotional stability, equanimity, positive mood, and self-control. Extraversion, emotional stability, and openness correlated negatively with anxiety and depression levels. Conscientiousness correlated negatively with anxiety. No statistically significant correlations were observed between personality traits and cognitive function, sleep quality, olfactory function, or fatigue. Personality scores explained 36.3% and 41% of the variance in scores on the anxiety and depression scales, respectively. Two personality profiles with lower levels of emotional stability were associated with depression and anxiety. Conclusions: Our study shows higher levels of neuroticism in patients with post-COVID syndrome. Personality traits were predictive of the presence of depression and anxiety, but not cognitive function, sleep quality, or fatigue, in the context of post-COVID syndrome. These findings may have implications for the detection of patients at risk of depression and anxiety in post-COVID syndrome, and for the development of preventive and therapeutic interventions.

Post-COVID syndrome can develop in all patients who have had COVID-19, regardless of the disease severity. Clinical manifestations postCOVID syndrome vary greatly, but the most common symptoms include fatigue, anxiety and depression disorders (ADDs), and cognitive impairment (CI).Objective: to evaluate the efficacy and safety of Cholytilin (choline alfoscerate) and the combined drug MexiB 6 in patients with post-COVID syndrome and fatigue, ADDs, and CI.Patients and methods. The study included 100 patients aged 22 to 71 years who have had COVID-19 5.4 months ago. Inclusion criterion: cognitive complaints, fatigue, and emotional disturbances. The evaluation included neurological exam, Montreal Cognitive Assessment Scale (MoCA), Frontal Assessment Battery (FAB), 10-words list task, Multidimensional Fatigue Inventory (MFI-20), Hospital Anxiety and Depression Scale (HADS). Study participants were divided into two groups. Patients who had ADDs (anxiety/depression level according to HADS ≥8 points; n=50) were prescribed with MexiB 6 (1 tablet three times per day). Patients with CI (mean MoCA score ≤25 points; n=50) were prescribed with Cholytilin (2 capsules (800 mg) in the morning and 1 capsule (400 mg) at lunchtime). The follow-up period was 60 days.Results and discussion. According to MoCA scores, a decrease in cognition was observed in 58% of participants, while 28% did not notice CI earlier. ADD fere present in 51%, and fatigue — in 100% of patients. We observed a significant reduction in fatigue severity (from 62.42±7.18 to 52.32±16.36 points; p&lt;0.05) in patients prescribed with MexiB 6. The majority of patients noted a significant increase in physical activity, decreased fatigue, improvement of attention and physical well-being, and increased workplace efficiency. We also found a significant decrease in ADDs severity: ADDs either regressed completely (in 42% of participants) or became subclinical (in 48%; р&lt;0.001). CI severity also reduced according to mean МоСА (from 26.60±1.31 to 27.28±1.39 points; p&lt;0.05) and FAB (from 16.98±1.06 to 17.20±0.90 points; p&lt;0.05) scores. In a subgroup of patients with mild CI treated with Cholytilin mean МоСА (from 23.50±0.99 to 26.36±1.34; р&lt;0.001) and FAB (from 16.02±0.91 to 16.96±0.99; р&lt;0.001) scores significantly increased. Complete regression of CI was observed in 74% of participants (р&lt;0.001). We also found a decrease in ADDs (р&lt;0.001) and fatigue (mean MFI-20 scores decreased from 42.28±10.73 to 35.60±8.10; р&lt;0.001) severity in all study participants.Conclusion. Patients who have had COVID-19, regardless of the disease severity, have a high prevalence of fatigue, ADDs and CI, and MexiB 6 and Cholytilin have a potential in their treatment.

Post-COVID syndrome: Clinical pattern and impact on health related quality of life

Other: Multidisciplinary pain facility treatment outcome for pain-associated fatigue

To observe the clinical effect of ureklin and aspirin combined with rehabilitation training in patients with acute cerebral infarction. A total of 120 patients with acute cerebral infarction admitted to our hospital from January 2018 to January 2021 were randomly divided into control group and observation group. Both groups received conventional treatment. On this basis, the control group was treated with aspirin combined with rehabilitation training and the observation group was treated with aspirin combined with rehabilitation training and ureklin. The clinical efficacy after 2 w of treatment and safety during treatment of the two groups were counted and the level of serum cytokine, hemorheology, neurological function and quality of life were compared between the two groups before and after 2 w of treatment. After 2 w of treatment, the total effective rate of control group was lower than that of observation group (p<0.05). After 2 w of treatment, level of serum vascular endothelial growth factor and scores of activity of daily living and Barthel index in both groups were higher than before treatment and there was statistical difference between observation group and control group (p<0.05). After 2 w of treatment, levels of serum homocysteine, cystatin-C, plasma viscosity, platelet aggregation rate, hematocrit, fibrin and score of National Institutes of Health Stroke Scale in both groups were lower than those before treatment and there was statistical difference between observation group and control group (p<0.05). During treatment, the total incidence of adverse reactions in the observation group was 6.67 % and there was no significant difference between the observation group and the control group (11.67 %, p>0.05). Ureklin and aspirin combined with rehabilitation training could effectively improve the synthesis of serum cytokines, hemorheology and neurological function in patients with acute cerebral infarction and improve the quality of life of patients, with better clinical efficacy.

Insomnia is one of the various symptoms frequently found in patients with post-covid syndrome (PCS) (19.1%). The WHO Stress Management (WSM) is an eclectic psychotherapy that combines mindfulness and relaxation which, theoretically, can be effective in treating insomnia due to PCS. This study aimed to explore the effectiveness of WSM in improving the Insomnia Severity Index Score for people with PCS. This was a quasi-experimental pre-test-post-test control study on 18 participants in the population of online self-isolation group in the Telegram who experienced insomnia. The intervention applied was WSM. These participants were compared to 18 controls who only received psychoeducation. Clinical insomnia symptoms were examined using the Insomnia Severity Index (ISI) before the intervention, then the control group was given sleep hygiene psychoeducation, and the treatment group was given WSM in 5 Zoom on-cam meetings once a week for 30-60 minutes. A re-assessment using the ISI post-test was then performed, and data were analyzed statistically. There was a change in score for insomnia symptoms in the treatment group (delta score 27.50) compared to the control group (delta score 9.50, p=0.00; OR 0.00, p=0,99, 95% CI). Thus, WSM can improve the insomnia score in the population with PCS.

Objective To investigate the correlation between insomnia and sleep quality in adolescents. Methods According to Insomnia Severity Index (ISI) Chinese Version, 3342 students technician training in school were divided into non insomnia group (N = 2345) and insomnia group (N = 997). Sleep and emotional state were assessed by ISI Chinese Version, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Self?Rating Anxiety Scale (SAS) and Beck Depression Inventory (BDI). The social demographic data were collected simultaneously. Results The number of insomnia, daytime sleepiness, anxiety and depression in the population was 997 (29.83%), 568 (17.00%), 243 (7.27%) and 1287 (38.51%), respectively. The comparison of social demographic data between 2 groups showed that the proportion of female ( P = 0.000), poor physical condition ( P = 0.000), non?only child ( P = 0.006), high learning pressure ( P = 0.000) and smoking ( P = 0.027) in insomnia group were significantly higher than those in non insomnia group. The total scores of ISI Chinese Version ( P = 0.000), ESS ( P = 0.000), SAS ( P = 0.000) and BDI ( P = 0.000) in insomnia group were significantly higher than those in non insomnia group. Pearson correlation analysis showed that ISI Chinese Version and PSQI scores were positively correlated with ESS score ( r = 0.361, P = 0.000; r = 0.064, P = 0.000), SAS score ( r = 0.326, P = 0.000; r = 0.069, P = 0.000) and BDI score ( r = 0.529, P = 0.000; r = 0.067, P = 0.000), and ISI Chinese Version had higher correlation ( r = 0.300-0.600) with the above scores than PSQI ( r < 0.100). Further partial correlation analysis showed that ISI Chinese Version score was negatively correlated with PSQI score ( r = ? 0.056, P = 0.001). Conclusions Higher proportion of female, worse physical condition, more non?only child, greater learning pressure and higher smoking rate were observed in insomnia group. Daytime sleepiness, anxiety and depression in insomnia group were more serious than those in non insomnia group, but PSQI score can not distinguish the above differences. Compared with PSQI, ISI Chinese Version is more closely related to daytime sleepiness, anxiety and depression, and might be more suitable for assessing insomnia in adolescents. DOI: 10.3969/j.issn.1672-6731.2017.09.007

In the article the features of training in rehabilitation of patients with cerebral palsy. On the basis of literature analyses the peculiarities of rehabilitation of children with cerebral palsy. Revealed that the majority of children with cerebral palsy face problems because they are associated with delayed development or abnormal development of the statokinetic reflexes, disorders of muscle tone, paresis. The goal of treatment and rehabilitation of children with cerebral palsy is to reduce the degree of disability, improving self-service capabilities, i.e. the maximum adjustment to daily life. Accordingly, the physical rehabilitation in a specialized clinic is important, because it improves physical condition contributes to effective correction of the functional deficiency of the locomotor apparatus, provides training cardiovascular and respiratory systems, leading to better activity of the child in learning activities and adaptation in society.

Peripheral Muscle Dysfunction in Patients With COPD: Comparing Apples to Apples?

The elderly population is increasing globally. Thus, researches focus on the causes and treatment of insomnia, a noteworthy ageing problem. This study aims to investigate the relationship between chronotype and insomnia and whether sleep hygiene mediates this relationship in older adults with depression (OAD). We assessed subjective insomnia severity, sleep hygiene, chronotype, depressive symptoms, and anxiety symptoms of 82 OAD and 70 healthy controls using the Sleep Hygiene Index (SHI), Insomnia Severity Index (ISI), Morningness-Eveningness Questionnaire (MEQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). The mediation effect of SHI and ISI scores were evaluated in the relationship between MEQ and BDI total scores in OAD. The results showed that MEQ performed its effect on BDI through ISI with full mediation (effect = -0.16, SE: 0.07, 95% CI: -0.3230 to -0.0336). The mediation effect of SHI and BDI scores were evaluated in the relationship between MEQ and ISI total scores in OAD. In this model, it was found that MEQ significantly performed its effect on ISI through SHI and BDI. BDI and SHI predicted the ISI variable as partial mediators (respectively, effect = -0.05, SE: 0.03, 95% CI: -0.1073 to -0.0100; effect = -0.06, SE: 0.02, 95% CI: -0.1051 to -0.0129). Sleep hygiene practices could be essential for the natural functioning of the biological clock and the interrelation of depression and insomnia. Longitudinal follow-up studies of structured sleep hygiene approaches are needed in terms of cost-effectiveness, in OAD.