Alternative Rehabilitation Research Articles

Influence of Gender on Rehabilitation and Reintegration of Recidivists: A Study of Female Inmates in Women’s Prisons in Selected Counties in Western Kenya

Women were nearly never mentioned in the history of criminal justice literature, while recidivism is one of the most fundamental concepts in the field. The high rate of female recidivism having resulted in an increasing number of people being jailed and then discharged back into society, and the high risk of re-arrest, re-incarceration has become a top priority for governments, sociologists, the general public and those included in correctional facilities. The research took place at three Western Kenya women's prisons: Kakamega Women's Prison, Bungoma Women's Prison, and Busia Women's Prison. The study's overall goal was to look into the influence of gender on female recidivists' rehabilitation and reintegration. The research was based on the following precise goal; to determine the patterns of recidivism among female prisoners in selected counties in western Kenya prisons. The study used a descriptive research approach and was based on gendered route theory and relational theory. Repeat offenders from the respective jail facilities made up the research population. To acquire the desired representation from the study population, purposive selection was performed. For this study, 150 female respondents were chosen from a target population of 240 recidivists. Questionnaires and guidelines for Key Informant Interviews were utilized to collect data. The quantitative data was analyzed using SPSS version 20.0 for windows, and the qualitative data were analyzed thematically. The study emphasizes the importance of introducing alternative rehabilitation approaches such as vocational training for female recidivists having manufacturing, processing, and farming technical talents and abilities. The study provides useful information and identifies a knowledge gap that the Kenyan prisons department and stakeholders would make use of to enhance legislation and rehabilitation techniques for female inmates. Females had a greater rate of recidivism, according to the study. The survey also discovered that the available rehabilitation programs don't really match the demands of the inmates. In addition, failure by the society to accept the female ex-convicts back into the community and to offer them new opportunities for employment may result in further recidivism. Keywords: Gender, Rehabilitation, Reintegration, Recidivists, Female inmates DOI: 10.7176/PPAR/11-8-05 Publication date: October 31 st 2021

Gender-Specific Programming and Trauma-Informed Approaches

Yoga has been making its way into juvenile detention centers, but little research has looked at the pos-sible effects of yoga on this special population of individuals. The purpose of this paper is to review the relevant literature available on the effects of yoga on youth involved with the justice system and its potential for rehabilitation. Notably, the objective here is to highlight the need for gender-specific pro-gramming, specifically those designed with women and girls in mind. This paper takes a gender-responsive and trauma-informed approach when discussing literature on alternative rehabilitation and, importantly, identifies the gaps in previous research while offering ways of improvement. The findings in this review highlight the need for trauma-informed care and gender-specific programming. Importantly, this review identifies the need for race-sensitive programming while addressing cultural, historical, and gender-based issues within the field of criminology and criminal justice. Overall, we find that gender-specific programs are useful but lack in implementation and program evaluation. With that said, more research is needed in this area of study.

Discharge destination after hip fracture: findings from the Irish hip fracture database.

Although home continues to be the place from which the majority of patients are admitted, less than one third of patients are Discharged Directly Home (DDH) following hip fracture. Once ready for discharge, DDH as opposed to Discharge to an Alternative Location (DAL), i.e., community care, rehabilitation facility or long-term care, is a high priority for patients and clinicians alike. Not only is DDH integral to the quality of life of patients, it is also an essential driver of the socioeconomic cost of hip fracture care. We analysed 21,819 cases in the Irish Hip Fracture Database from 2013 to 2019. Descriptive and analytical statistics were conducted. 29% (n = 6476) of patients were DDH during the study period. On multivariate analysis, the odds of DDH decreased as age increased (OR 0.28, p < 0.01, 95% CI 0.24-0.34). Patients who were independently mobile prior to fracture were 47% more likely to be DDH (OR 1.47, p < 0.01, 95% CI 1.29-1.68). Those mobilised early post operatively were 24% more likely to be DDH (OR 1.24, p < 0.01, 95% CI 1.06-1.45). Patients who waited > 72h prior to surgery were 30% less likely to be DDH (OR 0.70, p < 0.01, 95% CI 0.56-0.88). The authors identified patient characteristics that increased the likelihood of DDH, i.e., younger patients independently mobile prior to fracture, who received timely surgery and early post-operative mobilisation. The Irish Hip Fracture Standards (IHFS) incorporate 2 out the 3 modifiable factors identified, which reinforces the importance of the IHFS in improving patient outcomes.

Prioritizing greenhouse gas mitigation strategies for local governments using marginal abatement cost

Abstract Cities and other subnational jurisdictions have emerged as key agents for plans and policies to mitigate global climate change, with many presenting their strategies through climate action plans (CAPs). A critical review of CAPs from local government jurisdictions in California found that many CAPs lacked quantitative information on the economic cost and emissions reductions of proposed strategies, precluding decision-making based on the cost-effectiveness of competing policies. In response, this study develops a framework for comparing strategies based on their life cycle emissions mitigation potential and life cycle costs in a marginal abatement cost curve (MACC) to allow for side-by-side comparison. This framework was piloted with the cooperation of two California counties, Yolo and Los Angeles, to analyze six strategies in the transportation sector: intercity bike lanes, installation of roundabout intersections, alternative pavement rehabilitation, electric bus fleet, alternative fuel city fleet and installation of solar canopies in parking lots. Applying the life cycle approach revealed strategies that had net cost savings over their life cycle, indicating there are opportunities for reducing emissions and costs (roundabout intersections and solar canopies). The life cycle accounting processes also revealed that some emissions reduction strategies in fact increased emissions relative to no action (intercity bike lanes and alternative pavement rehabilitation). Despite the attractiveness of a life cycle-based MACC to support local government decision-making, there is the mismatch between a life cycle perspective and the annual emissions accounting used in most CAPs and associated policies. Future work should explore how to marry the life cycle and annual accounting methods and incorporate other sustainability concerns, such as equity and environmental justice, to support local decision-making.

Ефективнісь нетрадиційніх методів лікування та реабілітації дітей із частими захворюваннями органів дихання в умовах закладу дошкільної освіти

Objective: to prove the efficiency of using alternative therapies and rehabilitation of children and rehabilitation of children with chronic bronchitis at preschool institutions. The experiment involved children from a specialized kindergarten, a special medical group for children aged 6–7, who often suffer from bronchitis. The following indicators were taken into account: respiratory rate, heart rate, vital capacity of the lungs, tests with breath holding on inhalation and exhalation, depth of breath. In order to prevent exacerbations of chronic inflammatory diseases of the bronchi and lungs, children underwent herbal medicine, exercise therapy and breathing exercises, salt therapy, improves blood and lymph circulation in the lungs and pleura, which contributes to the activation of regenerative processes. One of the main tasks of preventing chronic bronchitis in children is to increase the body’s resistance, strengthen its protective and compensatory adaptive mechanisms. The study outcomes indicated significant positive changes in the cardiorespiratory system of children with chronic bronchitis. Regular classes have contributed to improving the level of functional capabilities of the cardiovascular and respiratory systems of preschool children. Children had excellent values of heart rate, respiration, high sample rates with respiratory retention, and respiratory depth at the end of the experiment. Conclusions. It has been proved that the physical rehabilitation of children with chronic bronchitis significantly improved their quality of life and reduced the risk of disease progression. A preventive and health experiment conducted indicated the efficiency of the proposed forms of exercise therapy, salt therapy, herbal medicine in the rehabilitation process. Significantly improved attendance by children of the preschool institution, which indicates the improvement of children’s health, improvement of their immunity, increased efficiency and activity of children.

Osseoperception in transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation: a prospective study.

Endo-exo prosthetics (EEP), which belongs to the transcutaneous osseointegrated prosthetic systems (TOPS), provides an alternative bone-anchored rehabilitation method for transfemoral amputees. It led to the question of whether transmitted forces from prosthetic feet are perceptible by osseoperception resulting in proprioceptive feedback of ground conditions. The following hypotheses emerged for our trial with the null hypothesis: EEP fitting after transfemoral amputation does not influence osseoperception. Alternative hypothesis 1: EEP patients achieve better osseoperception results than transfemoral amputees fitted with socket prosthesis. Alternative hypothesis 2: EEP carriers achieve comparable results with regards to their osseoperception as non-amputees. N = 25 patients with EEP (mean age = 50,6 ± 9,4, male/female = 15/10) N = 25 patients with socket prostheses (mean age = 52,6 ± 13,1, male/female = 19/6) and N = 25 healthy volunteers were included in the experimental case-control study. In three blinded test modules (V1, V2, V3), the participants had to identify different degrees of shore hardness (c) of different materials (rubber balls (shore = 5-25c), foam cushions (shore = 5-30c), foam mats (shore = 5-30c) with their prosthetic foot (or a personally defined foot in healthy volunteers) without footwear and had to rank them into the correct order according to their tactile sensation and the degree of hardness. A maximum of 10 points could be scored per run. This experimental observational study included N = 75 participants. The mean age for the entire cohort was 42.8 ± 16.6years and the BMI was 26.0 ± 4.8. Our results show a significant level of differences in tactile osseoperception between all groups (p < 0.001). A correlation between the mean values of V1-3 and the PMQ2.0 as well as the mean values of K-Level and the prosthesis wearing time per day showed for PMQ (r = 0.387, p = 0.006) and K-level (r = 0.448, p = 0.001) which is a moderate effect according to Cohen. Our study results suggest that the EEP treatment can lead to an improvement in tactile sensory perception via the bone-anchored implant, which can lead to an increase in quality of life and improved gait safety.

Effectiveness Of Blood Flow Restriction Training On Aerobic Performance During Cycling Exercise In Healthy Adults.

Blood flow restriction (BFR) has emerged as an alternate rehabilitation modality, intending to enhance functional outcomes in various populations. However, there is a lack of research evidence on the efficacy of BFR during aerobic exercise. PURPOSE: To compare aerobic capacity following a cycling protocol with BFR at 60% (BFR-60) versus 80% (BFR-80) occlusion. METHODS: Ten healthy participants (26 ± 3.0 years; 6 males; 4 female) were randomly assigned to either: BFR-60 or BFR-80. Aerobic Capacity was measured at baseline, and three weeks during a sub-maximal stationary cycle ergometer protocol connected to a metabolic analyzer for the assessment of peak oxygen consumption (VO2 peak). Aerobic testing consisted of performing the YMCA protocol which consisted of pedaling at 70 rev/min with a load of 25-watts. Heart Rate (HR) was monitored continuously at the end of the first three minutes and used to determine the load increase. Subjects cycled for 15 minutes at which point a 25-watt increase occurred every 3 minutes until the participant reached one or more of the following criteria: 80% of their predicted HR (T80) using the HR reserve formula, an RER >1.0, or a leveling of the oxygen curve. Given the small sample size and the non-normal data distribution for the variable of T80, a Mann-Whitney and Wilcoxon tests were used to evaluate between and within (time) groups differences, respectively. For the between-group comparison, a composite score for T80 based on the pre-post difference was calculated for both groups. Then this calculated difference was used to compare both groups. Peak VO2 was normally distributed, therefore, a 2 x 2 (group by time) ANOVA was used to perform between and within-group comparisons. Statistical significance was at an alpha of 0.05 for all analyses. RESULTS: The between group comparisons of the T80 was not statistically significant. The within group comparison for T80 for the BFR-60 group approached significance (p = 0.08) while the BFR-80 group was not significant (p = 0.89). The within time ANOVA approached significance (p = 0.09) while there were no between group differences (p = 0.99). CONCLUSIONS: Aerobic performance over time was seen to improve primarily in the 60% occlusion BFR group. The small sample size or short intervention duration might have affected the effectiveness of this intervention.

Short Review on Reinforced Concrete Beam - Column Joint : Earthquake Response and Rehabilitation Techniques

It is highly recognized throughout the entire literature that there are many serious attempts to investigate the structural behavior of Reinforced concrete (RC) beam column joint. These studies tried to cover many key elements that usually govern the intended behavior of such structural element. It can be also from any simple survey during that literature that the reported failures in the past confirm the fact that the used design methods did not play the required role in providing good safe design. The most classic trend in strengthening the reinforced concrete joints was the addition of transversal bars. However, there are agreements throughout the recent contributions that increasing the level of reinforcement illustrated and optimum value and the extra addition may give negative results. In contrast, many alternative rehabilitation techniques were examined in the past such as Slurry Infiltrated Fiber Reinforced Concrete (SIFCON) blocks and Fiber Reinforced Polymer (FRP) sheets which gave good results regarding mechanical strength, stiffness and ductility behavior. The current study tries to present an overview with respect to past research programs that deals with such concern of science.

Recycled Asphalt Pavement Materials in Transport Pavement Infrastructure: Sustainability Analysis &amp; Metrics

Transportation infrastructure is one of the largest consumers of natural materials. To improve the environmental quality and sustainable development of transportation infrastructure, it is important to implement sustainable strategies in pavement construction and rehabilitation. The use of recycled materials is a key element in generating sustainable pavement designs to save natural resources, reduce energy, greenhouse gas emissions, and costs. The objective of this study was to propose a methodology for assessing the environmental and economic life-cycle benefits when using recycled asphalt pavement (RAP) materials in highway projects. Previous studies on life cycle analysis (LCA) using RAP focused on the economics and/or environmental impacts during the material production process. Thus, there is a need to consider sustainability analysis at all stages of construction and rehabilitation during the performance period of pavement structures. This study addresses this need with the proposed methodology. The suggested approach could be potentially implemented in a pavement management system (PMS) so as to introduce sustainability principles in optimizing alternative rehabilitation strategies. The methodology includes various steps for the analysis, starting with condition assessment of the existing highway, identifying alternative structural pavement designs, predicting service life, setting up alternative rehabilitation strategies, and conducting life cycle environmental and economic analysis. To demonstrate the value of the methodology, a comparative parametric study was conducted on two real case study projects representing actual field conditions for primary roads in Maryland. These case studies were used in order to quantify the economic savings and environmental benefits of using different levels of RAP in highway rehabilitation. The results of the analysis indicate that incorporating RAP in pavement rehabilitation can contribute substantially to cost savings and environmental impact reduction (e.g., greenhouse gas emission, energy, water, and hazardous waste). The benefits illustrated in this study are expected to encourage wide adoption of the proposed methodology and the use of recycled materials in highway construction and rehabilitation. The methodology is transferable where similar materials and highway construction techniques are used.

Effectiveness of home-based cardiac telerehabilitation as an alternative to Phase 2 cardiac rehabilitation of coronary heart disease: a systematic review and meta-analysis.

AimsThe onset of the COVID-19 pandemic saw the suspension of centre-based cardiac rehabilitation (CBCR) and has underscored the need for home-based cardiac telerehabilitation (HBCTR) as a feasible alternative rehabilitation delivery model. Yet, the effectiveness of HBCTR as an alternative to Phase 2 CBCR is unknown. We aimed to conduct a meta-analysis to quantitatively appraise the effectiveness of HBCTR.Methods and resultsPubMed, EMBASE, CENTRAL, CINAHL, Scopus, and PsycINFO were searched from inception to January 2021. We included randomized controlled trials (RCTs) comparing HBCTR to Phase 2 CBCR or usual care in patients with coronary heart disease (CHD). Out of 1588 studies, 14 RCTs involving 2869 CHD patients were included in this review. When compared with usual care, participation in HBCTR showed significant improvement in functional capacity {6-min walking test distance [mean difference (MD) 25.58 m, 95% confidence interval (CI) 14.74–36.42]}; daily step count (MD 1.05 K, 95% CI 0.36–1.75) and exercise habits [odds ratio (OR) 2.28, 95% CI 1.30–4.00)]; depression scores (standardized MD −0.16, 95% CI −0.32 to 0.01) and quality of life [Short-Form mental component summary (MD 2.63, 95% CI 0.06–5.20) and physical component summary (MD 1.99, 95% CI 0.83–3.16)]. Effects on medication adherence were synthesized narratively. HBCTR and CBCR were comparably effective.ConclusionIn patients with CHD, HBCTR was associated with an increase in functional capacity, physical activity (PA) behaviour, and depression when compared with UC. When HBCTR was compared to CBCR, an equivalent effect on functional capacity, PA behaviour, QoL, medication adherence, smoking behaviour, physiological risk factors, depression, and cardiac-related hospitalization was observed.

Total Laryngectomy-Still Cutting-Edge?

Simple SummaryComplete removal of the larynx (total laryngectomy) offers a curative approach for advanced laryngeal and pharyngeal cancer. If the operation is performed after radiotherapy wound healing problems have to be taken into account which can be managed by adapted reconstructive techniques. Laryngectomy results in the loss of voice which can be managed e.g., by using a voice prosthesis with a significant increase in quality of life. Total laryngectomy still represents a relevant surgical procedure in modern head and neck oncology.Surgical removal of the larynx (total laryngectomy) offers a curative approach to patients with advanced laryngeal and hypopharyngeal (squamous cell) cancer without distant metastases. Particularly in T4a carcinoma, laryngectomy seems prognostically superior to primary radio(chemo)therapy. Further relevant indications for laryngectomy include massive laryngeal dysfunction associated with aspiration and recurrence after radio(chemo)therapy, resulting in salvage surgery. The surgical procedure including neck dissection is highly standardised and safe. The resulting aphonia can be compensated by functional rehabilitation (e.g., voice prosthesis) associated with a significant quality of life improvement. This article presents an overview of indications, preoperative diagnostics, surgical procedures, including new developments (robotics), possible complications, the choice of adjuvant treatment, alternative therapeutic approaches, rehabilitation and prognosis. In summary, total laryngectomy still represents a relevant surgical procedure in modern head and neck oncology.

Cardiac Rehabilitation Based on the Walking Test and Telerehabilitation Improved Cardiorespiratory Fitness in People Diagnosed with Coronary Heart Disease during the COVID-19 Pandemic.

This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.

Remote Ischemic Postconditioning vs. Physical Exercise After Stroke: an Alternative Rehabilitation Strategy?

There remain debates on neuroprotection and rehabilitation techniques for acute ischemic stroke patients. Therapeutic physical exercise following stroke has shown promise but is challenging to apply clinically. Ischemic conditioning, which has several clinical advantages, is a potential neuroprotective method for stroke rehabilitation that is less understood. In the present study, the rehabilitative properties and mechanisms of physical exercise and remote ischemic postconditioning (RIPostC) after stroke were compared and determined. A total of 248 adult male Sprague-Dawley rats were divided into five groups: (1) sham, (2) stroke, (3) stroke with intense treadmill exercise, (4) stroke with mild treadmill exercise, and (5) stroke with RIPostC. Focal ischemia was evaluated by infarct volume and neurological deficit. Long-term functional outcomes were represented through neurobehavioral function tests: adhesive removal, beam balance, forelimb placing, grid walk, rota-rod, and Morris water maze. To further understand the mechanisms underlying neurorehabilitation and verify the presence thereof, we measured mRNA and protein levels of neuroplasticity factors, synaptic proteins, angiogenesis factors, and regulation molecules, including HIF-1α, BDNF, TrkB, and CREB. The key role of HIF-1α was elucidated by using the inhibitor, YC-1. Both exercise intensities and RIPostC significantly decreased infarct volumes and neurological deficits and outperformed the stroke group in the neurobehavioral function tests. All treatment groups showed significant increases in mRNA and protein expression levels of the target molecules for neurogenesis, synaptogenesis, and angiogenesis, with intermittent further increases in the RIPostC group. HIF-1α inhibition nullified most beneficial effects and indicative molecule expressions, including HIF-1α, BDNF, TrkB, and CREB, in both procedures. RIPostC is equally, or superiorly, effective in inducing neuroprotection and rehabilitation compared to exercise in ischemic rats. HIF-1α likely plays an important role in the efficacy of neuroplasticity conditioning, possibly through HIF-1α/BDNF/TrkB/CREB regulation.

A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT

A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT

Revision of active middle ear implants (AMEI): causes, surgical issues and rehabilitative transition at a single implanting center.

To report on failures related to active middle ear implants (AMEI) surgery, within a series of subjects treated at a single Implanting Center. A retrospective review of 79 cases of implanted AMEI has been performed to report the failure ratio, the causes for the failure and the selected rehabilitative solution. The AMEI included 25 Vibrant Soundbridge® (Medel, Innsbruck, Austria), 20 as round window vibroplasty (RW-VSB) for mixed hearing loss, 5 as incus-vibroplasty for sensorineural hearing loss; 7 MET/Carina® (Cochlear, Melbourne, Australia), 2 MET for mixed and sensorineural hearing loss, 5 Carina for sensorineural hearing loss; 43 Esteem® (EnvoyMedical, St Paul, USA) for sensorineural hearing loss; 3 Maxum® (Ototronics, Texas, USA) for sensorineural hearing loss; 1 Codacs® (Cochlear, Melbourne, Australia) for severe mixed hearing loss. The overall complication rate affected 20% of the implanted devices, individually ranging from 6.9 to 100%. Hardware system failures were recorded in all the AMEI, ranging from 10 to 50%. The alternative auditory rehabilitation included replacement of the same system in 2 cases, use of a conventional hearing aid in 3 cases, Cochlear implantation in 4 cases and implantation in the contralateral ear in 2 cases. The present clinical experience showed that, in spite of the successful functional rate displayed by the majority of the AMEI implantees, complications may occur to a certain percentage of cases and should prompt the professionals to select alternative solutions, starting from the (re)adoption of a conventional hearing aid and ending up to Cochlear implantation.

Blue-Light Therapy Strengthens Resting-State Effective Connectivity within Default-Mode Network after Mild TBI.

Background:Emerging evidence suggests that post concussive symptoms, including mood changes, may be improved through morning blue-wavelength light therapy (BLT). However, the neurobiological mechanisms underlying these effects remain unknown. We hypothesize that BLT may influence the effective brain connectivity (EC) patterns within the default-mode network (DMN), particularly involving the medial prefrontal cortex (MPFC), which may contribute to improvements in mood.Methods:Resting-state functional MRI data were collected from 41 healthy-controls (HCs) and 28 individuals with mild traumatic brain injury (mTBI). Individuals with mTBI also underwent a diffusion-weighted imaging scan and were randomly assigned to complete either 6 weeks of daily morning BLT (N = 14) or amber light therapy (ALT; N = 14). Advanced spectral dynamic causal modeling (sDCM) and diffusion MRI connectometry were used to estimate EC patterns and structural connectivity strength within the DMN, respectively.Results:The sDCM analysis showed dominant connectivity pattern following mTBI (pre-treatment) within the hemisphere contralateral to the one observed for HCs. BLT, but not ALT, resulted in improved directional information flow (ie, EC) from the left lateral parietal cortex (LLPC) to MPFC within the DMN. The improvement in EC from LLPC to MPFC was accompanied by stronger structural connectivity between the 2 areas. For the BLT group, the observed improvements in function and structure were correlated (at a trend level) with changes in self-reported happiness.Conclusions:The current preliminary findings provide empirical evidence that morning short-wavelength light therapy could be used as a novel alternative rehabilitation technique for mTBI.Trial registry:The research protocols were registered in the ClinicalTrials.gov database (CT Identifiers NCT01747811 and NCT01721356).

Effects of rehabilitation methods on lower-limb muscle function and functional performance in patients with cystic fibrosis: A systematic review

Objective: To investigate the effects of rehabilitation methods on leg muscle function and functional performance in cystic fibrosis. Data sources: A literature search was conducted in PubMed (MEDLINE), Scopus and the Cochrane Library from inception to October 12, 2020. A secondary hand search through reference lists from identified articles was conducted. Review methods: Three authors independently checked the full-text copies for eligibility of relevant articles. Randomized controlled trials were included. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The PRISMA guidelines were followed. Results suggestive of leg muscle function (e.g. strength, power, endurance, and fatigue) and functional performance were reported. Results: The search identified 8 studies (233 patients). The overall quality of these articles was good. Rehabilitation modalities investigated were physical exercises (aerobic, anaerobic and resistance training) (n = 7) and neuromuscular electrical stimulation (n = 1). Most studies (n = 4) reported on the effects of combined aerobic and resistance training and showed improvement on leg strength when exercises were supervised. Aerobic training alone or the use of neuromuscular electrical stimulation also enhanced leg strength, whereas anaerobic training did not. Two studies evaluated leg fatigue and found no improvement compared to standard care. One study assessed the effect of exercises on functional performance and found no improvement when compared to standard care. No studies emphasized the impact of rehabilitation methods on leg muscle endurance or power. Conclusion: Combined aerobic and resistance training enhances leg muscle strength in cystic fibrosis. There is insufficient data on other leg muscle outcomes, nor on alternative rehabilitation strategies.

High-Intensity Interval Cycle Ergometer Training in Parkinson's Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject Research Design.

Background: People with Parkinson's disease (PD) experience not only motor problems but also non-motor problems that seriously impede their daily functioning and quality of life. The current pharmacologic treatment of PD is symptomatic, and alternative rehabilitation treatments, which preferably also have a disease-modifying effect and promote neuroplasticity, are needed. Recent studies suggest that high-intensity interval training (HIIT) is promising for promoting neuroplasticity in human PD, with short training time and reduced burden. Biomarkers for neuroplasticity such as brain-derived neurotrophic factor (BDNF) and neurodegeneration (including neurofilament NfL and α-synuclein) may play a role, but their response to HIIT is not well-investigated.Objectives: The aims of this study were (1) to study the effects of 4 weeks of HIIT compared with 4 weeks of continuous aerobic exercise on motor and non-motor outcomes of PD and (2) to investigate the association between HIIT, motor/non-motor performances changes, and blood biomarker levels for neuroplasticity and neurodegeneration.Study Design: Single-subject research design with alternating treatment setup (ABACA) and frequent repeated measurements was used. Each participant received different intervention conditions (B/C) interspersed with baseline periods (A, i.e., ABACA or ACABA), and frequent repeated assessment of outcome measures is done to quantify within-subject, individual response patterns with sufficient power for data analysis. Blood samples were collected once a week in the baseline and training phases (A1 and B/C) and once every 2 weeks in the washout phases (A2 and A3).Intervention: Four subjects with PD on stable dopaminergic medication, two in Hoehn–Yahr stage 1–2, and two in Hoehn–Yahr stage 2.5–3 followed an ABACA or ACABA schedule, consisting of blocks with 30-min sessions of “B” (HIIT) or 50-min sessions of “C” [continuous aerobic exercise (CAE)] 3×/week for 4 weeks, separated by baseline “A” periods of 8 weeks for a total duration of 28 weeks.Outcome Measures: Outcome measures include disease status [Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)], blood biomarkers (BDNF, Nfl, and α-synuclein), measures for functional mobility (including an activity tracker), and activities of daily living, as well as cognition, mood, biorhythm (sleeping problems), and quality of life.Data Analysis: Visual analysis of trends in level, slope, and variability in response patterns was carried out, confirmed by longitudinal regression analysis with phase (ABACA) as the independent variable.

Telescopic overdenture as an alternative rehabilitation for the loss of several anterior teeth due to traffic accidents

Background: Telescopic overdenture is a prosthesis consisting of a primary coping, or an inner crown, that is attached to a supporting tooth in the oral cavity, and a secondary coping, or an outer crown, attached to a denture, which must be compatible with the primary coping. Purpose: The purpose of this study was to restore function and aesthetics and uplift the psychological status of the patient by fabrication of a fixed removable prosthesis using the existing abutment teeth as a telescopic overdenture. Case: A 36-year-old female came to the Prosthodontic RSGM UNAIR speciality clinic on her own volition to make front dentures for her upper and lower jaws after a traffic accident one and a half years ago. The patient had an arch bar installed two months after the accident, which was removed after two months. The patient wanted new dentures to improve both her ability to eat and her appearance. Case Management: Preliminary treatments performed were; maxillary and mandibular scaling and root planing; crown lengthening of tooth 15; extraction of teeth 16, 41, 42, and 43; and alveolectomy of the mandibular anterior region. Before the definitive treatment to improve the aesthetic appearance could be carried out, the first step was to make maxillary and mandibular transitional dentures. These were to be used while waiting for healing to occur, following the socket preservation in the mandibular area. Then, for the definitive restoration, we used telescopic overdenture for the maxilla and a removable partial denture for the mandible. Conclusion: Telescopic overdenture is recommended for patients who need good aesthetics for anterior tooth loss. Telescopic overdenture uses double crowns as the retentive elements, which give better aesthetic results compared to clasps, thereby improving the psychological status of the patient. In addition, they have better retention and stability compared to conventional complete dentures.

A Systematic Review of Literature: Alternative Offender Rehabilitation-Prison Yoga, Mindfulness, and Meditation.

For years, jails and prisons have been looking for ways to lower their health care costs. In addition, they have been looking for ways to reduce violence behind walls and reduce recidivism rates postrelease. Recently, criminological research has shined light on the use of alternative rehabilitation to help inmates cope with prison life, improve their overall health, and rehabilitate. Some of these techniques include yoga, mindfulness, and meditation. This article discusses the impact of these techniques in the criminal justice system, highlights the major findings, and identifies the gaps needed to be filled by future researchers.